Health Care Reform: Still An Original And Simple Proposal

Hello America,

Remember me, I'm the doctor with forty years experience in military, academic, and private medicine who offered the five-bullet point common sense solution to health care's ailments, with no new taxes and no addition to the national debt, located here.

Well, tonight I listened to the well-thought out and well-studied bipartisan plan of Senator Max Baucus, Chairman of the Senate Finance Committee (the half Democrat/half Republican "gang of six"). Amazingly these plans parallel the three insurance bullets I laid out in the five-point plan one month ago in the L.A. Times Steve Lopez interview. Senator Baucus also soundly rejected the government or public option plan as unacceptable to American voters, as this would have raised our national debt 1.5 to 2 trillion dollars, as stated by no less than financial wizard than Warren Buffett himself in a New York Times op-ed piece three weeks ago. As an alternative, Senator Baucus proposed an ingenious basket of state run co-ops that could be sold across state lines. Notice no federal co-ops!

I also listened to President Obama lay out the utopian wish-list plan favored by the extremely partisan left wing of his party.

Guess who gets the nod from my perspective, for bipartisan reality and feasibility, to save and improve our unique, innovative American health care system, and not saddle our country with unsustainable structural debt?

I vote for Senator Max Baucus.

We still need bullet #4, meaningful complete national tort reform, as already established successfully in California for 34 years, and lastly bullet #5, the federal mandate to our 159 urban medical schools to take care of the hard core indigent and illegal alien populations within their shadows, as best exemplified by the extremely successful USC/Los Angeles County Medical Center model. An added plus to this plan is that our medical schools can get back to their teaching mission while providing great training for our future doctors.

So with Max Baucus' three insurance bullets, and with the two additional common sense solutions above, we've arrived at real improvement and reform in our health care system, with no new taxes or debt.

Follow 5 Simple Steps:

1. Change the current 50 state patchwork of private insurance programs to a national clearinghouse of private insurance choices to increase competition.

2. Return health care insurance companies to the pre-1984 federal regulations that limited their fees to administration only.

3. Move away from employment-based care but require coverage of all working citizens.

4. Enact meaningful tort reform.

5. Get the 159 urban medical schools back to serving their local indigent populations.

Comments

[dumboldfarmer]

With all due respect, it would be much, much simpler to just go with a single payer system. The insurance giants have been feeding at the trough for too long and are gorged with their money.

Actual health care quality has declined and if it is both the insurance system and the health care systems that are responsible. When insurance companies negotiate with hospitals and doctors, consumers quality of care loses.

[iblogleft]

I vote we flood the market with doctors by offering free medical school and put elitist, rich old men out of business, or make them work for a living again.

I can assure you that you are no more important than the man that picks up your trash.

This is an example of elitism at its finest, and exactly what happens to people who start to believe that they have indespensible services that no others could possibly do.

The Baucus plan is spit on the face of the average American taxpayer, and a 60 billion dollar giveaway to people who think they actually deserve it.

Not just that, but you actually believe this plan will not bankrupt this nation? It most certainly will.

[Marlyn]

"Senator Baucus also soundly rejected the government or public option plan as unacceptable to American voters" ???

He is so WRONG!

[Mildmannered]

."3. Move away from employment-based care but require coverage of all working citizens."

Please explain what this means.

[Mildmannered]

Dr. Toffel:

"In April, a Wall Street Journal story suggested that blood clots following surgery or illness, the leading cause of preventable hospital deaths in the U.S., may kill nearly 200,000 patients per year"

How do we prevent these hundreds of thousands of deaths caused by minor medical mistakes?

[Mildmannered]

Dr. Toffel:

How do we reduce the deaths of 100,000 Americans whose deaths are caused or influenced by infections picked up in hospitals?

That is more than double the number of people killed in car crashes, five times the number killed in homicides, 20 times the total number of our armed forces killed in Iraq and Afghanistan.

[ajwriter]

"Return health care insurance companies to the pre-1984 federal regulations that limited their fees to administration only."

By this, do you mean insurance companies return all of their premiums as care, except for administrative expenses? In other words, they must be non-profit?

If that's what you mean, this is the key to reform.

If so, please lay out some details for how this could be achieved. I think if this were clearly achievable, many people would be in favor of it. I think it should be done first and prior to any other reform.

