A PROPOSED BILL
It’s our healthcare and our government – The current bill Obama is proposing does not cut in until 2013 so I think based on their calculations we have 3 years to write this bill for our children. Let’s write it ourselves. If they don’t like it RECALL ‘EM. If they vote to put their bill in place RECALL ‘EM. We write it, (they can do the details) if we make a mistake-Too bad, it’s our bill, our healthcare and our country. We are the taxpayers and we make the rules.
PRICEWATERHOUSE REPORT CUTS HEALTHCARE COSTS BY 50%
America does have the highest healthcare cost in the world. But Price Waterhouse believes that it is caused by a combination of government involvement and poor management. If the possibility of reducing our healthcare costs by 50% sounds impossible, it may not be if you consider that Australia has the lowest cost per person for health care and it is about 50% less of what we pay now.
PRICE WATERHOUSE COOPERS EXECUTIVE SUMMARY OF SAVINGS AREAS
GENERAL AREAS OF WASTE
CLINICAL SAVINGS $312 Billion Total
Defensive medicine ($210B)
Preventable readmissions ($25B)
Poorly managed diabetes ($22B)
Medical errors ($17B)
Unnecessary ER visits ($14B)
Treatment variations ($10B)
Hospital acquired infections ($3B)
Over-prescribing antibiotic ($1B)
OPERATIONAL SAVINGS $126-315 Billion Total
Claims processing ($21 – 210B)
Better use of IT ($81-88B)
Staffing turnover ($21B)
Paper prescriptions ($4B)
BEHAVORIAL SAVINGS $303-$493 Billion Total
Obesity ($200B)
Smoking ($200-$567B)
Non-adherence to treatment ($100B)
Alcohol abuse ($2B)
The full report is available from this link. You will have to input some information about your company to get this report.
NOTE TO REPUBLICANS
It is embasrrasing that after 25 year of control of the country, you have left our medical care deteriorate into this disgraceful condition. Thanks only to capitalism, we can still go to the Doctor and get a pill.
We did not elect our Conservative Representatives to raise their career campaign funds on the backs of our healthcare. Republicans need to trash this 1000 page healthcare/tax bill/campaign funding source and gift that keeps on giving and enact the agenda described below. This agenda make force you to look elsewhere to get elected and may force lawyers to cut back on their car collections and yachts, but it will cut medial costs, improve healthcare, provide free healthcare to many and based on what your words suggest, should deliver exactly what you are promising to the American people. Lower costs, better service and better coverage to all. Who knows, if you do a good job, maybe the AMERICAN PEOPLE may have a hand in your re-election for a change.
INSURANCE REFORMS-Insurance profits range between 1-3% which is a reasonable profit. Most US based companies range between 20% - 40% profit. Microsoft has 30% profit margins. IT'S TOO MUCH! Where is our free computer insurance???
The following agenda items would cut costs of insurance, cut lawsuits and provide REALLY free healthcare to those who need it.
-Deregulate the medical insurance business. Government regulation only drives UP prices. COMPETITION makes commerce better-not government regulations.
-Create specific exclusions for abortion insurance or government funded abortion. If there are no exclusions, courts (California and others) have held that they must be included-even if they are not specifically in the bill or after the bill is written .
-Make insurance payments tax deductable to taxpayers. (They are deductible for employers right now)
-Move to make non-insurance cash payments for medical procedures tax deductable as well
(Paying cash will reduce rates and cut insurance rates as well)
-Move to make individually paid insurance more attractive (Company paid insurance benefits causes higher rates because the employee does not ask for lower rates)
-Create incentives for people to shop and use lower cost service providers (Prices for similar procedures vary widely and insurance companies do not require the lowest prices from their providers-only a range of prices. Those prices can vary widely.)
-Require doctors to allow pre-paid cash for services (Most do now but not all)
-Stop emergency room medical care treatment for illegal aliens unless it is for trauma-require ID and require payment in full before release.
-Require any illegal who receives unpaid emergency room treatment to be deported or held in prison until deportation is possible. (If they paid it would be up to INS laws)
-Require payment of medical services directly from the country of origin to the hospital, from the government of the patient or as a result of direct payment or from money being paid to it by the US government as trade or support income, or other resources as a fine-Not as a civil international lawsuit which would take forever to collect. Reimbursement should go back to the hospital within 90 days.
-Set up government clinics for government supported patients for emergency and non emergency healthcare with reduced cash fees. No free services. (This would free up emergency rooms for Americans-saves $14 billion)
- Allow health savings accounts and catastrophic insurance (they will be banned under the current bill)
-Special catastrophic insurance for young people under 35 years old with lower rates
-Allow insurance to be sold over state lines (Increases competition and lower rates.)
