A practical approach to progress
By Dr. Larry Fedewa
(September 24, 2019) One of Washington’s most respected experts on legislative advocacy, Dr. David Rehr, now a George Mason University professor, has recommended that we present a list of separable items in an integrated proposal to reform health care. The strategy is that we should be able to get bipartisan support for some of our ideas and thus build a foundation for the larger reform. This is a sort of step-by-step approach to implementation.
“The Dr. Larry Show” on this Wednesday, October 2, 2019 at 7 pm, will feature their report on the following draft propositions (in increasing order of controversy):
- A federal program for medical students like ROTC — free tuition in return for 2 years past-grad service. Rationale: critical shortage of medical personnel. (A postscript should provide for military medics to get certified as civilians.)
- A federal IRS provision to allow legitimate research and development costs for medical technology equipment to be tax deductible, thus reducing the market cost for buyers and therefore users. Rationale: to dramatically reduce the cost of technology-based therapies, which are currently priced in the $thousands even treatments of common diseases such as cancer.
- A federal law defining health insurance as interstate commerce to override the differing laws of the 50 states. Rationale: dramatically reduce the administrative costs of medical insurance.
- A federal law defining liability for medical mishaps as restricted to provable harm to victims with pre-determined limitation of financial penalties (tort reform). Rationale: elimination of defensive medicine and reduction of costs for medical liability insurance as major cost drivers.
- An IRS stipulation prohibiting US employers from claiming medical benefits to employees as a tax-deductible cost of doing business, leaving all medical and health matters to the personal responsibility of individuals and heads of household. Rationale: the buyer of health care thus becomes the individual who is the final decision-maker of therapies and treatments.
a. An ancillary provision that DHHS maintain and publish a directory of ALL medical insurance organizations
b. That States be encouraged to form special funds for the treatment of the indigent stipulating that hospitals be reimbursed for their care.
c. That health savings accounts be treated by the IRS in the same way as retirement funds and municipal funds (i.e. unrealized capital gains non-taxable).
Clearly, the items under 4, and 5. above are the most controversial and most in need of further development. Nevertheless, acceptance of any reform is a step forward.
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