Archive for category Health Care System Design

Healthcare Standstill — poor prognosis

So, what’s the problem with US healthcare?  What’s the fix?  What’s the medication for the ailing health system?

Start over.  Begin again.  Throw out the mess.

Usually, complicated problems are solved incrementally by finding each small problem and fixing each one until the huge problem is resolved.  This approach has failed healthcare in the United States.  The evidence is overwhelming.

  • rising cost
  • declining health
  • inability to train enough workers
  • high infant mortality
  • inability to control drug costs
  • focus on cost instead of health
  • fragmented improvement efforts

THE UNDERLYING PROBLEM IS THE US DOES NOT HAVE A HEALTHCARE SYSTEM:  NO SYSTEM TO CORRECT, NO SYSTEM TO MEASURE, NO GOALS TO MEET, NOBODY WHO IS ACCOUNTABLE.

The measure of a healthcare system is an average.  It’s not whether one guy is cured from leukemia but whether the average baby survives, the average citizen can get a doctor appointment, can purchase medications, and can have surgery if needed.

Sadly, if you are a legislator every problem looks like a financial problem — you can pay more or pay less.  You tried the first option so now you want to try the second option.

Supply and demand economics does work  But, it just has to be applied the correct way.  If the salary paid to a lawmaker is dependent on improving health in the country then the economic theory would work fine.  It does not work fine when complicated treatments are marketed to a population with low health literacy (and that includes the President and Congress past and present).

The reason Medicare-for-all seems so appealing is because it is a system.  Perhaps it’s not as good as the systems in other countries, but it’s the system we know.  It’s time to stop complaining about cost and complexity.  DO SOMETHING and KEEP IT SIMPLE.

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A Design For American Health Care

ahc_logo2What an opportunity!  A design for American Health Care that is badly needed, a blank slate, an open door, a blank check.  So what blogger could resist the obvious invitation.  First is the logo — I hope you like it.  No more Medicare, Medicaid, Indian Health Service, Veterans Administration, Blue Cross or United Health.

Who gets AHC?  Well, every US citizen.

How much does it cost?   The annual out of pocket cost is limited to just $1000.

Is there any paper work?  NO.  No paperwork, no bills, no EOB, and no insurance claims.

What do you need for healthcare?  Just your AHC card.

What is the price list?

  • Office visits:  $25
  • ER visits $50
  • Thirty day prescription $10
  • Surgery  $100
  • Hospitalization $200
  • Medical equipment $75
  • Medical devices $75
  • Ambulance $100

What is the national healthcare budget?  It’s set by congress.  Initially budget neutral at three trillion dollars (or whatever budget neutral at this time).

Where does the money come from?  Taxes.  Instead of insurance premiums it’s included in your taxes.

Do insurance companies go out of business?  No.  They process claims from healthcare providers, pharmacies, hospitals etc.  The person getting healthcare does not need to be involved with all the paperwork.

What government agency runs the program?  Medicare, under the AHC name.  Providers bill the claims processor and AHC pays the processor.

Is great American health research affected?  No.  This is a health care system.  Research is not health care and is outside the system.

Can people obtain health services, like for cosmetic surgery?  Sure.  Any services you want to purchase yourself outside AHC is fine.  But, you still pay the same taxes.  AHC does not pay for private care.

Are the States excluded?  No.  The States are responsible for managing AHC in their States.  The Federal Government sets the standards for the country.  The States make it happen.

Why would national costs be lower?  Because America as a country negotiates prices and because cost would be capped by the congressional budget for care.  The cost would be the same the first year.  Waste is a major problem — with better management of a system waste can be addressed.  Since about one half of US healthcare cost is consumed by waste there is lots of room for improvement.

What about poor people?  The deductible would be lower than $1000 — but because the deductible is low to begin with not many would need this help.

Now would be a good time for the applause.  Your humble blogger thanks you.

 

 

 

 

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