-Stop mandates on heath care insurance (Saves $200 billion)
-Allow ala carte insurance just like a car. If you don’t want collision for your car you don’t have to pay for it. Healthcare should be the same with varying deductibles and features
-Allow health savings accts
-Privatize Medicare and Medicaid ($100 billion in the losses and fraud each year)
-Privatize SCHIP program and reduce eligibility to the poverty level
-Means test drug prescription plan
-Help to provide insurance portability from job to job. But quite frankly, we are already there with COBRA. COBRA ELIMINATES pre-existing conditions.
-Maintain COBRA but extend it to 2 or three years and create an independent administrator so the small company does not have to administrate COBRA-Which is very costly to a small co.
-Review guaranteed issue policies to make them more affordable and maybe means test or have government support for them.
-Review but don’t eliminate pre-existing conditions. The actually window of pre-existing waiting periods are very small-and actually only exclude based on a person who HAD NO INSURANCE for 12 months prior to the new insurance application, excludes only very specific conditions and for most groups, pre-existing conditions are waived. ALSO, pre-existing conditions are one of the few ways that people are ENCOURAGED to maintain their health insurance.
-Do not force insurance companies to waive pre-existing conditions. This would waive up the cost of healthcare and actually ENCOURAGE people NOT to buy insurance. What if you could wait to insure your car till you got in an accident? Would you buy insurance? Read the information about pre-existing conditions in the following section.
If the government is so focused on making sure everyone maintains their insurance-why does that same government DISCOURAGE the most important factor to encourage people to do so on their own?
-Review and possible provide assistance or risk pools for government assistance for guaranteed issue which can be up to 300% of normal rates.
-Allow people to opt out of health insurance if they choose-but they would have to pay cash for services. Hospitals have plenty of means to collect on people who receive cash services.
-Review proper application of community rating standards or eliminate it
-Rates should be based history of illness-just like car insurance
-Allow self insurance and captive insurance (Many companies do this now)
-Create an equal rate structure for individuals to get rates that are the same as group rates and features. Any individual should be able to get health insurance at the same rates as a group. An individual is no more of a risk as a single person than as a group. Why is car insurance not required to be sold to groups only?
REFORMS TO CUT THE COST OF HEALTH CARE.
(Most of this is pretty simple stuff-You don’t need a 1,000 page bill unless you are hiding taxes, death panels and election slush funds-I believe we can cut insurance premiums in ½. Government healthcare could DOUBLE them. Mass rates are up 47%)
LEGAL REFORMS – MEDICAL MALPRACTICE - THE LAWYERS’ LOTTERY.
Medical costs that go to Lawyers are over 2% industry wide plus malpractice insurance and defensive medicine cost over $200 Billion. WHY DOES THE PROPOSED BILL NOT TOUCH ANY OF THESE COSTS? The following legal reforms would DEVISTATE Lawyers, but would cut the costs for health care, which is so important to Democrats, so LET’S DO IT!
We may also want to stop the solicitation of defendant complaints for class action medical lawsuits (As seen on TV). If someone is sick as a result of medical neglect, they should know it without being solicited by lawyers from Texas on TV. TV ads to join class action lawsuits just foster fraudulent claims. (Yet there are some positive attributes to class action lawsuits that should be addressed.)
-IF INSURANCE REFORMS ARE SO IMPORTANT TO DEMOCRATS-WHY ARE MALPRACTICE REFORMS NOT A PART OF THE BILL? It could be because malpractice insurance is the bank that Lawyers go to for quick settlements and big money.
-The first step would be to create a regulated malpractice insurance premium fee structures in malpractice insurance that takes into account risk, on a cost plus basis with a structured regulated profit. Currently, as risk drops-rates for malpractice insurance to Doctors premiums do not drop. This increases profits to the malpractice insurance companies which promotes more lawsuits and settlements. This needs to change.
-No lobbying allowed for malpractice insurance. Their only effort is to raise rates and profits for the insurance companies.
-Create a blue ribbon panel of non-political Physicians to assist in regulation of malpractice insurance
-Make mandatory loser pays in medical lawsuits AND plaintiff pays in any settlements
-Set up arbitration panels for malpractice insurance claims
-Cap punitive damages and non-economic caps to 500k. -End jointly and severally liability (limits plaintiffs) This was done in Alabama and cut lawsuits by 90%.
- Create court set and approved fees for all medical litigation, with hourly rates and caps set, just like the Bankruptcy court fee structure. There should be no big contingency percentage fee’s allowed for attorneys. The entire system could be just duplicated from the Bankruptcy court which is a cost set fee structure approved by a Judge.
-Eliminate unions in the health care industry or at least make them operate at a PRODUCTIVITY STANDARD at least equal to a standard of the general private productivity formulas.
