Here we are again. Health care is at the forefront with three state plans to choose from. Let’s create a workable and fair solution, because people are really dying for us to get this done.
According to the World Health Organization, France is ranked No. 1 in health care. Better outcomes and lower costs, all with a public-private system and public-private funding. So let’s steal some ideas.
Let’s establish our own state-run Medicare-for-all system, which is 20-percent co-pay or optional Gap insurance. We’ll provide 100-percent vouchers to those under the poverty level and a 50-percent voucher if under twice the poverty level. Throw in 100-percent relief when a family is hit with a catastrophic illness, and let’s develop a reasonable end-of-life solution (ie, automatic no-code on people over 90 unless the family is able and agrees to absorb future costs).
Just 5 percent of the population consumes 70 percent of our health care, and most of that is by us old geezers. We need to cut that.
Let’s mitigate the overbilling and fraud by moving those displaced from the insurance industry to a Medicare oversight commission. Even let private insurers bid on this, since they will no longer benefit from the current inefficiencies. Let’s create medical courts to lower tort abuses and excessive costs of defensive medicine, and give any punitive damages to the health care fund rather than to the attorneys and patients who have already been compensated.
I’d keep an option like Medicare Advantage. Even though it costs 12.5-percent more than Medicare, it gives patients other choices and private insurers a role. They could even bid on the Medicare administrative contracts.
The fraud in nursing homes and home health agencies must be eliminated and prosecuted, and we should pass a law that requires employees to be educated on the whistle-blower statutes and rewards. Let the employees provide the oversight, though with such a law I expect the owners to clean up their act fast.
Reimbursements in Medicare (or our version of it) should be increased to ensure top pay for good doctors. State sponsored rebates of medical educational costs should go to all resident students who finish in the top 10 percent of their class, providing they agree to a two-year state internship.
We also need a patient database for transparency of physician utilization, best practices, practice variations, medication conflicts, and etc, with patient names kept secure unless released by the patient for travel purposes. That software is already available, free, from the Veterans Administration.
I don’t like co-pays and deductibles, but it may be the only way to achieve political acceptance. Eliminating these is not a liberal giveaway, and in time we’ll find that they cost more money than they save. Studies already show that they deter care until that care is more expensive to treat or becomes untreatable, so they have a long-term negative cost value. Some mothers even go without their blood pressure meds to save money, then they have a costly stroke or die. We can do better.
What we have is not working, and those standing in the way of change should be sidelined. This is the most business-friendly and public-friendly solution available, and even the insurance industry wins something here. It would reduce the maze of physician and hospital paperwork, and substantially reduce our excessive administrative costs. For the same dollars we spend caring for 85 percent of the population today, we could care for 100 percent.
While initially we’d need the employers’ help in transitioning – say, with a payroll tax – we should phase them out over five years and make it 100-percent taxpayer funded. As it is employers just add their costs to their product price and we reimburse them at the cash register. We don’t need these middlemen because they don’t really reduce our costs, and by making them more profitable, more jobs would move to Wisconsin and fewer will leave. At least until other states catch on to us.
Jack Lohman is a retired business owner from Colgate, author of "Politicians – Owned and Operated by Corporate America" and founder of http://www.ThrowTheRascalsOut.org. He can be reached at jlohman@execpc.com.
