Let's just start with a question what do we think is a more primitive need, basic health care or education? I am not sure we all agree but I think its health care. The constant chatter out of Washington (Mostly Republicans) is that a government option would mean that we wouldn't have a private system. Just in case someone missed it our K-12 education system is a public one and last I checked there were plenty of private schools around. Is the public school system a great one, I would be the first to point out that it isn't, but ponder the alternative for a second is a bad education or a sub par one better then not knowing how to read at all... A public health care system may not deliver excellent care to all its patrons... last I checked our current private system with the highest paid doctors on the planet... doesn't either. The goal of a health care system at least a public one should not be to provide heart transplants, brain surgeries, or other complicate procedures to the masses. Instead the goal should be to provide basic services to everyone in an efficient manner. (No the regional county hospital is not an efficient manner) I am well aware that the goal should be to save everyone and the goal of the public school system is to graduate everyone. Unfortunately the first priority has to be to provide baseline services and then work on improving the system from that point on... I am not a guru by any means and I definitely don't know all the nuances but I think the solution to this problem has to be multi-faceted... Here are some of my suggestions
- Increase the number of AMA certified Medical schools ( the number of Caribbean Schools has gone from 3 to something like 30 in the last few years if nothing else those would be dollars spent on our soil ... stimulus anyone) Theoretically an increase in Supply of doctors should decrease salaries
- Provide federal loans that could be considered grants if the Physician or health care professional chooses to stay in the primary care fields. Incentivizing Primary Health care would go a long way in keeping better people in the primary fields rather then losing them to Specializations.
- Create a government option that is designed to compete with the for profit Insurance companies... such and entity would be required to provide baseline profit returns to its own fund and its reports made public so it could be self sustaining.
- Create a separate federal board with state offices to hear about claims that are denied by Insurance carriers. The board would be made up of Industry experts and the decisions of the board would be binding.
- Create a national Information system. A system of Medical Records for all citizens housed and run by the government. Access to the system would be fee based as to help defray the cost.
- Provide Grants and low interest loans to allow for practices to update software to interface with nationwide system. Prioritize grants and loans based on practices that provide a higher percentage of care to low income families as these practices tend to be less profitable. Grants should also be prioritized based on specialty with primary care practices taking precedence over others.
- Create legislation that requires all health Insurance carriers to provide Insurance to the at risk population, each carrier would be required to insure a certain percentage of people that would otherwise be considered uninsurable. The percentage would be fixed providing a measure to spread risk across the whole system and not burden any particular carrier.
- New legislation to bring the Health Insurance system under national purview considering it is fragmented and currently run state by state.
- A review of the current Reasonable and Necessary and Usual and Customary standards employed by the industry. Health care professionals should be responsible for determining what care they believe is best for their own patients. Doctors would be subject to blind audits at random by a board of their own peers and those that abused the privileges would be reimbursed at a lower percentage. Boards would be set up nationwide and could loose their accreditation as they would also be cross audited by each other.