-End retirement for healthcare workers. Typically there are 2-3 workers on retirement for every worker. The general population has long abandoned retirement from the private sector work place. Why should the private sector who does not receive retirement pay for medical workers to get retirement-at a cost of jobs to the private sector…THEY SHOULDN’T. Health workers should have the responsibility to save for retirement just as the private sector and rely on social security and savings in future years.
WE NEED TO TAKE LAWYERS OUT OF THE HEALTH CARE SYSTEM. Let them play the lottery at the 7-11 like everyone else.
DOCTOR INCENTIVES
-We should allow Doctors to take tax deductions for pro bono work-WORLD WIDE. This would create a huge support market for really free health care on a privatized basis to those in need. What could be cheaper than REALLY free health care? Most Doctors would love to do it. The only problem is that REALLY free health care provides no KICKBACKS AND PAYOFFS for the politicians
Why is it that politicians all lawyers to write off expenses for a lawsuit that is not even filed yet-But Doctors cannot write off services provided to people who are in need of free health care?
I think the Doctors need a better lobby.
-Increase fees to Primary Care Doctors and make Medicare and Medicaid equal to other reimbursements.
-Decrease paperwork with universal forms and IT reform (saves $200 – $300 billion)
-Do not REQUIRE medical records
-Do not require that online medical record computers are the PROPERTY of the federal government.
Why do the Democrats REALLY want confidential medical records online???
-Create statutory guidelines for government payment to Doctors with penalty and interest to be paid TO THE DOCTORS if the government is 30 days late with payments.
-Review HMO’s for feasibility. Things seemed to cost more since we adopted Sen. Kennedy’s ideas that created HMO’s.
-The government must stay away from preventative health care
-Review VA care and develop new standards of care for our troops
IMMIGRATION
Any person who is GRANTED legal status as opposed to EARNED legal status shall not be eligible for ANY social services FOR 10 YEARS -including medical services or MEANS TESTED INSURANCE REBATES OR SUPPORT MONEY - which is the same restrictions for ANY person who comes into this country LEGALLY.
While you cannot restrict offers to granted status immigrants, they should not have the right to any GOVERNMENT REIMBURSEMENTS that offset these costs. They should pay and should have to pay the FULL PRICE as other US citizens will have to pay for those who earn over $66,000 or whatever other means test will be assessed..
This reason is that IT IS MANDATORY-That any person who enters this country LEGALLY must have a sponsor and that sponsor will maintain those who are sponsored at a level of 125% of the poverty level and that ANY social services that are received by the sponsored immigrants will be repaid in full to the entity that paid such services to the sponsored immigrant.
Go to page 18 of this form to see documentation of support under threat of a state lawsuit
So, if a person who comes into this country LEGALLY must not receive medical or social services for 10 years-then a person who is GRANTED legal status should be held to the same regard.
How the GRANTED immigrants survive here without welfare, food stamps, free medical and other social services are up to that person. If they cannot survive without those benefits they should be deported-Or maybe they should ask a person who immigrated here LEGALLY how they did it. The answer will usually be the same-They stayed off drugs, turned off the TV and got a job.
This is the big secret behind GRANTED STATUS. These 10 year waiver of all services are waived for legal immigrants. And if they are NOT waived-You would see a FLOOD of immigrants RUNNING away from the USA when GRANTED STATUS becomes effective.
DRUG COMPANIES
-Review the FDA and reduce the standards for all drug development restrictions and requirements. It costs far too much to develop new drugs and takes far too long to introduce them into the marketplace in the US as compared to other countries
-Maintain the current DISTRIBUTION CONTROLS in this country. The US has the tightest control of its drugs. EACH PILL is tracked from manufacturer to the patient to ensure that there are effective-unadulterated medications reaching the consumer.
The rest of the world does not have this tight distribution control on drugs. Think what would happen if a terrorist entered poisonous drugs into the system and killed hundreds or thousands. For this reason alone-cheaper foreign drugs should not be introduced into this marketplace.
-Enhance the private market and government research assistance
-Enhance fund raising for non-profits (Cancer Society etc) with increased tax deductions etc.
-No decrease in patent protection timeline-Decreasing patent time will not change development cost-Such cost would have to be amortized over a shorter period of time resulting in higher drug costs and less drug research
OTHER IDEAS – Lets think about private based incentives or tax deductions for ideas that really work. It is questionable whether outcome based or preventative based medicine is really workable or will just create a giant boondoggle.
OTHER AMMENDMENTS
Just like Congress does, we could also put some non-related agenda items in this bill from our general agenda. If we do the work to get this to pass we might as well take the top 10 or 20 major changes and add them in.