[jhNY]

A doctor has lots of nice things to say about Max Baucus and his plan, written by an insurance lobbyist, yes, but still his plan, in that they think exactly alike. Why have the health insurance and big pharma folks given Baucus over $2 million for his perpetual re-election machine? Because they think he's a free-thinker who can't be bought? Or because they think the buffalo and elk and ranchers deserve to be dazzled by a slick over-financed campaign, of the type usually reserved for the metropolitan areas of our fair land?

[research]

Medicare for All: HR676.

Sign the Petition!!!!! http://healthcare.kucinich.us/petition/

[johnashman]

Too slow to react to changes, subject to bureaucrat tinkering, incentivizes over care, over testing, unnecessary surgeries, rationing, drives doctors from the system, incentivizes mediocrity, etc, etc, etc.

[SpiralUp]

and the doctors driven from the system will go where to practice their art? What country has more medical "freedom" than we do. Hmmm. Peru? Thailand. Check your passport, don't let the door hit you in the ass.

[Maxiesid]

Private insurance companies should not be part of healthcare at all. Trying to care for a person's health by tying it into making a profit is morally reprehensible, and fiscally irresponsible and should not be a part of this country's conversation on how to do reform. Medicare for all. That is all we should accept, nothing less, nothing 'creative' and certainly nothing that has been proposed by the insurance companies or their bought and paid for shills (in case that isn't clear- Max Bacaus comes in at the top of that list) .

[Virtual Deux]

I totally agree. The idea of an automobile type must have insurance does not by any means insure that folks will have coverage. The idea that insurance companies will still be able to adjust premiums does nothing to control cost. The concept that government run healthcare must fall is mistaken, and the idea that the cost is to much to do now, reprehensible.

One wonders where all the people who said the same exact things about WPA programs are now - and do they still believe it was wrong?

[johnashman]

Dr Toffel,

Would you look at my plan, which isn't entirely incompatible with yours -

http://64.203.97.61/SolutionsLab/Solution.aspx?Guid=2d50363e-00be-44e8-9251-9a6589ba820d

[rad21]

White House should negotiate with the Insurance companies. Insure all, no denial of coverage and permit portability. Immediate 30% reduction in premiums and another 20% reduction over next two years. Half the savings to come from Insurance and the other half from the delivery of care. This will reduce healthcare cost from 17% GDP to 11%; making American business competitive in the world. With such a deal, all sides should be on board to sign off on a bill. If the insurance companies do not deliver, the Public Option will deliver by 2012.

For insurance companies, the immediate reduction in premiums will be offset by the 47 million getting insured with govt / taxpayer help. The reduction in premiums costs will help American business and reduce govt subsidies to those who need help. The immediate benefit to the working Americans will be a bird-in-hand, if the insurance companies renege on bringing down healthcare costs.

[BBackSoon]

I don't hate this idea. I want to think about it but I don't hate it.

[rad21]

Healthcare is not a political issue. I hope politicians do not make it one. Many knowledgeable about healthcare, and make a living developing serious policy, can design a healthcare system. The problem, they have no time to waste, fighting the rotten money-greased politicians and their fellow travelers. Some of these border on being ignorant hacks or insurance company employees. The problem now, the insurance companies spend more time, money and human resources on rescission - eliminating policy-holders when they get sick, than on making sure / helping their policy holders get appropriate care, using a system of social workers and nurse-counselors.

Congress (Democrats and Republicans together) can pass laws making healthcare mandatory; thus bringing everybody into the insurance pool, eliminating cost-shifting and making healthcare and its cost cheaper for all.

[sheila]

1. Medicare for all.

done. thanks.

[johnashman]

1A. Bankruptcy for all.

done. thanks.

[BBackSoon]

Already well on my way. Thanks.

[BBackSoon]

I think your suggestions make sense but there is something about them that I don’t trust. The problem is the fact that the Max Baucus plan was written by an insurance industry insider. Now that in itself is not enough to disqualify it, but you must admit that when someone is on the inside they rarely do things simply because they are good for the average person. They may be good for the bottom line or the Executive Board but rarely good for the populous.

I also find it impossible to believe that just because we open the state markets to all the various players that they will not simply collude to keep health care premiums and costs high so they all continue to make massive profits. They have been gouging us for the last 6 or 8 years and cannot be trusted to sit by quietly and let the ‘Market’ set their price.

What exactly is ‘limiting their fees to administration only’? Would that still include massive payment packages to executives? And that in itself is encouraging the massive size and complexity of these Giant Companies.

And what about the practices of denying claims and kicking people out of programs? Your simple plan has holes that one could drive an ambulance thru. And guess who gets to pay for that?