The present bill spends $ 1 Trillion per year for the next 10 years.
What, if anything could be done for healthcare for a mere $ 100 Billion per year of the next 10 years? Here's one possible outline, but I would like to hear yours:
1) Spend $ 75 Billion per year for the next 10 years on Primary Care clinics managed by the Red Cross near the emergency room entrances of 2500 hospitals in USA. These clinics would be staffed by 3 physicians each (paid $ 166,000) per year and 10 Red Cross Volunteers (paid in refundable tax credits at $ 100/day), and one or two Pharmacists, or PA's to dispense prescription meds from the on-site pharmacy. Security would be handled by Kroll or Blackwater or Pinkerton's or somebody like that on a roving and on-call short notice basis, so one security team could cover 4 or 5 clinics in a big city. The cost of renting the office space and the cost of the medications, and disposables, and tests, and electric, and water would be additonal costs. 2500 clinics, fully staffed and supplied for $ 75 Billion per year, and this includes the Red Cross's fees for management of the system.
Since this is government provided health care on a good samaritan basis with no charge to the patient, there is triple legal immunity (soveriegn, samaritan, and charitable). The patient don't get to sue. But they do get some healthcare -- maybe not the Cadillac coverage but real good Primary Care -- which is crucial because it cures and it also prevents. The meds can be acquired through a piggyback order on the VA's annual order, thereby getting an even bigger price break, maybe as good as Canada gets!
2) Now there's $ 25 Billion per year left to play with, how should that be used? Here's how: Use about $ 20 Billion to re-organize health insurance so that all insurors can offer coverage in all states, or most. Do not force insurors to insure people with pre-existing conditions. Let them run their insurance business along the regular lines and practices of insurance in the various states. In Maryland, we have a high risk pool, and all companies that sell insurance here must take a certain percentage of cases assigned out of the Maryland resident high risk pool. This amounts to a bearable not an unbearable burden for all the firms.
The other $ 5 Billion would be used for Tort Reform. Getting a Federal standard for damages in medical malpractice cases, and then forcing those cases into the Federal Courts, so that trial lawyers couldn't suck the blood out of the solvency of the practice of medicine as they are doing now (author = member of ATLA -- the people I'm talking about = me). Once tort reform is well begun, there needs to be more careful and frequent Board Certification of physicians. The doctors have to get a lot better if they are to be freed from oppressive lawsuits. They get better by closer regulation instead of by being terrorized and made examples of by sharky lawyers. This would cause all medical fees to go down. Less insurance costs means better priced services for patients.
This is one 10% Plan that I think would work 1000 times better than the Obama/Pelosi/Reid huge Break the Bank Megaplan.
But I want to hear your 10% plan -- Here's $ 100 Billion per year for 10 years, how would you spend it? Is there anybody health in USA that could be made better with that kind of money? How would you do it?
To get the $ 100 Billion, just close down one of our wars Iraq, Afghanistan, take your pick, it doesn't matter, closing down either one would save $ 100 Billion easy.
So, here's the money, what the plan Boss?
Comments for Serge and Warren:
Serge -- Herculean effort -- your post is substantive and good. Too socialist for me -- whenever the word humane is used I always check to see if my wallet is still there. Here's what I don't object to -- your 3% healthcare tax on all payroll including the super-earners. Good, that's fine. Your idea of training more healthcare workers by subsidizing tuition -- farsighted -- good idea.
Don't like the idea of putting everybody on Medicare. How is that fair? Some people have earned Medicare by 25 years of work and paying FICA, some have not.
Warren: Good ideas -- it looks like the GOP list. There's a possibility that the debate will result in an amendment that substitutes a much smaller and simpler bill for the present 2000 page monstrosity. Tort reform, and insurance across state lines are the biggies. But there must not be a requirement to insure people with pre-existing conditions -- that is not insurance -- it's just welfare -- it's a freebie!
sergbelxx
not one that would be true robust reform of the current anti citizen system.
sure you could come up with a bill thats even 1% of the cost of the current bill, but come on...who are we kidding..do we want reform or pretention of reform?
Also ask yourself....if the cost of health care reform is staggering to you, do you know that really means? it means that health care is super expensive and makes even more the case that something needs to be done. It is an indictment of the current systems out of control costs.
Personally via what my employer and I pay for coverage for my family of 3 for crappy coverage, the total annual premium is over $ 15,000 a year...and we just got a notice that starting next year they will be taking out an extra $ 600 a year from my paycheck ..and the same from the employers...meaning my crappy coverage will now cost about $ 17,000 a year.
come on now.....lets be serious...something is seriously wrong. Lets stop playing politics. This country belongs to we the people. this means that the laws of the land should be for our benefit and protect us ..not set it up so that we are gouged and pillaged.
Here is my plan.
Make medicare available to everyone....and improve medicare so that it covers more..like basically 85% of anything medical that any citizen might need, once an initial $ 150 annual family deductible is satisfied. Once a family incurs out of pocket costs of $ 1500 a year, the plan would be 100% coverage. Cost to seniors $ 80 a month cost to nonsenior adults $ 150 a month, cost for children $ 30 a month.
