A Ten-Point Health Care Plan for America
1. Malpractice reform
Decouple malpractice determination from awards.
Consider single-payer malpractice insurance for physicians (five percent of net income). Physicians adjudicate claims with judge/lawyers overseeing proceedings. Caps on rewards, no contingency fees.
Four-tier system where judgment and penalties are given out. (Specifics are at RadicalPrescription.org, pages 23-25.)
2. Insurance company reform
Insurance companies will be allowed to sell policies across state lines.
Reciprocity of state plans.
Eliminate state mandates from basic plans.
3. Affinity groups (AAA, church groups, AARP, etc.)
Allow them to buy health insurance policies. The market will determine which. Members of such groups will be allowed to purchase those plans.
4. Regulate coverage
Restrict rescission only to glaring fraud.
Regulate “usual and customary charges” paid by insurance company.
Prohibit non-payment of claims.
Prohibit denial of treatments ordered by an approved (contracted provider) physician.
COBRA insurance to be continued as long as patient can pay premium. Premium should be the same as what the employer was paying.
5. Medical education
Remove three to four years of college from pre-medical education.
Free or minimal cost for medical school. Three years of public service to underserved areas following completion of medical training.
6. Coverage
Establish high-deductible major illness insurance to cover hospitalization and catastrophic illness for those under 65. Incentivize the purchase for those under 30 years of age with an additional $1,000-per-year tax credit. Age limit may vary depending on actuarial determinations. This is to be provided by private insurance.
Outpatient health care should be an out-of-pocket expense.
7. Pharmaceutical industry
Government should be allowed to purchase drugs directly.
Drugs which utilized federal grant money for R&D should have limitations in cost markup. Those that did not are free to exercise full free market tools.
8. Fraud abuse
Enhance Medicare and Medicaid oversight for fraud and abuse.
9. Mandates
With exception of COBRA, terminate all existing government physician mandates. This frees physician time to care for patients.
Preventive medicine measures to be carried out by non-physicians, such as nurses, aides, social workers, all basic medically trained personnel.
10. Tax deductions
Tax deductibility for major illness (catastrophic) insurance, but not for comprehensive plans.
But this would make the government less powerful and large blocks of voters less beholden to the Democrats. Why would we want that?
So your prescription for health car reform involves more regulation and government involvement in health care. Swell.
How about you start with decoupling insurance from health care? Those are kind of two entirely different things. It drives me mad that we continue to call comprehensive subsidized health care plans “insurance.” If we allow companies, individual doctors, groups of doctors, hospitals, etc to all sell health care plans (such that you’re actually paying the provider directly for services), then we can separate insurance for catastrophic events or changes in health status from those plans. Then we get lower insurance premiums since they aren’t covering routine medical care. I suppose you kind of get at this in #6, but it isn’t entirely clear.
As for point #4, that belongs in some statist website. I thought we don’t dig on the regulations at PJM. As for point #5–remove 3 to 4 years from pre-medical education?? What?? So you’re saying that doctors ought not have an undergraduate education in basic sciences? Lets ignore that such a background might be essential to grasp the more advanced concepts of the first 2 years of medical school. This suggestion is puzzling in that making students jump through those hoops is essential to select the most serious and dedicated students for medical school. It is also essential in that kids right out of high school are not at all mature enough to begin a medical education. Hell, I’m not even sure that putting your average 22 year old college grad into medical school is a great idea. The free or minimal cost of medical school implies more government spending. Yeah, that’s a good idea. Here’s an easier solution: how about you just offer tax rebates to physicians for any volunteer work they perform during the year? Highly incentivize physicians donating time–then you can take care of those of limited means as well. Say one day a week at a free clinic equals a 10% reduction in federal tax burden.
#7: no the government should not buy drugs directly. That puts government in control–we don’t want that. Fail. #8: how about just phase out Medicare and Medicaid and then we don’t need to worry about fraud? Getting rid of government programs is always the best solution rather than regulating them even more.
#10: How about we just allow everyone to have health savings accounts which are not taxable at all? How about we keep the governments paws off of as much money as possible?
