Healthcare - When I rule the world. ;-)
Feb. 19th, 2004
10:26 pm - Healthcare
When I rule the world:
This is my take on universal health insurance. People want to sleep easy at night knowing that they are covered. The current problems with health care are getting covered, staying covered, and paying for it. The reason why it hasn't work yet ala Bill Clinton is that it is too expensive for the federal government to do without charging more in taxes. In most other countries that socialize the health care system results in doctors not being paid enough and patients not receiving the care that they need. Since the government would set the price for say what they will pay for a doctors visit, if the price is over the fair market value (unlikely) there would be a surplus of doctors. If the price is under the fair market value (likely) then there would be a shortage of doctor time. This is what you see in Canada with very long wait times for doctors. It used to be that a doctor would have fewer patients and would even have time to do house calls. The other big problem with our current system is mal practice insurance, good doctors are being forced out of some specialties because they cannot charge enough to pay for it. The reason why mal-practice insurance is high is that patients are being awarded high amounts (whether they deserve it or not) in the court room.
To keep down the cost of mal practice insurance, what we need is binding arbitration. I propose a 5 person panel, two doctors, two non-medical people, and a judge to evaluate the merits of each case. If they decide in favor of the patient, they decide the punishment for the offending doctor and the mollifying amount for the patient. Simple, it doesn't involve juries, or to a big extent lawyers and it doesn't cost nearly as much as a jury trial. Since they would be professional arbitrators they wouldn't be swayed by the emotion of the case or the snow job a lawyer might present. To make sure that it would be fair each side would have 1 appeal, it would be before another 5 member panel. However, an appeal would only be allowed however is the decision against them wasn't unanimous. This system would probably cut the cost of mal practice insurance down to a fifth of current rates.
The Next problem is that currently there are people who are uninsured. This I find unacceptable. However mandating that every one is covered by a government sponsored program is wrong as well. I believe that the government should make two mandates for insurance companies; one is that an insurance company cannot deny a person based upon anything other than their ability to pay (they may not do a credit check, just use a prepayment system), two an insurance company must charge the same amount for every person they insure (no discounts), third they must provide insurance for a certain percentage who legitimately can't pay or are children. This will spread the burden of the really sick and poor across all clients in a more efficient matter than the government taxing and subsidizing. Since all insurance companies would not be allowed to turn anyone down they would be forced to cut costs, such as with prescriptions. To help out the insurance company's pay for it, employers must continue to cover their agreed upon share of coverage for any no-fault employee layoff until the employee has found another job or is otherwise able to pay. This will do two things one is it will encourage employers not to layoff employees and when they do it will encourage them to help the laid-off employee find another job. If there insurance company doesn't honor claims then the patient could go back through the 5 person panel as mentioned in the mal practice section above.
The next main issue is that of prescription drugs. The two main problems are the advertising of drugs and the drug patent system. The advertising of drugs to the general public is irresponsible. The pharmaceutical companies should not be allowed to advertise prescription drugs in non medical specific journals. This will keep them from causing hypochondriacs to bully their doctor into prescribing the advertised drugs, when there maybe more effective medication out there (such as the placebo). The other problem is the drug patent system. Drug patents should be reduced from 20 years down to 7 years. Also drugs that are created with public money should be public domain. This should help scientists recover their altruism. The other change I would make is to allow insurance companies to do collective bargaining when it comes to buying prescription drugs (but not colluding to set prices for clients).
This system would effectively disband Medicare. Since the elderly would be paying the same amount as the young, the insurance could have to spread their costs across the whole of the population in a more efficient manner than we currently do by taxing and subsidizing. As for those individuals who can pay, but choose not to, they get what they pay for. This doesn't of course count for children, children are automatically covered whether their parents pay or not.
I believe that capitalism makes the most efficient use of resources. And except for some modifications to promote welfare or competition it doesn't need the government setting prices. Following the system outlined above and letting the free market run within these constraints, will give everyone access to health care and lower the cost for everyone.
What does everyone think?
[ Edited on February 21 at 04:09 PM. ]