This plan is based on pauper's primary care clinics run by the Red Cross.
The money to pay for it comes by giving a four for one deduction for all charitable donations made to the Red Cross earmarked "healthcare plan" on the donation check.
These clinics are combined with pharmacies. They practice medicine only and not surgery. They are located near hospital emergency room entrances. They are open 24/7 every day of the year.
It's OK for the Red Cross to limit its liability by making every patient sign a "Good Samaritan" form before any medicine is done or given. It's OK for the Red Cross to limit its rollout of these clincs to states that have strong "Good Samaritan" laws limiting liability for medicine practiced on a last recourse basis under emergency conditions. It's OK for the Red Cross to steer clear of the states that the American Trial Lawyers Association refers to as "The Bank" where juries will always award crazy amounts to plaintiffs in medical malpractice cases.
The Red Cross is just the Administrator -- they have to hire the doctors, rent the spaces, and equip the clinics. All pills are provided through the VA, which just piggybacks the Red Cross pill order onto the regular VA pill orders they place with Big Pharma (where the VA gets the pills at about half price, or less due to volume purchasing, and market power because of being the government -- same government that runs the FDA).
The doctors for this program shall all be American born, American educated, and Board Certified. They shall receive $ 160,000 per year for their work. This is not bias, this is caution and problem avoidance. Top notch people getting top notch pay will not be a problem for this program. With proper force administration data systems it will be possible to treat a maximum of patients with a minimum of doctors, at the cost of about $ 100 per patient (including the pills). Treat em and street em, but with ultra high quality standards due to personnel reliability verification.
The idea here is not to be country-wide universal. The idea is to cut the problem down by 65%.
When the problem is only 35% of its present size, come back, we'll talk again, there will be a plan to deal with that last bit. I call this disjointed incrementalism, and I say that as a strategy it is 1000% better than all strategies that must be country-wide and uniform from the get go.
Solve 65%, then see what must be done to clean up the rest.
Total cost to taxpayers = Zero
Total Forced Changes to People Insurance = Zero
Total Theft From Medicare Trust Fund = Zero
Total Effectiveness = 65% (not bad for a cost-free compulsion-free plan)
It's what you think that counts.
But this is a serious issue, and a serious proposal.
So, please, kindly hold off on jokes, clowny remarks, abusive remarks, and sarky snipes.
Let's have your very best deep thinking here. Strategize with me. It could make a difference.
[Tax Note: As a practical matter this plan would be paid for almost entirely by the very rich, who are in the 39% tax bracket. If they get a 4 for 1 deduction for a charitable gift earmarked for this program, then a $ 1,000 gift, reduces their Adjusted Gross Income by $ 4,000.
But $ 4,000 taxed at 39% would be around $ 1,600 in taxes payable. So, their $ 1,000 paid in gift helps them avoid about $ 1,600 in taxes owed.
The gift is marginally quite profitable to the very rich.
It would even be profitable at the margin for persons in the next two tax brackets below the 39% bracket.
People like to do things that are profitable to themselves. Some people even like to help their country, help other citizens, and help the needy.
The "ways and means" for the Red Cross healthcare pauper's clinics would be non-compulsory, non-invasive, non-disruptive, and would cost non-participants zero (or almost zero).
The very rich could painlessly help USA and their fellow citizens. They would!
TO MIKE:
I FIND YOUR IDEAS WONDERFUL. I PROPOSE THAT YOU AND I WRITE A JOINT OPEN LETTER TO THE PRESIDENT. I WILL TRY TO GET IT PUBLISHED. THE VOLUNTEERS WOULD NEED TO BE SCREENED WITH SOME CARE. HOW WOULD YOU FEEL ABOUT THAT? JUST A SIMPLE BACKGROUND CHECK, LIKE THEY DO FOR VISTA WORKERS. YOUR VALUE OF THE TIME CONCEPT IS SUPERB BECAUSE IT ALLOWS PERSONS AT THE LOWER END OF THE EARNINGS PYRAMID TO PARTICIPATE AND ENHANCE THIS PROGRAM AND GET FINANCIAL REWARDS FROM IT -- SO IT'S NOT JUST REWARDS FOR THE RICH. EVERYBODY IN THE PROGRAM GETS REWARDED.
Not every hospital would be covered. This program would start in states where the law is most favorable to protecting Samaritans. So figure $ 100 Billion per year.
The present budget of the Red Cross (3 Billion) is not relevant. I want their management talent not their bank account. The tax deduction will upgrade their bank account by a hundredfold. They get those charitable gifts. Money would pour in.
The shortfall would be in getting willing doctors. Each center would need more than one, plus some part-timers. Would $ 160,000 be adequate compensation? I don't know.
Please keep in mind that the idea of a universal coast to coast uniform one-size-fits-all solution is the very idea I am rejecting. So, it's unfair to evaluate my idea as if it had to be done that way.
I want to pick and choose, where I get the best legal protection, where my workload will be level loaded, and where my case throughput can be maximized creating the greatest savings for the healthcare system.
Even if every hospital were covered, hiztreeb has got his math wrong.
5764 Hospitals Times $ 160,000 Doctor Salaries = $ 922,240,000
Nine hundred twenty-two million, two hundred and forty thousand.
Not quite a Billion dollars.