I mean no offense Dr. Weiss, but this sounds like something a RINO would come up with. Which is to say it’s basically socialism light. It’s understandable since you’re from L.A. and you’re surrounded by a bunch of lunatics spouting statist nonsense all day long. And I feel your pain–I lived there for 20 odd years and even graduated from the University of Communism system. Once you leave California you discover that you want as little government as humanly possible and all plans that involve more government will become complete non-starters.
So your prescription for health car reform involves more regulation and government involvement in health care. Swell.
How about you start with decoupling insurance from health care? Those are kind of two entirely different things. It drives me mad that we continue to call comprehensive subsidized health care plans “insurance.” If we allow companies, individual doctors, groups of doctors, hospitals, etc to all sell health care plans (such that you’re actually paying the provider directly for services), then we can separate insurance for catastrophic events or changes in health status from those plans. Then we get lower insurance premiums since they aren’t covering routine medical care. I suppose you kind of get at this in #6, but it isn’t entirely clear.
As for point #4, that belongs in some statist website. I thought we don’t dig on the regulations at PJM. As for point #5–remove 3 to 4 years from pre-medical education?? What?? So you’re saying that doctors ought not have an undergraduate education in basic sciences? Lets ignore that such a background might be essential to grasp the more advanced concepts of the first 2 years of medical school. This suggestion is puzzling in that making students jump through those hoops is essential to select the most serious and dedicated students for medical school. It is also essential in that kids right out of high school are not at all mature enough to begin a medical education. Hell, I’m not even sure that putting your average 22 year old college grad into medical school is a great idea. The free or minimal cost of medical school implies more government spending. Yeah, that’s a good idea. Here’s an easier solution: how about you just offer tax rebates to physicians for any volunteer work they perform during the year? Highly incentivize physicians donating time–then you can take care of those of limited means as well. Say one day a week at a free clinic equals a 10% reduction in federal tax burden.
#7: no the government should not buy drugs directly. That puts government in control–we don’t want that. Fail. #8: how about just phase out Medicare and Medicaid and then we don’t need to worry about fraud? Getting rid of government programs is always the best solution rather than regulating them even more.
#10: How about we just allow everyone to have health savings accounts which are not taxable at all? How about we keep the governments paws off of as much money as possible?
I mean no offense Dr. Weiss, but this sounds like something a RINO would come up with. Which is to say it’s basically socialism light. It’s understandable since you’re from L.A. and you’re surrounded by a bunch of lunatics spouting statist nonsense all day long. And I feel your pain–I lived there for 20 odd years and even graduated from the University of Communism system. Once you leave California you discover that you want as little government as humanly possible and all plans that involve more government will become complete non-starters.
P.S. – Sorry, forgot to tell you great post!
a few of these ideas are pretty good, but I am not so much in agreement with about half of these.
Most outstanding: cut medical education by 3-4 years? I don’t think so.
I already have a feeling this is something BHO would go for though. That is all we need, more lousy doctors. I am in the medical field and there are plenty out there that do not give me much confidence…
medical and premedical education is very important
Why discuss proposals now? Its a bit too late…the bills have been written, introduced, discussed and already voted ont… But yours are ok too, some of these ideas have already been planned.. and even if a bit too late many more ideas like these could have come from the right wing much earlier. Instead, many on the right chose to remain silent, deciding to make their headlines by rantining on and on, ridiculing those that tried to make any progress on the issue. Its a real shame, but at least there were a few republicans that joined the debate, and they have made a real positive contribution. However, good effort ! Nice to see the thinking side.
The vaporative bill is being written behind non-transparent closed doors by partisan politicians with no medical training from a non-written concept approval. Who do you trust, the provider or the bureaucrat?
A cost savings idea passed to me by an old doctor was for the patients to keep their own records, pay cash, and file their own insurance. He was able to manage his clinic at $10.00 a visit. The overhead comes in the record keeping and malpractice insurance. Five minutes of doctor time can expand to 20 minutes of records, billings, and re-imbursements with at least 5 persons handling the submission in a very streamlined office.
Discussing the alternatives that are studiously avoided by the present thrust is definitely the right thing to do. The congress and the administration are now trying to impose a system which the electorate does not want and did not ask for!
