My version of Health-Care Reform

March 22, 2010

Okay, I’ve read the bullet points of the reform package. If I had to put together a package of reform measures, what would it include? Here’s my take:

1. Everyone has to be insured. Rationale: The only way to control spiraling costs is to spread the totals over a larger pool. That’s simple economics. I know, I know, you don’t want the government telling you what to do. I don’t either. So, play it this way: pay for insurance (reasonably-priced), or opt out of the health care system entirely. No more having your cake and eating it, too, in other words. The emergency department would not be required to see someone who has refused to participate in a health plan, for example.

2. Costs need to be capped at no more than 25% of a household’s income for insurance.

3. Expand Medicaid immediately to assist those who lost their jobs and insurance so that continuity of care is ensured. Or have a subsidy kick in to cover the cost of continuing one’s previous insurance.

4. Cap medical malpractice lawsuits and settlements. Malpractice insurance is a huge drain in physician income.

5. Work to foster a “this will save money…” atmosphere in health-care places of employment. This is a big one: All too often practitioners of healing arts simply shrug and say, “It’s okay, we’ll charge it to insurance…” No wonder costs have skyrocketed. It also goes to overall price schedules as well. As mentioned in my previous entry, an ECG now runs about $2000 in the ED. For what reason? No, make the cost of a service equal to what it’s worth. A technology older than I am really doesn’t warrant a price tag higher than my used truck. Let’s say the machine costs $25,000. Out of that, say it is good for approximately 2,000 ECGs. That means the cost of the machine is $12.50 per ECG over the life of the machine. So, the hospital needs to make money, to pay for salaries, upkeep of the machine, etc. So let’s set a price of about $400 per ECG. The machine is paid for, Cardiac Tech’s salary is paid for, and the cost to read it by the doc is paid for. Or have the doc bill it separately and use the extra funds to pay for newer technologies and/or equipment. But through the roof pricing “just because they can” has no place in this post-market crash economy.

6. This may bite, but require recipients of Medicare and Medicaid to submit to drug testing, and revoke their standing if they fail the tests. I’m serious. There are legitimate needs out there, and someone who isn’t working because they choose to sit around and get high isn’t my problem. And I choose to make sure it STAYS “not my problem.” I know there are those who have been addicted and who struggle to stay clean and sober. Fine, I’m all for helping honest efforts to improve. But the ones who draw public funds (Medicaid and/or Medicare) and who are using what little money they have to buy illegal drugs have lost my sympathy. Make random drugs tests part of the process. I have the feeling a large number would drop from the rolls.

7. Provide cost breaks to those who make an effort to improve their health.  If you participate in a gym or weight-loss regimen, get a discount for doing so.  Provide card-swipe locations at popular trails or other types of proof of one’s working out and exercise regimen.   Assume all insureds smoke, drink and weigh too much from the outset, then provide discounts to those who can be verified to be making a solid effort towards health-care maintenance.

8. Include dental care as a regular health-care issue, not as a cheap add-on. Really, 50% coverage? The costs of dental care are also skyrocketing. Why not 80/20 like most other insurance plans? Same for vision and hearing. Hearing is especially important to me. (I’m nearly deaf). Why do the blind get money for being blind, but the deaf do not? I’m not begging for money, but from a health-insurance standpoint, it would help things a lot to have coverage for hearing issues as well as vision.

9. Those on disability automatically qualify for Medicaid. I found this out in my disability search. In NC, an individual like myself must be disabled to qualify for Medicaid. However, in my case and most others, I still won’t get it. Why? I’ll make just a few dollars more than the maximum allowed to receive Medicaid, even though I would be on disability like they require. Mind boggling, isn’t it? I fail to see why someone who makes 1002.00 per month on disability is ineligible while the person who makes 903.00 or less is eligible. The drug prices alone for meds I require cost nearly $400.00. That means I net around $500. Not even enough to make a house payment or apartment rental. Not only do they want me in poverty, but they want me in abject poverty, getting my food from food banks, my housing from Section 8 housing, utilities under a special arrangement with the utility companies, etc. No, that’s not what any person would want. And why am I, being male, discriminated against when others who are female are given whatever they ask for? I get kids are important. I have one, thank you very much. But what does my son have to do with my own health situation?  Not a darn thing, unless you count the effect of being a dad on my stress level.  No, no more discrimination of males and childless people in the health-care game.  It’s based on my needs and my health situation, as well as income, not on my sex or child status. 

For better or worse, that’s my take on it. Comments welcome.

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