Healthcare Reform and One Way to Approach It
There has been some discussion on the current
problems of Health Care delivery and the reasons why they cannot be corrected by the current system. There are several plans
for Health Care reform and at least two fully developed bills are in the hands of legislators. One is SB840 in California and
the other is HR676 in the U.S. congress. Both bills are flawed. They either utilize too much of the existing private health
insurance industry or require an extensive buyout of existing private insurance company assets. This requirement would cost
many billions of dollars in tax payer monies. In addition, they both call for a system wide “go live” date that would require
the whole structure and all funding to be up and running by that time.
Given our experience with
TennCare, I have little confidence that this massive startup would go smoothly. One of these plans would put the total cost
of the new system squarely on the taxpayers while offering everyone unlimited coverage for all medical wants. This, of course,
would lead to unlimited expense. Considering our current national debt and ailing nature of our economy, it is not conceivable
that health care reform can be financed in this manner. Neither of the offerings from the presidential candidates is viable.
They are discussed elsewhere.
There is a simple way to approach healthcare reform. It would allow utilization
of an existing organization and network. Startup could be in increments, avoiding a TennCare-like go live date. Medicare,
as it exists, is close to being Universal Health Care for everyone 65 years and older. We simply need to improve it and to extend
it to the rest of the country. There are many organizations who currently advocate modifying Medicare, though they vary in their
approaches. Medicare is already in place, has a functional structure with regional offices and has a huge “provider network”. Billing and information mechanisms are currently in place and working. Though Medicare is a single payer network, it is not
socialized medicine. A more fully developed concept of this can be found on my website, but I will discuss it briefly below.
The current Medicare system is functional but is an incomplete product. Hence we have the Medicare supplements available through
private insurance and the so called “Medicare advantage” plans. These are expensive options for our older citizens and are significant
profit sources for private insurance plans. The first step in rational Health Care reform is to expand Medicare until it is complete. Since some people are in excellent health and do not want to have the expense of a full health plan, it is still reasonable to have
a basic Medicare plan for them. People of a more advanced need will want full coverage, including medications. All plans
would be offered through Medicare itself and therefore would not have a profit markup. These changes would make Medicare a complete
product with no need for any private supplements. With this simple step, all persons 65 years and older would have universal coverage
and at much less cost than they are currently paying. An amount of time would then be taken to make sure that the funding and infrastructure
growth are adequate to allow taking the next step.
The second step would be to take the above enhanced
Medicare product and apply it to those persons under 18 years of age, and also to pregnant women. The funds that are currently
used to supply healthcare to them would be applied to Medicare itself. This would now give universal healthcare to the youngest
and oldest populations of our country and to women at a critical time in their lives. Time would now be allowed to re-evaluate
funding and to expand the infrastructure as needed.
The third and final step is to begin with the older
population that is not currently covered by Medicare, those less than 65 years of age, and to expand coverage backward by age groups. As each new group enters Medicare they would begin paying their healthcare premiums into Medicare itself. The additions of these
funds to Medicare would allow Medicare to be more self-sustaining. This stepwise approach to universal coverage would avoid
a complicated startup so we could actually begin implementation very soon, perhaps within months.
As
noted above, I do not feel that the expense of the healthcare system can be shouldered totally by the taxpayers or by adding the cost
to our already atrocious national debt. Americans are already accustomed to paying a premium and having a copayment. Getting
the private healthcare insurance companies out of healthcare delivery would allow the monies that are currently being used as the
corporate profit to be applied to the overall cost of the system. This would give much lower premiums and much lower co-payments. Additionally these premiums and co-payments could be easily scaled down to an individual’s income range. Each person would have
a healthcare identification card that would be identical to every other card, except for the identification number. Everyone
would be treated the same. There would be no way to identify the rich or the poor at the doctor’s office. We would all
be equivalent for healthcare delivery purposes.
I strongly feel that we need to develop a single payer
universal health plan that gives all Americans and all visitors to America equal healthcare coverage. The monies are currently
being spent and the care is currently being delivered, though it is not equally divided across the country or across groups of people. The United States should be the example used by other countries on how to treat and to care for each other. Let’s force Congress
to take action. We can do this if the average American voter will take interest and to help force it through.
If any representatives of the health insurance or legal industries would like to discuss this, I would be happy to be available.
Mark
E Green MD
463 POB BMH
Maryville, TN 37804