Figure I'm not covering every hospital, but more than one doctor will be needed per pauper's primary care clinic, let's say I cover a third of the hospitals, with three doctors at each clinic, plus volunteers, so still come out at under a billion per year, without the drugs.
Let's triple that to account for the drugs. So three billion per year.
This is probably about 10% of the money that would come in. Red Cross should keep some. Participating hospitals should get some. The rest can go to a fuller and better rollout in future years, after the Beta Version year. Maybe we could upgrade to half the hospitals, or even more. So it's retained earnings for future growth and development, which could someday include minor surgery (a few stitches etc).
1) Figure $ 3 Billion per year, not $ 100 Billion per year (my mistake, now corrected)
2) Shanghai's comments are 100% devoid of merit. His misunderstandings are too numerous to correct. Suffice it to say, he understood absolutely no part of my plan. Not one thing.
Mike
I think that you have a very good idea.
This would be very effective, low cost and would not cause all of the drama and the huge costs associated with the so called health care plan put forward by the Obama administration.
You can even cut the costs further with the use of volunteer doctors and nurses in addition to the paid staff.
I volunteer as an instructor for the American Red Cross myself. Even though I only have time to teach 5 to 10 hours per month, when you have a large number of volunteers that adds up very quickly.
We have a core of paid people. This makes certain that you always have people when you need them.
In addition there are a large number of people like myself who volunteer and donate time when possible.
The volunteers like myself cut down on the number of paid staff that you need. That dramatically cuts your costs.
If you just had each Doctor and Nurse in a community volunteer 5 to 10 hours per month (whch is not very much) to the Red Cross for an activity like this, you could cover most of the health care for the poor and uninsured in every community at very low cost.
(Edit) I like your idea regarding the tax deduction.
I see a further opportunity, if you were to change the tax code to permit people to deduct the value of their time that they donate to the Red Cross.
Currently the value of the time that you donate is not tax deductible. However if the tax code were changed to allow people to deduct the value of their time, you would have far more volunteers.
For example, when I teach classes at the Red Cross, the students in those classes pay to take the class.
The revenue that I generate for the Red Cross when I teach a class is approximately $ 100 to $ 150 per hour that I teach.
If the tax code were changed to permit me to deduct that $ 100 per hour that I generate for the Red Cross, that would make it very attractive for me to volunteer even more time to teach classes for the Red Cross.
I would be willing to bet that you would have no trouble getting all of the volunteer Doctors and Nurses that you need if you were to permit them to deduct $ 100 per hour for every hour of their time that they volunteer for the Red Cross.
(Edit) Thank you Dolphin, you have a great idea.
Also, it is fortunate that Doctors and Nurses already have had extensive background checks. It would just be a matter of checking with the State on the status of their licenses, certifications, and any records of disciplinary actions.
MakeAmyUp!
Ill be honest with you, i am going to have to go back over and read your question maybe a 3rd or 4th time to fully understand it. And that's due to me and my lack of coffee. But the American Red Cross is amazing and they helped me out greatly after i had my fire and lost everything. These primary care clinics sound like they might just work!
Red Cross Rules!
hiztreebuff
I applaud your willingness to think outside the box as well as your investigation of alternative solutions.
Forgetting about the drugs, rent and other operating costs and just focusing on the doctors: There are currently 5,764 registered hospitals in the U.S.,which would mean the cost of one doctor per hospital to be about $ 922 billion/year. The current operating budget of the American Red Cross is between 3 and 4 billion a year. Am I missing something, or not understanding something about your idea?
shanghaiduck
you have essentially proposed a centrally administrated health care system that directly employs doctors, and relies on the government to control costs by:
1. managing costs through negotiation,
2. mandating and regulating accountability and quality standards, and
3. reducing administrative costs by regulating compensation and system efficiency.
this is a single payer system. which, i might add, the neocons are fighting tooth and nail against.
the differences in your system are:
1. renaming taxes as "tax deductions" for costs that consumers would have to pay anyway. what's the difference between a tax and a cost, if the consumer has to pay either? there are two:
a. the agency receiving the payment is not the same
b. people are not required to pay.
thus, if no one is willing to participate, the system fails. but if people get a 4x deduction for participating, this is the same as the government paying 4x as much for the same system, which will be manifested as cuts elsewhere or increased taxes, or an increased federal deficit. again, the system fails.
at the risk of sounding snarky, there is a major point that needs to be brought up: the reliance on the idea that "charity" should be the main engine of serving the public good -- especially as promulgated by groups that denounce any action to serve the public good or offer a social "safety net" to people as socialism, communism, or a plot to kill the voters most likely to help oppose the ideas. how can a system dependent on charity work when it is enacted by uncharitable people?
2. your system would only cover 65% of the people. this is not much improvement. also, it would not pay for surgery, which is the most significant access problem in our current system. primary care is useless if no steps can be taken to fix problems.
there are other discrepancies in logic, but i don't want to make you feel like i'm being mean by pointing them out or disagreeing. like the misnomer that malpractice suits are relevant, or the pervasive "i hate foreigners" idea that points right back to the charity issue.
usually the anti-immigration sentiment is a clunky veneer for plain racism. it's black people and mexicans being referred to. no one is objecting to japanese or british people -- whose higher standards of education make them into /real/ competition for jobs Americans "would" do.
in any case, i largely agree with most of your proposals, and i support a single payer system. why don't you?
Orignal From: Q&A: A Better Healthcare Plan? You tell me what you think.?
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