When the government wages war on the citizenry, we better fight back with all we’ve got. And what have we got? Freedom of expression, so let’s use it!
With existing government programs financially unsound, let’s not create new ones! The constitution does not start with “We the lemmings”!
A 5% flat rate for malpractice insurance, assessed against net income? That’s loony. I am a pediatrician, a fairly low risk specialty – I should pay the same premium as a neurosurgeon? 5% of the net income of all physicians in the country would be way, way more than needed if the tort system were actually reformed, and a flat rate would be hard to sell unless rates came down for all or most physicians.
The Opaqueness of Obamacare Transparency
A favorite buzz word of Barack Hussein Obama’s campaign for the presidency, aside from his vague invocation of “change,” was “transparency.”
Transparency may not be as vague a concept as change but it has become the biggest prevarication of Obama’s presidency especially when it comes to the abomination of Obamacare.
For the edification of this administration, in a political context, “transparent” is defined by Merriam-Webster as ”free from pretense or deceit : frank b : easily detected or seen through : obvious c : readily understood d : characterized by visibility or accessibility of information.”
Nowhere in that definition is any allusion to subterfuge and opaqueness which have supplanted any semblance of the transparent in the executive and congressional machinations surrounding the effort to change how Americans receive medical treatment.
Good grief, Barry! I really hope you and your cohorts don’t actually believe the mass of Americans are so stupid that they can’t see through your carefully-crafted deceptions.
Most Americans are not mind-numbed ACORN-ers who slavishly tow the socialistic, Obama-line and suck up the propaganda out of Washington these days. Nor are we about to be suckered into believing Obamacare includes anything approximating Americans’ concerns for their health interests.
So much is pouring out of D.C. of late, little of which is encouraging, that, by design, it’s difficult to keep up with it all.
That technique could be called, “Toss all kinds of BS against the wall and hope some of it sticks,” or, “Hit ‘em with a disinformation overload and hope they give up in frustration.”
Sorry, Obamians! Again, the vast majority of us are not members of ACORN. In other words, we think.
To keep real Americans abreast of the latest developments in the effort to seduce us into buying into Obamacare, here’s a quick summary of the latest news from the health front:
Baucus Bill Will Make Medical Deductions Out of Reach for Millions: . . .
(Read the rest at http://www.genelalor.com/blog1/?p=1269)
Why does healthcare insurance have to be provided by employers? One no longer stays at the same company for an entire career and this tactic just amounts to a reduction of “real” wages. Get employers OUT of the healthcare business. The auto industry is an example of WWII promises made when wage control was in effect now biting us in the behind.
And…insurance isn’t healthcare. It’s covering our risk for a major medical event. Allow tax-deductible Medical Savings Accounts for annual visits and routine care with premiums for major medical also deductible to a certain level. MSA money not used can be carried over to old age when more people need complex care.
Insurance carriers should be allowed to compete across state lines with “outlier” illnesses insured by state pools.
The government can help by organizing an electronic medical system, standardized insurance forms and data on the appropriate charge for various proceedures by region. It can also straighten out it’s Medicare, Medicaid, VA, Indian Affairs, etc services that are a disgrace. Actually, the VA has improved over the last 10 – 12 years. Who was the guy that did that? Hire him…fast.
Thanks for your thoughts. Not perfect but all would do more to drive down HC costs than anything in congress right now. Low medicare-medicaid payments already increase private insurance premiums through cost shifting. A public option will do the same thing. These bills are about government control not health care. I agree the decision and acceptance to med school should occur after the first year of college. Why should 3 people go through pre-med for every 1 that’s accepted to med school!
The plan limits individual choice, adds layers upon bureaucratic layers and increases costs for taxpayers, seniors, and middle class families. And it can’t guarantee people who have coverage they like won’t lose it.
With Senator Snowe’s vote, the proposal was passed 14-9 despite the Congressional Budget Office (CBO) Director’s testimony earlier in the day stating that the total impact of the legislation was unknown because of the lack of legislative text to analyze. Even with limited information, the nonpartisan CBO recognizes that the plan will cost $904 billion while leaving 25 million Americans uninsured–all at a cost of more than $31,000 per covered individual. Alternative – a fine of only $25,000.00. Happy with your new health care,now?