Add a 3% health care payroll tax similar to FICA to everyone's paychecks with not ceiling as to max salary...meaning the guy earning $ 10,000 a year pays 3% of his income towards health care fund, and the guy making $ 100 million dollars a years does the same.
The problem with your proposal is there is no humanity in it. You seem to be crunching numbers and dont care very much about treating people right. Look at all the civilized industrialized countries around the world...which ones do it the way you suggest? how many do it about the way I suggest?
Your point about closing down one of the wars to find money for your 10% health care plan is more proof of your obsession with fantasy like number crunching. There is no war in Iraq..its an occupation and we have a plan to systematically withdraw going on right now already. AS for Afghanistnan, while I agree we should be phasing out of that too, I do not view things as either that or healthcare. We can phase out of there and still good health care reform to the people just the way I described above. the one thing your view point refused to acknowledge is that money can be found by way of premiums to the people to enroll and taxes from payrolll...especially on the wealthy. Tell me exactly how somone making 1 million dollars a year is hurt by paying a 3% payroll tax to health care fund so that we solve the problem in a humane and well accepted way.
Some price mandates should also be established that apply to all health care providers not just ones who serve the public option customers, so that for example instead of a root canal costing as much as $ 900, there would be a max price of $ 300 etc. A first visit to a doctor would not cost more than $ 40 if the doctor only talks to you for like 5 minutes or less, and Xray should not cost more than $ 50 etc...
Also, people wanting to study to be doctors and nurses should get free grants to do so to cover 3 quarters of their tuition costs for med school and nursing school. The same for other health care professionals. ....and any money they borrow should be interest free.
Warren T
1. TORT REFORM
2. ALLOW ACROSS STATE PURCHASE OF HEALTH INSURANCE
3. END ALL EMPLOYER PAID HEALTH INSURANCE INCLUDING THE GOVERNMENT
4. MAKE POSSIBLE FOR JUST ABOUT EVERYONE TO GET INTO SOME KIND OF GROUP PLAN
5. ELIMINATE MEDICAID AND REPLACE IT WITH A SYSTEM WHICH COVERS THOSE WHO CANNOT GET REGULAR INSURANCE DUE TO EITHER THE COSTS OR NOT BEING ELIGIBLE
6. BASE THE RATES ON THAT PERSON'S OR FAMILY'S INCOME WITH EVERYONE PAYING AT LEAST SOMETHING
Century25
This is one of those 'you can't get there from here' situations. First of all, we are depending upon our elected servants. Yes, servants. We are paying them to do the jobs they campaigned for. We, the people, can't do much more.
The biggest problem is that once upon a time, we had a medical profession. It became a medical industry. Industry. Big business. Big profit maker. That is a bastardization of everything the healing art was intended to be. It used to be that way, an altruistic calling to help humanity.
And so now we have on our hands an industry that is greedy for maximum profit.. Weaning the investors away from sucking the well dry, while increasing the care factor.. quite a task. The addiction for utmost profit from minimal service has been entrenched for decades now.
Our capitalistic country has lost it's 'checks and balance' structure. Capitalism is like a fire. Both can serve us well. But like a fire, capitalism is extremely and endlessly 'hungry' in it's eternal quest for 'growth' - growth.. a favorite term of any capitalist. With the fire, we need a furnace.. else the house becomes the source of 'growth' - not a desirable long term plan. As it is with capitalism.. the hunger for 'growth' has consumed our nations GNP to an alarming extent. Capitalism has no 'furnace' - aka: checks & balances' to contain it, like it once had, circa 1960's. And at the same time the benefits have dwindled. The law of diminishing returns has presented itself to the patient.
The only way I can see for us is to make medical care a right for all. Medicine must be a profession. Everything but elective procedures should be provided cost free. Elective medical care must be left to the 'medical industries' business. That, of course, is a pill the 'industry' will fight tooth and nail. They have the bottomless pockets to fund the battle. We only have our elected servants to fight for us.
Yes, wars are stupid and senseless. But there too.. war became a vast enterprise. It is our monster that lurks below our radar. Most Americans aren't aware of the vast, worldwide network of bases and manpower that have grown out of World War 2, never to be closed but to expand and expand.. the 'defense' industry is immense. For the 2009 fiscal year, the base budget of the Department of Defense rose to $ 518.3 billion. Adding emergency discretionary spending, supplemental spending, and stimulus spending brings the sum to $ 651.2 billion. Defense-related expenditures outside of the Department of Defense constitute between $ 274 billion and $ 493 billion in additional spending, bringing the total for defense spending to between $ 925 billion and $ 1.14 trillion in 2009.
Trying to 'apply the brakes' to either 'industry' is like trying to drag ones shoe in order to stop a runaway freight train. We are in quite the pickle..!!
Orignal From: Could You Suggest an Alternative Healthcare Bill 10% the Size of the Present One?
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