@fatman Said
First, let me say that I have no sympathy for insurance companies, public, private, or otherwise. I frankly believe the world would be better off without insurance for profit. It is common sense. If you profit from fear of misery and misfortune, you are highly motivated to generate as much fear of misery and misfortune as possible. No good can come of that. It is not the fear if illness and death that plagues Americans, it is the fear of the cost of combating illness and death that does so. Health insurance companies contribute nothing but the illusion of respite from that fear. The cost of that illusion is beyond the dreams of avarice.
The so-called public option is no better. Insurance executives are not stupid. After all, they are able to convince almost all of us to give them money based solely on the fact they have more money than we do in the first place. As s matter of fact, the insurance industry depends on cost being beyond the policy holder?s ability to pay. I fear, therefore, that a public option would simply become a ?dumping ground? for high- risk, and low profit customers. It would be a way for the insurance companies to weed out unprofitable and therefore highly undesirable policy holders, pass that cost to the taxpayer, and profit from the remainder. Business as usual.
It would have the effect of government protecting insurance company profit interests. The insurance companies would continue to succeed in their mandate of profit, while the government would fail in its mandate to hold those profits accountable to the interests of the People. I am convinced a public insurance ?option? would inevitably translate as ?po?folk?s only option? and further erode the sacred and elusive equity we seek through reform.
Not one to criticize without offering alternatives, here is mine: As background, I submit that government working in cooperation and concert with business at any time is a conflict of interest. The role of government is to protect the individual from the ?collateral damage? generated by highly motivated and skilled profiteers. Beyond that, there should be as few restrictions on business as possible. They cannot do that if their economic interests are common with the entity they are tasked with controlling. Separation and balance of power, such as the constitution provides for government itself is called for, and should be the model. Unless this happens first and is accepted by government as a mandate and a value, all attempts at reform in any arena will be futile.
Business has the right and responsibility to generate profit through any means available within the law. It has nor should it have any other concerns or obligations. Government has the right and the responsibility to legislate controls of said business to ensure that the direct profit interests of business are indirectly in the interests of the People. Attempts to accomplish this goal already exist in the tax structure. Control of the individual is accomplished by virtually every piece of legislation ever written. Legislation is the reason I do not make my living by hitting people over the head, and taking their wallets. I submit business should be subject to the same limitations under the law as I am. At present, they are not.
Further as background, the current health care fiasco is a matter of using the wrong tool for the job. Health care costs are not an insurance issue in the first place. It is absurd to imagine that a company who can foot the bill to restore or replace my car or my house destroyed by disaster can also foot the bill to restore or replace my health, lost a little at a time through the natural ravages of time. It is also a process that will ultimately fail. Why insurance companies are interested in underwriting an endeavor that must ultimately fail is beyond me. The maintenance of my health is a continuous ongoing process, involving associated costs. As those costs at present far outstrip my means to pay them, the problem is one of money management. I don?t know about you, but if I encounter a money management issue, I don?t call an insurance agent. I call a money manager.
I don?t like managers very much either, but in comparison to insurance agents, they are better equipped and trained to manage what has become the biggest money management problem in our nation?s history. All that is needed is a way to generate the money for them to manage. I submit that that the nation?s bills must be paid by the nation, and that the health of each American is the concern of every American. That is why the first question out of our mouths when we greet friend or stranger is invariably ?How are you?? I further submit that the money paid in those bills must go to those who do the work, not some middle man who actually contributes nothing substantial to the health care process. I therefore propose:
1. Legislate a ban on health insurance based on actuary tables and premiums on December 31st2013, at which time this plan will be implemented.
2. Require any and all companies and independent providers in the health care industry to register as such on a federal registry of healthcare professionals.
3. Provide base tax incentives for registration, and federally legislate the providing of unregistered health care services or material to any entity as a criminal offence.
4. Legislate that any American person or self-identified entity in the United States receiving money from any source will pay into a federal fund a percentage of a total amount commensurate with the amount of money they receive.
5. Mandate that the fund total will be the total amount of the previous year?s total national health care cost, plus or minus the general inflation rate, plus a maximum of 7%.
6. Only a majority vote of the governors of the fifty two states and territories can arbitrarily increase the fund?s requirements within that 7%. Any governor can call for such a vote, but to do so must provide a specific increase percentage. If more than one governor calls for an increase, the increase will be the average of the specified percentage by each governor.
7. Such calls for a vote must be within five business days of the year?s funding deadline. State legislators may mandate the conditions under which state governors can call for a vote, but may not force a governor to call for a vote.
8. Allocate those funds to the individual states in an amount based solely on population. State legislators can increase the fund amount for their individual states through legislation, and collect and add it to their state?s specific fund, but under no circumstances can they decrease that amount, or divert it to other purposes.
