How can you argue about a reform plan when you don't even know what will be in it? And yet, town halls go on and on through the hot and lazy last days of summer.
So, as my father used to say, if you want something to cry about, I'll give you something (raised hand above my shrinking frame). Here are ten simple things we can do to reform health care.
- Make health insurance mandatory, but make coverage compulsory for insurers. The insurers can't survive if they don't have the healthy people on their rolls as well as the sick, and the healthy young people often opt out. (As it is, the rise of DNA testing is going to change the insurance industry as people use their DNA test results to decide whether or not to buy insurance and what kind to buy. In the future, without mandatory health insurance the system will collapse.)
- Make everyone pay something -- employers, employees, and the unemployed, but make the premiums reflect true costs. Medical care is expensive. Subsidize those who truly can't pay. Become tranparent about the costs of medical care.
- Regulate insurance companies like utilities, and do it nationally. Allow buyers to buy across state lines.
- Negotiate with drug companies nationally.
- Put a limit on jury awards and on legal fees in medical cases.
- Go back to the days of banning law firm and drug company advertising. We have created an artificial demand for drugs that treat overactive bladder and restless leg syndrome by re-defining annoyances as sicknesses and creating pills for them at great expense.
- Make computerization of medical records mandatory within a few years, and subsidize (i.e., tax credits) record conversion to get it done. Introduce uniform applications, medical records, and claims forms nationally, preferably open source.
- Increase the number of doctors and nurses by providing subsidies and tax benefits to both students and medical educational institutions. Provide some form of loan forgiveness for primary care docs , pediatricians and geriatricians. Not every doctor visit should be to a specialist.
- Put everyone under the same system. No separate deals for Congress, Federal and State employees, high paid executives, or special groups like retired railroad workers.
- Basic coverage for everyone, with 5 star benefits only for those who can pay. Not everyone can have a Cadillac.
I wish I had thought of all these. Some of them are mine, but the bulk of them come from a retired insurance industry exectutive.
Now go off and fight in your town halls.