Thanks for this list. Some things are above my head as a private non-medical citizen, but some of them mirror my own amateur thoughts on what we need to change. This week I was writing about why I personally don’t support Obamacare, with my belief we can tweak our existing system with a 3 page bill. I just can’t understand why Congress has to overhaul the entire system, rather than incrementally improve the things which are faulty.
Page 1. Sell across state lines
Page 2. More support for a robust gym class in schools to encourage a healthy lifestyle
Page 3. Tax credits for staying healthy
http://www.brianking.name/why-im-against-obamacare.htm
This bill would take about a morning to write up, and an afternoon to pass through both houses and reach the President’s desk. It makes an honest crack at lowering costs by increasing competition, it addresses our future by trying to build a healthier population (admittedly this won’t happen overnight), and rewards those of us who have been fortunate enough to be healthy most of our lives and make healthy choices like not smoking. Next year Congress can tackle some of the other wrinkles of health care, again, in small steps. Go for the low hanging fruit.
Instead, we have a bill that has sucked up months of manpower, takes 1000s of pages, and politicians have no idea what is actually inside it. The push now is to pass the bill simply because it says “healthcare reform” on the cover, without a care in the world for all the BS that is inside. Truly sickening.
Dr. Peter Weiss M.D.:
Best article I have seen here or anywhere else!
I wish someone in the right place would listen to your ideas.
It’s never too late!
Err, you left out tort reform.
Why not loosen your grip on prescription medications? Mexicans can buy all kinds of drugs under the guidance of the pharmacist. I have saved a bunch since the GERD drugs became OTC. How many emergency room visits are simply to get some Cipro for an infection?
How is a consumer to “shop around” for medical services when even elective procedures require “estimates” that you have to pay to receive?
We need insurance companies to publish the established rates for procedures.
We need foreign dentists to be allowed to practice in the U.S. if they pass a test instead of having to go through dental school all over again.
I was wondering, couldn’t we have a system where people subscribe to a hospital in lieu of purchasing insurance? Members of a hospital would pay a monthly subscription fee, and in turn be able to receive care at said hospital for a small equivalent of a co-pay. Non-members could still come, but they would have to pay full price. A payment plan can be worked out for those non-members who are admitted to the ER.
Obama’s plan to force you on welfare:
http://blog.heritage.org/2009/10/16/morning-bell-obamacare-puts-you-on-welfare/
Your idea to place restrictions on companies that benefit from govt R&D would be disastrous since it would kill public-private sector research cooperation.
DD
@3. TQ: – How about you start with decoupling insurance from health care? Those are kind of two entirely different things. It drives me mad that we continue to call comprehensive subsidized health care plans “insurance.”
AMEN!!!
Why is this such a difficult concept for so many people? Has the government done THAT good of a job brainwashing Americans into thinking that “coverage” and “health care” are the same – and that we’re entitled to receive it, essentially “free”?
The socialist, Great Society central planners started this brainwashing process with Medicare, which was followed by health care costs beginning to rise at rates higher than inflation.
They continued this process with HMOs – hardly different from the costly, failed program that was recently implemented in MA, with Mitt ‘RINO’ Romney’s cheerful support. HMOs – mandated, comprehensive group coverage – were followed by a significant jump in the rate of health care cost increases, thereafter MUCH higher than inflation.
As the HMO program slowly fell apart, the feds intervened once again with government-supported, comprehensive group coverage through employers. This was intended solely to keep people addicted to ostensibly “free” health care (i.e., little if any money actually leaves the patient’s wallet at the time of service), thereby disassociating the consumer of health care from the provider and distorting the perceived value of health care goods and services. Again, what followed was another jump in the rate of increase in health care costs, which at this point has gone literally out of control (i.e., there is NOTHING working to keep those costs down).
The free market for health care has been utterly destroyed by government meddling and support of comprehensive group health care insurance. Routine health care is the ONLY cost of living we pay for through a group insurance policy and it’s the ONLY commodity cost of living whose prices have skyrocketed at rates multiple times that of inflation for decades.
