By Jack E. Lohman
The health care system is broken, and it will get worse before it gets better. We can fix the system overnight or we can make it a ten year project, which the for-profit health care interests would like to drag it out to.
There are many areas that must and can be fixed, but simplicity is the key. Simple is less expensive and simple doesn’t break. And the simplest system already exists; it’s called Medicare-for-all. We don’t need complicated insurance pools or anything else; we need to provide health care, and here’s the best way:
Delivery system; Single-payer: The simplicity of a Medicare-for-all system can provide health care to 100% of our population for the same money we are paying for 85% coverage today. Means-tested co-pays will help keep costs to a minimum. Transfer all Medicaid and BadgerCare patients into this single system. Alternatively, find a mechanism to expand the VA and armed forces medical systems to replace our private sector health care needs.
Who should pay for the health care system? The taxpayers rather than employers, though some phase-in will be necessary. We are paying now when employers add their costs to the price of their products and we reimburse them at the cash register. By eliminating the costly middlemen we can cut the costs by a minimum of 30%. Help fund the system with a surcharge added to criminal fines and by diverting punitive damages from malpractice awards. A tax-free charitable endowment can also be established.
Medical Education: Increase the availability of doctors and nurses by providing free college education to high school students who both rank in the top 10% of SAT scores and maintain college grades of A or B. Give those in the C range some debt assistance. The better students should be allowed into the specialties and the poorer students required to serve longer internships and perhaps even be limited to lower level positions that cannot endanger patients.
Universal IT: We must maintain all patient, doctor and hospital information in a highly secure universal health database. Start with the patient answering a lengthy on-screen health questionnaire, add the physician’s diagnosis and treatment, provide the physician a list of treatments provided by other physicians around the country and under the same circumstances, and alert the physician when medications are incorrect or will interact with other meds the patient is on. This will reduce practice variations, medical and prescription errors, and provide to the patient cost and quality of treatment transparency of the physician.
Certificate of Need: Require all major hospital expansions and purchases of high-tech equipment to be approved by a (re-established) CON board of review.
Physician self-referrals: Prohibit the billing of high-tech equipment by physicians and clinics (because they become profit-making cash cows that result in over ordering and wasteful spending under the current fee-for-service structure). Referring patient testing to well-equipped hospitals or independent labs has always worked well.
Medical Malpractice: Replace the 12-man jury system on malpractice cases with a three-person panel staffed by retired (or at least nonconflicted) physicians and nurses. If guilty, all awards should be determined by this panel. Economic damages shall consist of the patient’s out-of-pocket expenses, reasonable pain and suffering, and reasonable legal costs. If punitive damages are to apply, they should not go to the patient that has already received economic damages, but instead paid into the universal health care fund.
So now we will learn whether Democrats and Republicans can work together in the best interest of their constituents, or whether the $1.4 million in yearly campaign money from health care interests carry greater weight.
-- Lohman is a retired business owner from Colgate and founder of http://www.ThrowTheRascalsOut.org. He can be reached at jelohman@gmail.com.