Healthcare Reform: Nine Must-Have Components of Real Healthcare Reform
Posted: Tuesday, February 16, 2010
by Mogama
http://www.mogama.info
Do the masses believe that health care reform is dead and gone? Not me... Any ordinary American who has first-hand experience of our health delivery system knows that changes are way overdue. Like my friend who on average has been hospitalized for a week every month for the past five months or so. He told me that his medical bills average $10,000 per visit/week spent in the hospital. He knows the system is screwed up. Only those who live in a bubble wish to leave things as they are.
IMHO, health care reform that deserves the name must have the following nine components:
1. Cost Control . I shared in a previous article that our family's premium rose 20% within five years, and a friend's premium skyrocketed nearly 100% in three years. The cost of health care must not be exclusively profit-driven. There has to be a maximum amount per doctor visit or medical procedure. You know, like a restaurant's menu that shows the prices? Another way to control cost is to tie health care premium to one's ability to pay. Take 4% of income as one's share of health insurance premium: then one who earns $50,000 per year pays a $2,000 annual health care premium, while a $25,000-per-year earner pays $1,000. Want additional coverage? Simple: Just pay for that.
2. Portability . Every employee should be able to move his/her health insurance from company X to company Y. If as a Wal-Mart employee, Harriet is paying a $1500 annual premium, and she's pleased with her health care plan, she should be free to work for K-Mart without starting from scratch for a new health care deal.
3. Coverage for All Legal Residents . Yes, individuals should be required to buy health insurance. Why? Because illness is more certain than accidents: Except for New Hampshire and Wisconsin, every American state requires every driver to buy liability insurance. Why not require the same for health insurance?
4. No Denial for Pre-Existing Condition . It is sickening for such a generous society as America to deny health care to those who really need it. It should be as simple to insure one with cancer as it is to insure a disease-free teenager. Common sense says the sickest should be put ahead of the health insurance cue, not barred from even standing in line.
5. Can't be Dropped because You're Too Sickly . The new rules must prevent insurance companies from dumping people because they're frequently sick. Is dropping the sick from coverage not the same as the insurance companies acting like "death panels" to decide who die now or later? Within the risk factor of the insurance concept, the high cost of insuring the frequently sick will be more than offset by the low cost of insuring the hardly sick, since the number of too-sickly people is much lower than the number of healthy people.
6. Plan to Save Medicare . It's an oxymoron for the nation to reform healthcare over the grave of Medicare, unless our leaders can find a way to include Medicare-like services within a new healthcare system.
7. Public Option . We've heard the tired old argument that a govern-run health program will ruin America's health care industry. What sense does it make to say that an economy built on competition will be threatened by greater competition? Are we to believe that private health care providers will roll over and allow the government to stop them from making profits? What a joke! Look, public schools have not yet bankrupted private schools. Or shall we say FedEx and UPS are about to shut down because of the unfair advantage from that "public option" known as the US Postal Service?
8. Cap on Medical Malpractice Liability . There must be a limit on malpractice lawsuit, if the goal of health care reform is the health of patients, not the wealth of prosecutors. Some experts estimate that malpractice reform could save $54 billion dollars that could go towards providing health care instead of stuffing lawyers' bank accounts. Just like doctors and insurance companies must not be allowed to charge whatever they want, those who sue them must not be given whatever amount they desire. When that happens, doctors and insurance companies simply pass the cost of lawsuits down to us.
9. Performance Pay for Doctors. Why shouldn't doctors be paid based on result? Why should medical practitioners be paid for their training and time only? Like most other professionals, doctors need to earn their hefty compensations. Does it make any sense to pay the doctor when his surgery fails to achieve any medical benefit for the patient? In some cases, when his treatment worsens the condition of the patient?
This simple rule works with most service providers in our economy. Few months ago, I took my car to Raben Tires and paid for a new set of tires. In less than one month, the two front tires were leaking air constantly. I drove back to Raben Tires, and they fixed my tires without charge. If those guys had been my doctor or hospital, I'd be charged every time I return for the same problem.
BTW, did I read somewhere that doctors in India tie their pay to their performance? Now, that's real accountability for doctors.
