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‘One Problem, One Bill’: Real Health Care Reform

Instead of President Obama's gargantuan bill, let's take the problems one at a time and address them individually.

by
Dr. Peter Weiss

Bio

February 25, 2010 - 12:00 am

Pelosi tried and failed. Harry Reid couldn’t do it either. So President Obama has put his plan for health care reform on the table and now he wants to ram it through both the House and Senate.

The president is acting as if he came up with some new and improved concept for health care reform, when all he’s done is repackage an old, out of touch with reality proposal that nobody wants, except maybe Harry Reid and Nancy Pelosi.

Not only is there no price tag on the bill, but the chattering class puts the over-under at $1 trillion. And I’ll go with the over.

His “proposal” is full of disingenuous plans at best and outright malpractice at worst. If he were a doctor, I’m sure the trial lawyers would be lining up to sue him for gross negligence. His proposal will cost more than the Senate version. It includes more taxes and more subsidies, and insinuates the government into even more aspects of health care. I could keep piling it up, but I’d be writing what every intelligent person already knows. Instead, let me remind people of what his proposal will not do.

It will not reduce the deficit, unless, of course, you use some kind of special math. Also, the majority of those uninsured will be placed on Medicaid, as if this is some great accomplishment. The Senate version and now the president’s version use Ponzi scheme math by collecting 10 years of revenue for six years of service. Isn’t Bernie Madoff in jail for something like that?

Most of you are familiar with another thing the president does not tell you. That is, of the 37 million who currently do not have health insurance, some 40% chose not to pay for it. They’re young and don’t need a comprehensive plan, but they could easily get a catastrophic plan if it were available. These are the 18- to 34-year-olds who will soon be forced to buy comprehensive insurance to help pay for those of us who are older.

We  have a real problem with the 12 to 15 million Americans who are denied insurance because of pre-existing conditions, and I’ll answer that in a moment. Before I do, I will give the president credit in two areas he reintroduced. First, there is Medicare and Medicaid fraud and abuse. We all know its rampant. Presidents before him tried but failed to fix it. Maybe this time we’ll be more successful.

One reason for this fraud is that only 3% of Medicare expenditures go towards administrative costs. The government does not have the resources to investigate all the fraud and abuse. The same can be said about the state’s Medicaid programs.

The second area where Obama is actually right is Medicare Advantage. This is an expensive program that I’m not sure we can afford in its current format. It is running on average 13% over the cost had the services been run through regular Medicare.

I understand the temptation to draft one bill to solve all the problems in the system. But we’ve all witnessed the reality of this unrealistic approach. So I have a simple solution that will either bring people together to create meaningful reform, or expose the partisan political operatives and their true agendas. I call it: “One Problem, One Bill.” Republicans don’t have to accept the current terms of debate that call for a gigantic mish-mash of government intrusion and political payoffs that will only complicate our health care system further. Instead, on every possible front, we need to offer one bill that solves one problem.

We can all agree that one problem is the cost of insurance. So in one bill, provide the legislation that will allow insurance policies to be sold across state lines. That will increase competitiveness and drive down costs.  One problem, one bill.

Mandated coverage is a huge problem that increases coverage costs. States force insurance companies to cover everything from chiropractors to acupuncturists to massage therapists. We need one bill to reduce the number of these mandates and reduce the cost of your insurance coverage.

Being denied for a pre-existing condition is one problem we could all face. So in one bill, we need to allow groups such as AAA,  CostCo, and even church or community groups to pool their money and purchase health insurance plans for their members. By doing so, individuals would now be considered a part of a group plan which eliminates any problems with pre-existing conditions, since they would be under ERISA laws. This also allows portability of insurance as well.

Next up, you can’t read an article about our country’s health care problems without reading about the cost of drugs. That’s why we need one bill to help create drug coverage that is fiscally responsible. We could require drug companies that take federal money for research and development to sell their products at a certain price. No federal money, no constraint. To keep the cost of drugs down, they should be imported and re-imported. The government should also be allowed to purchase medications directly; this will drive the cost down considerably. One bill with these solutions will drive down the cost of drugs.

One last problem: lawyers. We all want to eliminate true waste in defensive medicine and documentation. Obama said he’d even work with Republicans on this one. That’s why we need one bill to eliminate contingency cases in malpractice suits. We can also create a loser-pays system to make lawsuits much less frivolous for trial lawyers. Contrary to what the president says, defensive medicine is the most costly problem in health care reform and President Obama is ignoring it like the plague. We can remove the lawyers from the doctor-patient relationship with one bill and make your health care much more affordable.

If any one of those bills are not passed, it will be much easier for all of us to understand who is obstructing meaningful reform. And it will be much harder for senators and congressman to hide from you the corporate and political masters they’ve really been serving.

Mr. President, you asked for new solutions that will work. Well, here they are. I’m sorry I won’t be able to attend your bipartisan meeting today. I’m working.

Peter Weiss M.D., F.A.C.O.G., is Director and Founder of The Rodeo Drive Women's Health Center. He is also Assistant Clinical Professor of OB/GYN at The David Geffen School of Medicine at UCLA. He was health care adviser to John McCain's presidential campaign. Dr Weiss is an Attending physician at Cedars Sinai and St Johns Health Centers
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