Health Care Common Sense

Throw out the garbage being spewed by the White House and congress. There are some fairly simple and inexpensive solutions which would vastly improve our health care delivery system and dramatically reduce costs. Lets remember, world leaders and the wealthy elite come from all over the world for treatment in America. Health care in America is second to none. It is the delivery system that is broken, not the quality of our health care.

1. Tort reform. Place a limit on tort claim awards and corresponding attorney's fees. Cap awards at $250,000 and limit attorney's fee awards to 10 - 12%. People like John Edwards milk the system and become fabulously wealthy, but each of us pays that cost in higher insurance premiums, higher medical costs and the ordering of unnecessary or superfluous testing for even the most common of medical problems. Doctors feel like if they don't order every possible medical test, no matter how obscure, even though the likelihood of finding any negative results are perhaps miniscule, some trial lawyer will ruin them in that unlikely event. Doctors are human and miss things too. Medical malpractice exists and those tort claims should be prosecuted like any other tort. But for a neurosurgeon to have to pay $200,000/year in malpractice insurance coverage is absurd. The standard for testing and evaluation of various conditions should be medical reasonableness, not the remotest possibility of missing something. We would have more doctors willing and able to practice, and more free competition among doctors. Loosen medical school standards somewhat, so that we have more homegrown doctors, rather than those who complete less demanding programs in other countries.

2. Government provision of catastrophic coverage for everyone. This is what people fear most, that they won't be covered in such an event, but which event seldom occurs. This would eliminate the need for enormous malpractice awards, as the government provides necessary lifetime care. Government has the deep pockets to provide this coverage for all Americans, which when spread out over the entire population, would result in considerably less cost per person than the obscene numbers being provided to us as costs of Obamacare, as provided by the non-partisan Congressional Budget Office. Set a threshold level of future lifetime medical care and treatment, and anyone whose expenses exceed that amount becomes eligible for government assistance. The experts can flesh out the numbers, but it should not be a large actuarial challenge.

3. Convert emergency rooms to real emergency rooms. If you don't have a true medical emergency, head down the street to the urgent care. People have been gaming the emergency medical system in this country for decades, as they know that generally they cannot be turned away from an emergency room simply because they cannot pay, and they will go there for even the most minor of afflictions. Set up a triage system in every emergency room. In questionable cases, have a real doctor spend a few minutes with each patient right away to be able to quickly determine whether a true emergency exists. A sore throat is not an emergency. This will also greatly curtail cases of people dying in the waiting room as they await being seen. Those without emergencies should be denied treatment. They will have to find help and pay for it themselves, or through their own insurance or other resources. Gaming the emergency room system will no longer be possible. Initiate an E-verify system, so that medical providers can instantly check the immigration status of anyone seeking emergency care. True emergency cases can postpone the E-verify check pending true emergency treatment, but thereafter immigration status would have to be verified, if not, customs notification, and indemnification demand made to home country of immigrant.

4. Set federal standards for insurance coverage, eliminate State standards (most of which differ) through federal preemption. All insurance companies would offer similar coverages within federal guidelines, all would cover preexisting conditions, and all could compete nationwide. Additional coverage could be made available at additional cost to those desiring it - free market competition. This would include prescription coverage. All coverage would be freely transferable and portable. Employers can select standard or enhanced coverage for employees. If employee leaves that employment, he can select standard or enhanced at the same cost his employer paid. 

5. Amend current system such that ALL Americans, including federal employees, congressmen, senators, unions, etc., all have the exact same coverage options and access to medical care. That is fundamental fairness. You can be sure lawmakers will sing a different tune when their own family health care is at stake. They cannot approve any program they don't feel is appropriate for their own families. 

6. Initiate means testing for Medicare. There is no reason for the federal government to be responsible for the health care costs of all elderly, regardless of circumstances. As to Medicaid, set federal standards, preempting State regulation. Welfare and/or unemployment status would enable government subsidized health care in addition to existing benefits, on a par equal with minimum coverages offered privately to general citizenry. No more, no less. Those eligible and able to work would have to be seeking gainful employment, etc. 

Lets put the federal government in charge of things that make sense: Setting nationwide standards of coverage and care, handling catastrophic care, tort reform. Lets not get the government involved in health care decision making for individuals, or in maintaining electronic databases of our citizens' medical and financial records. Who in the bureaucracy has the right to determine if a senior or drastically ill person has a "duty to die."? This is America after all. 

The free market can sort out most of the problems if we eliminate arbitrary barriers to free competition. Government supervision and oversight of the health care system is not the answer. Government can, however, provide a healthy environment encouraging fair competition within the free market system, lowering costs and improving quality for everyone.