My Letter to President Obama - How to solve Health Care!

This isn't the topic I had wanted to use as my first post, but I've become a bit obsessed with getting my thoughts together on this. I don't know that I've got it as ironed out as I'd like, but I'm posting it now, and can update it later.

Dear President Obama,

I think I can solve this country’s health care problems. I’m serious. Not only that, but my taxes are all paid up, so that’s not something you have to worry about either. Anyway, let me present my plan to make universal healthcare coverage for every American in a way that is economically viable. Here’s how it works:

1. Everyone is on the same plan, let’s call it Americare. There is no more Medicaid, Medicare, or anything else like that. People could opt out of Americare (more on that later), but there is one government health care plan for everyone – Americare.

2. Everyone pays the same. Obviously as a average Joe (and no, I’m not a plumber) I don’t know enough about the actual logistics and numbers, but I’m picking one and running with it. Okay, everyone has 10% of their salary taken out of their paycheck for Americare. Heck, since we’re eliminating Medicare & Medicaid we can roll what already taken out for those services into it too. It’s flat percentage, what ever that ends up being. Everyone pays the same. This payment covers your dependants too. If you’re in a household with multiple incomes each worker pays the 10%, and if you’re in a household with only one income then only that person pays the 10%. NOONE is exempt from this. If you’re on social security, disability, or a United State Congressman you pay a straight fixed 10% NO EXCEPTIONS.

3. Everyone pays the same deductible and co-pay for using their insurance, and is allowed the same number of doctor’s visits. If you visit the doctor you pay $15 co-pay, plain and simple. No free visits; everyone can afford to pay a co-pay to visit the doctor. If you visit the emergency room you pay $50, no exceptions. If you need surgery there is a $500 deductible. In some cases that might be difficult for people to come up with, but they can make a payment plan with the hospital to pay it interest free or maybe have a system set up where the hospital bills the government and then they deduct an additional $10-$25 a month out of someone’s check until they’re paid up. The point is that there are NO free rides and everyone has the same coverage at the same price.

4. If people choose to opt of this plan and purchase insurance from a private carrier that’s fine they can do that; however, they don’t get off scott free. They still will get 5% of their income deducted (+ the stuff they’re paying now for Medicare/Medicaid) to help pay for Americare. Additionally they must prove that they do in fact have private insurance.

5. If we are going to be serious in addressing Health Care then we also HAVE to address the litigation side of it as well. Lawsuits in the country are ridiculous, and seeing as how most politicians are lawyers or former lawyers they seem reluctant to curb in the amount of money involved in lawsuits, but Americare can’t operate profitably with out addressing this issue, so we’re going to tackle this by making two changes:

• I think it’s called Tort. We will have a law stating how much money someone collects given a particular scenario. I believe there are several states that already do this for workers comp, so it’s not entirely unprecedented. Again, I’m just pulling the numbers out of the air, so they might need to be tweaked. If a doctor kills someone their family get one million dollars. If they are permanently paralyzed they get $500,000, loose an eye $250,000, etc, I think you get the jest of what I’m saying. NO lawsuits. This is only for when the doctor made a mistake or was negligent. Several medical procedures have inherent risks that a patient accepts and assumes where the doctor should not be held responsible, so they cases need to be spelled out too.

• We also need to address the “gross negligence” aspect of current lawsuits. It’s crazy right now that if a doctor was grossly negligent that the victim, or their family, gets extra money. There needs to be a punishment, but the victim should not be the recipient of it; after all we’ve already compensated them for their loss as stated in the previous paragraph. Here’s how will handle it with Americare, if client feels their injury was caused by the doctor being grossly negligent they submit a complaint to the local district attorney or maybe we need a new state lawyer office in each region where the attorney has some medical knowledge, but they concept is thus; the state investigates it, if there is a case, they bring a case against the doctor and the hospital. A judge hears the case from the state, and the defense of the doctor, hospital, and their lawyer. If the judge rules their was gross negligence he fines them and that money goes back into Americare because as we stated earlier there is no reason for the victim to get it.

6. Obviously everyone needs something to show that they have coverage, so I’ve developed a simple plan for that too. The Federal government will set the rules of what one needs to provide as proof of identity and what not, but the States will issue the Americare ID card. People will just need to go to the same place they get their driver’s license and pay $10 to get an official Americare Insurance ID card. At $10 it’s cheap enough that everyone can afford it. Make it last for 3-5 years. The states get to keep ALL of the money from this, since they’re doing all the work. Since the states are getting a bunch of additional revenue for doing very little it’s unlikely that they’ll complain too much. The only caveat is the cards HAVE to be uniform state-to-state, and difficult to counterfeit. The ID is actually a vital part of the plan, as I’ll explain below, so we do need everyone to get one.

7. Again we need to address the revenue side of the plan, and that’s going to require us to be honest. All too often people don’t pay their bills, and people need to pay if the plan is going to work, SO you have to have your card with you to get treatment. If for some reason you don’t have your card, you HAVE to pay upfront, and double the normal price. That’s still a very reasonable $30 co-pay doctor’s office visit, and $100 emergency room visit. It should be required for any surgery though. We do this for a couple of reasons. If you have your card and don’t pay, the hospital/doctor can just present the bill to Americare and then Americare pays the hospital/doctor and deducts the money straight out of someone’s paycheck. This may seem a bit harsh, but people have to pay if the plan is going to work! Another aspect of the plan is that illegal immigrants are covered too, and they should be. Most of them are working and are thus paying into the plan like everyone else; however, since they’re not here legally they can’t get an Americare ID card. They can still get treatment just like everyone else, but they have to pay upfront, and they pay more money.

8. It’s vital that the law reflects that a hospital/doctor is NOT responsible for treating people who can’t fulfill one of the following two requirements:

• Have and present an Americare ID card, or

• Pay the bill up front

9. They should still be required to triage people who are seriously injured, but ounce someone is stable, the hospital doctor is no longer liable for them. Additionally, people who are not legal residents of the country should not be entitled to expensive long-term care that provides an undue burden on the American taxpayer. This means that sometimes a hospital has to discharge people who could die, so there needs to be some type of prevision in the law that requires a hospital to provide this type of coverage (where the patient will die if discharged only) for a fixed amount of time, lets say somewhere between 15-30 days, while their family makes arrangements for them to be treated at either a hospital in their home country, or the family finds a way to pay for the coverage.

10. Americare needs to work for Dental, vision, and prescription drugs. Prescriptions drugs need to be addressed because they are quite expensive, and several Americans are taking loads of them. Basically Americare should fill any prescription with a generic at a fixed low rate of $5 or $10 or something like that, and have another system in place to pay for non-generics. My plan is a little weak here, but we need to find a way to provide coverage in a way that doesn’t cost the taxpayer too much money.

11. We want to avoid, as much as possible, creating any new government entities for this plan. Obviously we need to create some, but the fewer the better because health care is expensive enough already with out having to pay for unneeded and redundant workers.

Do you know what the best part of my plan is? You could let any American citizen read this and understand what the plan is, and basically how it works. It’s not some big nebulous congressional bill that no one understands. It’s plain and simple; it just needs the numbers tweaked, and few holes filled in.

I know that neither liberals nor conservatives; democrats nor republicans, will like my plan too much because it contains elements that both sides will find too difficult to swallow, but show me a better plan. If you are going to make a serious attempt to address reforming health care you need to address the lawsuits and end the entitlement that the current Medicare/Medicaid systems promote, and that’s the honest to goodness truth.

Sincerely,

ME