1. Cost Control . I shared in a previous article that our family's premium rose 20% within five years, and a friend's premium skyrocketed nearly 100% in three years. The cost of health care must not be exclusively profit-driven. There has to be a maximum amount per doctor visit or medical procedure. You know, like a restaurant's menu that shows the prices? Another way to control cost is to tie health care premium to one's ability to pay. Take 4% of income as one's share of health insurance premium: then one who earns $50,000 per year pays a $2,000 annual health care premium, while a $25,000-per-year earner pays $1,000. Want additional coverage? Simple: Just pay for that.
2. Portability . Every employee should be able to move his/her health insurance from company X to company Y. If as a Wal-Mart employee, Harriet is paying a $1500 annual premium, and she's pleased with her health care plan, she should be free to work for K-Mart without starting from scratch for a new health care deal.
3. Coverage for All Legal Residents . Yes, individuals should be required to buy health insurance. Why? Because illness is more certain than accidents: Except for New Hampshire and Wisconsin, every American state requires every driver to buy liability insurance. Why not require the same for health insurance?
4. No Denial for Pre-Existing Condition . It is sickening for such a generous society as America to deny health care to those who really need it. It should be as simple to insure one with cancer as it is to insure a disease-free teenager. Common sense says the sickest should be put ahead of the health insurance cue, not barred from even standing in line.
5. Can't be Dropped because You're Too Sickly . The new rules must prevent insurance companies from dumping people because they're frequently sick. Is dropping the sick from coverage not the same as the insurance companies acting like "death panels" to decide who die now or later? Within the risk factor of the insurance concept, the high cost of insuring the frequently sick will be more than offset by the low cost of insuring the hardly sick, since the number of too-sickly people is much lower than the number of healthy people.
6. Plan to Save Medicare . It's an oxymoron for the nation to reform healthcare over the grave of Medicare, unless our leaders can find a way to include Medicare-like services within a new healthcare system.
7. Public Option . We've heard the tired old argument that a govern-run health program will ruin America's health care industry. What sense does it make to say that an economy built on competition will be threatened by greater competition? Are we to believe that private health care providers will roll over and allow the government to stop them from making profits? What a joke! Look, public schools have not yet bankrupted private schools. Or shall we say FedEx and UPS are about to shut down because of the unfair advantage from that "public option" known as the US Postal Service?
8. Cap on Medical Malpractice Liability . There must be a limit on malpractice lawsuit, if the goal of health care reform is the health of patients, not the wealth of prosecutors. Some experts estimate that malpractice reform could save $54 billion dollars that could go towards providing health care instead of stuffing lawyers' bank accounts. Just like doctors and insurance companies must not be allowed to charge whatever they want, those who sue them must not be given whatever amount they desire. When that happens, doctors and insurance companies simply pass the cost of lawsuits down to us.
9. Performance Pay for Doctors. Why shouldn't doctors be paid based on result? Why should medical practitioners be paid for their training and time only? Like most other professionals, doctors need to earn their hefty compensations. Does it make any sense to pay the doctor when his surgery fails to achieve any medical benefit for the patient? In some cases, when his treatment worsens the condition of the patient?
This simple rule works with most service providers in our economy. Few months ago, I took my car to Raben Tires and paid for a new set of tires. In less than one month, the two front tires were leaking air constantly. I drove back to Raben Tires, and they fixed my tires without charge. If those guys had been my doctor or hospital, I'd be charged every time I return for the same problem.
BTW, did I read somewhere that doctors in India tie their pay to their performance? Now, that's real accountability for doctors.
This Article has been viewed 1,462 times. (Not updated in real-time.)
More commentsVery informative, insightful article. I agree with some of your points and some I don't but the one thing we do agree on is the need for health care reform.Please log in to respond to this comment.Good to hear from you, Linda. Hope you're warmer over there than we are here in Kentucky, still swamped by snow and cold.My article contains elements of health care reform that conservatives and liberals have trouble with. But I think we need all of these components for health care reform to benefit everyone across ideological lines. We won't get meaningful reform as long as conservatives reject everything that liberals want, and liberals return the partisan favor. ~mogama~Please log in to respond to this comment.
