by Dr. Larry Fedewa (August 25, 2019)
The goal of any new health care proposal must be to develop a patient-centered system. That is, a system which provides the patient the ultimate power to make his/her own medical decisions, which can be matters of life and death.
A secondary goal is to reduce the 2/3 of medical costs the US spends today ($3.5- $4 Trillion) thereby reducing the cost to the consumer.
The five major obstacles to these goals in today’s system are:
- A critical shortage of medical personnel
- Federal Government
- State Governments
- Health insurance companies
- Solutions –Medical personnel shortage
U.S. Public Health Service offers full cost scholarships to medical, dental, paramedics, nursing and similar degrees to any qualified American student who is willing to serve a 2-year term in designated practices where critical needs exist.
- Solutions — Employers are relieved from all responsibilities for employee medical insurance.
- Solutions — Federal Government Actions:
- Federal government sets limits on settlements for medical mishaps, ending need for “defensive medicine”.
- Federal government declares medical insurance to be interstate commerce, subject only to federal regulation, with one set of rules governing all health insurance. Eliminating a major cost driver for health insurance.
- Federal government maintains Medicare because of ethical and legal obligations.
4. Solutions — State Governments
- Oversight of standard business procedures governing organizations of private citizens designed to provide health insurance, whether church, credit union, cooperative, small business associations, neighborhood, or any other type of structure. This feature is the key to lowering health care costs by increasing competition for the patient dollar in the extended field offered by reduction of individual state requirements and the end to defensive medicine.
- Management of a pool of funding for indigent patients based on a small per capita tax of each buyer of health insurance – critical component to universal coverage. Perhaps a restructured Medicaid without federal involvement.
- State responsibilities limited to practitioner licensing for medical personnel and other specific responsibilities as indicated below
Solutions – Insurance companies
- There is still a place for insurance companies, albeit radically altered. The first factor to be considered is the new phenomenon of literally thousands of new organizations to emerge as the market for insurance carriers. This is a whole new opportunity for these firms — to seek out the new buyers, to develop new packages for buyers representing basically a new constituency – all anxious to maximize individual benefits to a much more vocal and demanding membership, and then to formalize the flexibility ceded to each member to choose treatments and decisions themselves rather than accepting bureaucratic stipulations blindly. Companies which cannot adjust to the new markets will not survive.
- Another opportunity will also arise, namely the custody and deployment of medical savings accounts. One of the first trends may well be the simple transfer of the new payroll income from health insurance premiums no longer deducted from payroll to a medical savings account. The recipient of these deposits may well be in a new branch of financial management. And who better to do so with high credibility than your familiar insurance agent?
Finally, there will be some differences in how the average person deals with his or her health care, but not that many. The two most significant are 1) you will become the direct buyer of your own health care with the money you saved from your enhanced paycheck; 2) you will now be making the sometimes life and death decisions that now are made by budget-watching bureaucrats in the insurance companies or the government.
© Richfield Press, 2019. All rights reserved.