Tort reform is fine, but there isn’t a single point in this plan that will increase competition among health care providers, restore the economic relationship between health care consumer and provider and actually work to bring health care costs down. It’s a plan only a Socialist-Lite® RINO would come up with as a weakened alternative – a reaction – to outright socialized medicine, and it leads in the same direction.
The health care problem in America is caused by the skyrocketing cost of routine health care, not “lack of coverage”. Arguing about “coverage” and “plans”, etc., completely misses this point and will lead to socialized medicine within a decade. Then you can kiss your Republic good-bye.
The real solution – one which would force routine health care costs back down into equilibrium with other routine costs of living – is much simpler.
Wow, Dr. Weiss’s plan has regulation written all over and throughout it. It’s tantamount to socialism, as much as Obama’s plan is, and as much as single payer is. Let’s stop the bugaboos and the innuendos, most of us here believe the system we have now is not working. Most of us want some form of regulated system where the government sets standards of some type. In fact i can argue most of us want some form of “socialized” medicine.
Now that we’ve gotten that out of the way, I would argue that a complete single payer system is the best for how to implement our goals: the most people getting medical care –Unless you believe as some Democrats do that the Republican and libertarian plans are to have some people “Die quickly”, then this is a no-brainer. Now the question becomes, which idea (plan) will do this most efficiently and cheaply? Which brings us to a new goal, which plan will cost the least? I would argue that within the concept of costs, we should consider both taxes paid and insurance company costs. there is no magical money that appears in my pocket or bank account when that money goes into the private sector. So now the question for your health care dollar is which method is cheapest? I would argue that single payer system is cheapest per individual.
But some people say, what about bureaucracy? Have you ever read an insurance company policy or dealt with an insurance company on a hard question? They can give the IRS or the former soviet union a run for (your) money in bureaucratic rules and regulations.
As for the question of death panels put as “Who will kill grandmother?” Insurance companies today have panels which regulate who gets treatment in order to maximize their profit.
Now i am not a fan of government or other bureaucracies running our lives, and believe that whatever idea for solving the healthcare mess comes about, eternal vigilance and individual relationships to their health and healthcare providers is absolutely necessary, nevertheless after studying all the alternatives, i believe a single payer (medicare for all) plan is the best.
@20. Dean: – … i am not a fan of government or other bureaucracies running our lives, [but] after studying all the alternatives, i believe a single payer (medicare for all) plan is the best.
Clearly, the most self-contradicting bit I’ve seen written at this site in a month.
This is like David S. claiming that he’s not a statist… right after proclaiming that the State should be handed control over our health care, given the authority to impose effectively unlimited taxation and allowed to control every other facet of our lives through cap-and-tax-and-spend legislation.
The system we have now was invented by the government, and has led to skyrocketing, out-of-control health care costs. That’s why it doesn’t work. Pretending that the government can ever fix what it has made successively worse with every attempt is tantamount to insanity. And the notion that “most of us” want socialized medicine is utter horsesh!t. People don’t “want” it. But because Congress is now completely ignoring the will of the People, they’re growing resigned to the idea that it’s going to be shoved down their throats whether they want it or not.
All the recommendations in the world will make no difference with this crowd of Statists in power. They are not interested in listening to you Dr. Weiss or anyone else. While many of us are trying to act reasonable, the mistake is trying to reason with “people” who have not the faintest intention of listening.
Dear Dr. W…I so enjoyed your PJTV film…with the other doctors..and most of us are shocked, but not too surprised at the vote over the Insane HealthCare bill. But, just look at that woman who has been put in charge in the Congress…she is a joke of a politician…a rude reminder of what we have brought upon ourselves thru lack of vigilence… We will do better now…now that the S&%$# is hitting the fan.. I will continue to send out info to my family and friends, march, send emails, faxes…but that is all I am able to do. I will vote as and Independent or Conservative if I have to, but not much else is there within my power to do. These snakes have nested in Congress..and it has happened over many years…We must send in the eagles to see if we can take them out…the eagles being ourselves..our only hope..