I think I agree with pretty much all your points there, although ideally I'd like to see reforms go further and result in the creation of a fully "socialised" heath care system of the sort common in Europe (with private options on top of that). The evidence is clear - such systems work better, and are cheaper. Win win!I agree with performance-related pay for doctors, but I don't fully agree with you when you say " Does it make any sense to pay the doctor when his surgery fails to achieve any medical benefit for the patient? In some cases, when his treatment worsens the condition of the patient?" because a lot of medicine / surgery is about risk, and that kind of approach would make surgeons unwilling to work on high-risk patients where there was a high chance the surgery might not give any benefit (but a small chance of saving them or greatly increasing their quality of life for example).There'd need to be some additional regulation to ensure that risk is accounted for, but the overall goal of fair, performance-related pay is a noble one.Please log in to respond to this comment.Yes, Ben, I see the problem you point out regarding performance pay for doctors. I just think that something needs to change about how doctors get paid just about whatever price they name, regardless of the quality or effect of their service. Example: a gynecologist almost killed my wife, yet his pay was never affected by his blunder; the only way we could have held him accountable was to sue, which we did not do but probably should have done. ~mogama~Please log in to respond to this comment.
We are in agreement on a lot of your points - well thought out article and well written - thanks. Yes, something needs to be done.Please log in to respond to this comment.Yes, Marijo, there's no way we'll agree on all points when it comes to these political hot potatoes. Thanks for your friendly comment. ~mogama~Please log in to respond to this comment.
Mogama, you have some interesting thoughts on the subject. I especially like items 2, 4, 5, and 8.Please log in to respond to this comment.Hi there, Terry. Good to know we agree nearly 50% on these items. Thanks for reading. ~mogama~Please log in to respond to this comment.
Great article as always my friend. In a word, we need complete socialized medicine . . . period. It will eventually come to that when costs prohibit mainstream America from health care, and seniors go without. What a travesty.
Best........ePlease log in to respond to this comment.Thanks, Raymond, for reading. "...we need complete socialized medicine . . . period." I'm not sold on that, because of some of the nightmarish things I've heard/read about people with socialized medicine. My trust in government to run the entire health care industry is certainly not that strong. ~mogama~Please log in to respond to this comment.
You are all beautiful people, and I hope all Americans eventually receive the dignity they deserve from our health care delivery system, as you all speak of.But don't hold your breath until it happens!Unfortunately we already have performance pay for our legislators in the form of corporate campaign donations. This is why we do not have, nor will have, any substantial movement in this area for a long time to come. Is it any wonder how even people on government run heath care services now, can rail against this initiative, simply to support a particular dogma, even though it's against their own personal interests. Or how supportive legislators can just up and resign, as a protest against how the system isn't working, just days before his vote could actually help change things. Hmm?I'm sorry to ramble, I just feel the pain of all the victims of this current delivery system, and sometimes get carried away. You can thank Mr.Mogamas' bringing up the subject for that! Anyway people, we are talking about redirecting a considerable amount of profit in this economy, so good luck with that!Please log in to respond to this comment.I understand, David, why you are cynically doubtful about real health care reform. Our legislators have not given us reason to expect meaningful change in how health care is bought and sold in America. ~mogama~Please log in to respond to this comment.
"Only those who live in a bubble wish to leave things as they are."As one outside the bubble... I could not have said it better. Brilliant article. You, I would vote for.Please log in to respond to this comment.Thanks, Jean, for your encouraging words. As for the one "vote", let me consult with my family on our next vacation (which is like once a decade) to see if running for Congress is in our future. ~mogama~Please log in to respond to this comment.
Great article and well written if only people heeded to such things !!!!Please log in to respond to this comment.Hi, Ravi. Thanks for reading. I notice you live in India. Is it true that doctors in India get paid based on results? ~mogama~Please log in to respond to this comment.
Do you know my question ?America with all their talk about been big brother, healping people around the world? why don't they help their own people by giving everyone a free health care. when I hear how my sisters are paying so much for health insurance it hurts my stomach. what surprised me evenmore is that pastors are against free health care.where is the godlyness when we can't give health care to the poor man.Please log in to respond to this comment.You ask some very important questions, Regina. Let me quote you, "what surprised me even more is that pastors are against free health care." I can't figure out where their heart is myself. ~mogama~Please log in to respond to this comment.
This seems so straightforward to me. So why are people choosing not to understand this?Please log in to respond to this comment.Politics and special interest money, Zhana, that's why people are "choosing not to understand this". ~mogama~Please log in to respond to this comment.
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