There are a few of big considerations you have to take into account.
First is that health insurance companies are huge. Huge enough that they could probably create their own army and attack the government in a coup.
Second - we don't want the government taking over and slowing the health care industry down. It's slow enough.
Third - Prevention of diseases has to be a big part of this.
Fourth - Drug and health related research have to dealt with as well.
Fifth - The Doctors and Health care providers will be tough...If not tougher the insurance companies.
Sixth - Drug Companies....Something has to be done.
Seventh - Computerization of records and more fluid transfer of records from one health care provider.
I'm going to explain this quickly. It's a rather boring subject on the whole, so explaining it quickly will be the best for all of us.
First health insurance can be dealt with this way. We are a market economy, so why not let this work in our favor and utilize what is already set up.
People that are covered by a health insurance through work keep that insurance
People that are not insured at all. Whether they are jobless, homeless or just an independent business owner. You get the insurance companies together and you say we are going to offer this whole group of people to be covered together. The people in this pool are divied up without knowledge of class. Each person in that pool is examined and given a health risk from 1 to 5. 1 being Best health and 5 being Dire! Each of the insurance companies has to take the same number from each number. That way it is even.
After that everyone will have healthcare. The divied up people premiums are payed by the government if individuals are without work, homeless or with no means to pay an insurance premium. People that own there own self employeed would be able to pay a premium. That is the costly part at first.
Second we don't want the government taking over, but we also don't want insurance companies making all these exceptions, referrals and such.
So the government says that each insurance company......By the way in this system, there will be no independent insurance companies that work outside the system. They are either in or out. Any, the government sets a set of guidelines that every insurance company must follow. So that every insurance company has the same strict guidelines to adhere. There will not be choice. If they are to stay in business they must comply.
It will seem tough for them, but they will stay because there is a lot of money involved.
Third - We set up and require that people to manage their health. In particular the prevention of diseases is going to be paramount. People that
continue to smoke will not only have to pay more for cigarettes, but also have to pay something on their insurance. Anything that raises their risk, they must contribute what ever that access is. And there is no in or out for people either. They are in the pool. If they continue to drink and drug and need assistance from addiction specialist and hospitals, their rates will go up.
So, you say...How are the poor and the homeless going to pay. Well there will be none. A mission to be get every soul off the street. If they are jobless they will give jobs and places to live. Some of the jobs will be building these new places for people to live. People that are mentally challenged or have mental disorders will be set put in appropriate institutions. This is a wholly different topic I would like address at a different time.
Fourth - Also as part of this prevention effort, drug and health research will help offer grants to fund reseach and development for drugs. Incentives would
be based on the type of drug and the risk its development would help. This would help with the drug companies. Many drug companies complain that
drug prices are so high, because of the cost research and development. Not really true, because Canadian drug prices are far lower. It has more to do with the power we give drug companies in the United states and the cost of advertising these drugs.
Fifth - Doctors and Healthcare providers would have to adhere to the same things the insurance companies would have to do. They have to accept insurance
from every carrier and at set prices. Procedures would have set codes and prices across the board. No acceptions.
Sixth - Drug companies would have to come up with a cost analysis of every drug they produce to justify the price they charge. Whatever they put in they get
out with a 20% profit. Eventually this would be off set by the fact that the government would fund all research and development through the corporations so
that eventually the prices would fall.
Also companies such as Rite Aid, CVS, etc. would not be allowed to mark up the price of medicines to insane levels.
Finally I must say the one of the most important elements to this is that everyone is accountable. Including the patient.
I know there are probably huge gaping holes...I also don't have a staff of accountants to run numbers, but the cost the government puts into the system,
will eventually be returned.
I also think the risk assessment idea could be used to feed the starving people on our shores. Each person gets assigned a health risk number and
a corresponding food number that tracks the degree to which you stand. 1 being overweight and need of nutritional guidance to 5 malnurished. The hunger
number would assessed by each doctor and it be considered when re-evaluating your risk number.
Just some ideas....
........................................................................
JB had some great thoughts about the holes in my plan:
Each person in that pool is examined and
> given a health risk
> from 1 to 5. 1 being Best health and 5 being Dire!
> Each of the
> insurance companies
> has to take the same number from each number. That way it is even.
> After that everyone will have healthcare. The divied up people
> premiums are payed by the government. That is the costly part at
> first.
*** They are going to charge out outrageous amount to the government to take on the "Dire! 5" people. ***
Well the 1 through 5's would be distributed across the board evenly to all insurance companies.
>
> Second we don't want the government taking over, but we also don't
> want insurance companies making all these exceptions, referrals and
> such.
> So the government says that each insurance company......By the way in
> this system, there will be no independent insurance companies that
> work outside the system. They are either in or out.
> Any, the government
> sets a set of guidelines that every insurance company must follow. So
> that every insurance company has the same strict guidelines to adhere
> to.
> There will not be choice. If they are to stay in business they my
> comply.
> It will seem tough for them, but they will stay cause there is a lot
> of money involved.