-The people can lobby the government directly with the same means available to all others in government lobbying or persuasion
-The people can require civil means of penalty to enforce their agenda to any lawmaker or lobbyist
The government cannot ever take control of healthcare
Congress must read the bills and can pass no bill
(Add more)
PREVENTION BASED HELTHCARE
How is a stressed medical system suffering from reduced distribution and increased patient loads going to handle ANY more Doctor patient visits? With even ONE more visit per person per year for prevention, that will be hundreds and millions of additional visits that will have to be stuffed into the system. Plus more follow ups and retraining.
The quickly overstressed system will quickly grind to a halt and people will be dying in ambulances, delivering babies on the sidewalk and waiting years for cancer treatment. Just like patient care in Canada, England and other government run healthcare systems. The bottom line-which is really going to change their behavior when their doctor tells them to stop smoking, drinking and enjoying a nice steak, No one.
The real truth is that smoking, drinking, obesity and poor lifestyle choices actually REDUCE healthcare expenses because they die sooner. Undiagnosed cancer is far cheaper to treat when the patient dies as it is when expensive medical care allows him or her to live to 80 or 90 years old. http://www.gaige.net/article.php?story=2008020505465694 .
So why does government healthcare want to clog the system with healthy patients looking for diets and smoking cessation programs? Maybe preventative healthcare would work if the sick are ignored and left to die early, like government surveys report.
OUTCOME BASED REIMBURSEMENT
The main flag in outcome based payment systems is that virtually ALL of the failing, government healthcare systems worldwide are touting this as the Holy Grail to solve the healthcare crisis. Why you may ask? Most likely, because it would squeeze even MORE money out of the Doctors AND ALMOST GUARANTEE less service to the patient.
Outcome based medicine is another boondoggle. What is going to happen here is that there will be a flat fee paid to the doctors for a service solution. If you break a leg the Doctor will get for example $499. It will not matter how it heals, follow up will be nonexistent and if you have complications, the Doctor will get no more money regardless of how many time he has to see you. That Doctor will soon grow tired of not getting paid for his or her helping their patients and the wait to see the Doctor will grow longer and longer
And what about patient care. Maybe the Doctor does a bad job and you are still in need of proper treatment because your back still hurts. BUT WAIT-You were already treated AND THE Doctor was paid. According to the government you’re cured because you got outcome treatment there is no more money for you.
So you call your original Doctor who got paid in full for your treatment and your pain is still there. So you call him back and he sets you an appointment…In 6 months. Then it’s cancelled and he gives you another in 6 months. Oh, it was actually cancer… and now you are metastasized and you are going to die? So sorry. That’s your outcome. Government can’t change fate. You had a good life.
Seems the only good outcome is for the government who is guaranteed not to have to pay to CURE your illness-Only to take the smallest step possible to be blameless for your future health. Hey after all YOU WERE TREATED RIGHT? And at a huge cost to other Americans be thankful.
And why would the government experiment with your health by limiting your ability to have a Doctor cure your illness-Yet allow the lawyers RAMPANT access to sue everyone all the time driving healthcare through the roof?
But you can’t sue the federal government can you. But you CAN sue the Doctors. You know the ones with all the malpractice insurance. So the government will tell the Doctors what to do-and the LAWYERS will sue the Doctors for every mistake the government makes in your healthcare.
Sounds like most of the smart Doctors will quit and become RICH LAWYERS (It only takes 12-18 months). Except the Doctors who quit, move to another country, (India has a thriving private medical business), retire or go out of business waiting for government reimbursements or die of illness. We will be LUCKY to retain 50% of the Doctors we have today. NO LINES, NO DEATH BOARDS???
If outcome based medicine is so great, why not leave it to the option of the Doctor. The truth will be evident very quickly.
FEE FOR SERVICE is what ANY business owner needs to pay the bills and it is the best system available. It’s one thing for the government to experiment with money and taxes. But we should draw the line when they want to experiment with the best healthcare in the world by copying what has failed around the world. Let the Doctor decide.
ADDITIONAL IDEAS
Move to create organ donation incentives. Quite frankly, 25% of people on kidney dialysis die each year. There are 220,000 people who cost an average of $50,000 per year each to maintain renal function on an annual basis at a cost of $11 billion. http://www.usatoday.com/news/health/2009-08-23-dialysis_N.htm
What about harvesting or farming kidneys. This is an area to be addressed if health care costs are such an issue a solution should be delivered.
Move to create more education funded preventative health care in schools K-12
End sex-ed in schools. Teen pregnancy has only STATISTICALLY INCREASED since such education was increased by the NEA. Promote TEEN ABSTINANCE as a STATISTICALLY PROVEN WAY to reduce teen pregnancy and enhance learning focus-All of which have STATISTICALLY DECLINED since sex education was introduced in our schools.
Move to create incentives toward adult health care education and rewards
Move to create incentives toward exercise and eating ince
