Health Care - Lets Get Better

By Paul McConnell

"Health care dollars should be used to provide health care; not to fill out forms, for administrative costs, executive salaries, or extensive marketing budgets."

"We need a Universal, Single Payer, non-Socialized form of health care, allowing for cheaper, un-fragmented healthcare, where Doctors and Patients make decisions."

Health care should be effective, accessible, accountable, and safe. Health dollars and decisions should be targeted to the medical professionals who are responsible for the care, with a lesser amount to insurance company administrators, executives, and watchdogs.

Solution

Offer a Universal, Single Payer, non-Socialized form of healthcare, where doctors and patients make decisions. Remove health benefits from the workplace. Make health care premiums tax-deductible. Renovate government rules and programs. These actions will enable cheaper, un-fragmented health care based on a true risk pool, providing better coverage to more people.

· Offer Universal, Single Payer Health Care; however, ensure it is not Socialized Medicine.

o Universal #Universal Healthcare means that the insured choose a core benefit package (PPO, HMO, or Fee-for-Service), allowing them the health care access they want. Universal Coverage means that all people are insured.

o Single Payer # Means that one publicly accountable entity collects premiums and pays out health benefits, reducing the enormous administrative costs in medical care. The insurance companies can bid to administer the core options.

o Socialized Medicine # Under socialized medicine, the government would provide, direct, and run health care # this is bad. The United States has the world's best health care because we do not have socialized medicine. With Universal, Single Payer health care, the government is not running healthcare, only approving and standardizing health care packages and distributing benefits.

· Mandate that patients and medical providers have the ability to decide the patients' best care.

· Remove health benefits from the workplace. This will remove a burden from businesses, and encourage a system more capable of providing health insurance to full-time, part-time, non-working, unemployed, and retired people. Additionally, the emergency room will be used less for primary care and more for emergencies, lowering hospital's costs.

· Make insurance premiums tax-deductible, encouraging all to have effective coverage.

· Renovate government rules and incorporate government programs under one umbrella. For example, Medicaid is administered through some states, and carries a huge administrative burden because it offers multiple benefit and confusing rules.

Current State

The United States is a world leader in both providing health care and developing new treatments and cures. However, over the last twenty years, the trend in health care is one of providing less care and lower insurance benefits to the bulk of people, removing choice, and putting medical decisions in the hands of those not qualified to make medical decisions (i.e., insurance companies and managed care administrators). In particular:

Health care quality is poorer and fragmented. Fragmented care means:

o Patients do not always go to the nearest hospital nor do they receive continuity of care from the same doctors.

o Individuals have multiple insurance policies offering varied benefits, and medical providers must check these insurances.

The percentage of people without health care benefits is rising.

o Seniors need additional insurance to supplement Medicare, since Medicare only pays 80% of benefits with an $800 deductible.

o Children are falling through the health insurance cracks.

· The "paperwork" cost to doctor's offices and hospitals is enormous.

· The ability to afford prescription drugs is significantly lower, especially among seniors. Many HMOs have steep co-pays for drugs and maximum annual limits on drug benefits.

However:

· The quality of our medical professionals, including doctors, nurses, nurse practitioners, is among the best in the world. We also have world-leading facilities for both care and research. We should be able raise the health care bar for all.

How Did Health Care Get So Sick?

· "Health Care" companies are using administrators who manage medical care to "save money" rather than provide health care. Physicians have diminished control over proper care for patients because of the excessive government and insurance company oversite.

· Significant health dollars are being wasted on advertising by hospitals, HMOs, doctor groups, and drug companies.

· Complex insurance forms and benefits are necessitating too much office staff to fill them out and ensure payments have been received. Insurance companies take too long to make payments to providers and patients.

· Outdated and costly government rules and regulations are so complex that they often defeat their original intent. For example, the Children's Health program to cover children not eligible for Medicaid is too difficult to prove and requires too much paperwork. Also, Medicare rules allow doctors to perform only one procedure at a time when a physician could easily do more at his/her discretion.

· Nursing staffs # the front line in patient care - have been significantly reduced because of managed care. Skilled nurses have been replaced by unskilled patient care staff.

· Poor payment schedules by Medicare and Medicaid force nursing homes, radiology facilities, physical therapy facilities, mental health agencies, and established clinics and hospitals to either go out of business or to go "boutique"; that is, to specialize in heart surgery, genetic diseases, or orthopedics instead of just being a community hospital or medical facility.