>
> Third - We set up and require that people to manage their health. In
> particular the prevention of diseases is going to be paramount.
> People that continue to smoke will not only have to pay more for
> cigarettes, but also have to pay something on their insurance.
**So what about poor people who can't afford insurance in the first place? The government now has to pay their extra premium for smoking?***
I think homelessness and poverty can be dealt with more effectively as a problem in and of itself. It is a topic I plan to approach soon that I hope will answer this question more throughly.
> Anything that raises
> their risk,
> they must contribute what ever that access is. And there is no in or
> out for people either. They are in the pool. If they continue to
> drink and drug and need assistance from addiction specialist and
> hospitals, their rates will go up.
***Will this cause more people NOT to seek help due to their rates going up? Also, typically these are people who can't afford insurance in the first place, (i.e. they are drunk and have no job) so again does the govenment take over their extra premium costs?
And where do you draw the line on what constitutes something that your rates could get raised for?***
It just very well might, but may also increase the chance that these people will seek a clean and sober life. I've watched Intervention enough to know that people tend to take the plane to a treatment facility when they get cut off.
Prevention of addiction is a whole different topic that needs to be addressed though. These aren't people working 3 jobs just to keep food on the table and still have no health insurance.
Addicts are people that will live under a bridge to continue there habits. So addressing addiction and preventing addiction, just like the prevention of diseases would have to be paramount.
> So, you say...How are the poor and the homeless going to pay. Well
> there will be none. An mission to be get every soul off the street.
*** That would be nice but impractical. ***
If we took 1 tenth of the money we spent on the war in Iraq and put it toward getting people off the streets it wouldn't be so impractical. I think US policy has to be more egocentric. How can we cure the world's problems if we can't even cure our own.
If
> they are
> jobless they will give jobs and places to live.
*** They have a system like this in Jacksonville.
Some people just refuse to work. Some people refuse the free housing. In Jax, if you are homeless they give you a job, clothes, a place to live and food.
Yet there are still TONS of homeless people. They are given everything they need to get back on their feet and yet many of them never do. Many of them just make bad life choices and cannot change.***
Very true. There are lost souls out there that have given up on life. As I said earlier this is a topic in an of itself that I hope to address going forward.
> Some of the jobs will
> be building these new places for people to live.
> People that are
> mentally challenged
> or have mental disorders will be set put in appropriate institutions.
***WHo is paying for these institutions? What about the lazy that just don't want to work? Nothing's wrong with them, they just have addictions that prevents them from keeping a job. How are they dealt
with?***
>
> Fourth - Also as part of this prevention effort, drug and health
> research will help offer grants to fund reseach and development for
> drugs. Incentives would be based on the type of drug and the risk its
> development would help.
> This would help with the drug companies. Many drug companies complain
> that drug prices are so high, because of the cost research and
> development.
> Not really true, because Canadian drug prices are far lower. It has
> more to do with the power we give drug companies in the United states.
***There is lots of funding for research on drugs currently and they are incredibly expensive to develop. I'm not sure how much profit drug companies make, but they take a lot of risks. Drugs take decades to develop, scientist are expensive, the machines they use are expensive, and the drug companies liability is huge in a lawsuit if their drugs kill people. It takes a lot of money to make drugs! I can't comment on Canada b/c I do not know how much drugs are or why they are so cheap. If drug companies are pocketing excessive tons of money then that is wrong, but they certainly spend a TON of it producing drugs. Just think, if there was no financial incentive, many of these companies would not exist, drugs would not be made, and people would still be dying or in pain. I hear the pharma industry is having to make a lot of cuts recently and it is now harder to get a job there. That means less research gets done. Less drugs are developed. Less cures are
found.***
This is true, but in America drug companies spend many more times on advertising than they do on the amount it takes to develop a drug
>
> Fifth - Doctors and Healthcare providers would have to adhere to the
> same things the insurance companies would have to do. They have to
> accept insurance from everycarrier and at set prices. Procedures
> would have set codes and prices across the board. No acceptions.
*** You want to make sure doctors make good money too.
You don't want anyone doing that job.***
Well for doctors to buy into the system things would have to stay the same as far as pay scale. We are not talking about a completely communist system here. You know where the Russian Doctor makes the same wage as everyone else. Capitalism can need to help drive the system, not bring it down.
>
> Sixth - Drug companies would have to come up with a cost analysis of
> every drug they produce to justify the price they charge. Whatever
> they put in they get out with a 20% profit.
***What about the other 100,000 compounds they put a ton of money into researching that never were marketable? What is their profit on drugs now? (When you take into account ALL their expenses(lawsuits, scientists, lawyers, equipment, marketing)? ***
Marketing and advertising are a huge chunk. Doctor's offices see almost as many drug company representitives as they do patients. I know that is a stretch, but they are a lot of drug company pushers out there. Not to mention the budgets that are put into tv advertising. How many commercial breaks are there without a commercial for Cialis or Nexium, etc....
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