9. Mandate that each state hire an independent accounting firm to administer the fund, for a flat contract fee, under their state?s bidding process.
10. Federally mandate that all states pay all medical fees of their legal residents as billed from the fund.
11. If any state has a fund shortfall in a calendar year, the federal government will make up the shortfall
12. If that shortfall exceeds 2% of the total year?s fund, all nationally registered health care providers will pay an excise tax based on their percentage of the industry?s total profits to repay the shortfall in each state. If the shortfall is less than or equal to 2% of the repayment will come from the following year?s fund allocation of the specific state.
13. Eliminate Medicare, Medicaid, and any other federally funded health care agencies, except for the VA and the CDC on December 31st 2012. These institutions are already funded and to a greater or lesser extent work. The general health care system does not. Use the funds of these agencies to supplement the first year?s fund.
14. Any person with a social security number can then go to any doctor, hospital, dentist, or any other registered health care provider, and receive care and prescription medications without paying for anything out of pocket other than across the counter medications. .
15. Eliminate malpractice laws. They are redundant. Negligence and wrongful death are the same whether they are committed by your doctor, your barber, or your piano tuner. Less money changing hands and more jail time for grossly negligent offenders will eliminate many of the horror stories on both sides of the issue. Further, any care you may need in the future will be provided through the system, so the only case in point for such litigation is for punitive damages. Without the specter of open ended future health care costs for the plaintiff, and without the ?magic word? malpractice, juries will be less inclined to award outrageous penalties.
16. Allow any provider at any time to work outside the system, for any amount they can receive. This will ensure the super-rich will still be able to find a doctor greedy enough to be on call twenty four hours a day, and kill them graveyard dead with a powerful anesthetic on request.
Such a system would be expensive. Any system including the current de-facto fiasco is equally expensive. I am convinced that this system will in time reduce costs as the health care industry will provide direct services at the point of sale just as any other industry. So far as the daily interaction between providers and patients are concerned, the system is essentially transparent. The only differences the patients will notice are less uncertainty and less complication. The only difference the providers will notice is a drastic reduction in administrative costs, and the fact that they actually get paid for their services
By giving state governors limited control over a specific year?s funding, the lobbying efforts of special interests would have to involve a campaign across at least twenty six states, and concentrated on elected officials who do not necessarily have a dog in the Washington fight.
The system holds the healthcare industry accountable for cost increases, just as any other industry. Professional associations, stockholders boards, and institutional financial boards would be highly motivated to encourage their members to consider cost increases in the care they provide. It would soon become obvious that reform within the industry will depend on their cooperation and the adoption of industry standards, again just as any other industry. It would fall to those institutions to coordinate cost control efforts within their memberships, or collectively suffer the consequences. It is appropriate, as they are also the ones to collectively benefit from profit. Other industries will notice that that their health care costs are no longer tied to the number of people they employ, but rather on their accounts receivable. This will be passed along to consumers as a cost of doing business just as any other cost. In time this will actually cost them less. It will immediately give relief for the nearly insurmountable burden healthcare costs put on business during business downturns. As all industries pay their percentage equally, the health care responsibility of American industry will at last fall on a level playing field. Small employers will be able to recruit and retain talent competitively with large employers, who at present have an extreme advantage in their ability to provide health care benefits.
?Trickle down? does not work. ?Trickle up? has never been tried, but I suspect it won?t work either for the same reasons trickle down does not. This system relies on a lateral ripple effect, with legislation as the catalyst, and cost history as controls. The insurance industry relies on ever-increasing medical costs to make their products viable and marketable. As long as they are involved in the process, costs will never come down. A medical insurance company?s worst nightmare is the day when nobody needs or buys their product. They will use all means at their disposal to see to it that day never comes.
Under this system, health care providers will succeed or fail based solely on the quality and availability of their care. If the quality of care is poor, people simply will not show up, and the provider will be less successful. If too many show up, the availability of care will suffer, and many patients will go elsewhere for treatment. On the other hand if the provider is a good organizer and worth the wait, he or she could be wildly successful. How well the industry as a whole succeeds is based on both quality of care, and how well they hold down costs. Within the healthcare industry, it will all be about doing what it takes to get the largest slice of the fund pie as possible, without paying an excise tax that eats it all up. The health care industry will be the only industry competing for that slice.
Medical tort reform should consist of playing by the rules already in place, and eliminating redundant legislation. I am amazed that no doctor has challenged a malpractice decision on constitutional grounds, claiming double jeopardy and discrimination on the basis of his profession. I am no lawyer, but I think I could present a pretty convincing case on his behalf
Well, that?s it in a nut shell: It?s time we take care of each other because it is the right thing to do, and support businesses great and small because it is the American thing to do. Often I speak, and am not heard. Often I write, and am not read. Yet I speak and write here today, and respectfully request your consideration. I challenge you to meditate on these things as you consider legislation.