I hate the word should. Should implies, if not directly demands, an outcome, without doing the work necessary to providing an accompanying solution. Using the word should is laziness, and a way to avoid dealing with facts/immutable factors, that are easier to just ignore, rather than account for in a solution. "No Child Should Go Hungry Tonight"
Thus, I refuse to tell you what SHOULD happen. I have told you what it IS happening. Now, I'm going to tell you what MUST happen to fix it all, and if that doesn't happen, what WILL happen if we do nothing/listen to Bernie Sanders clowns.
1. First things first, make all health insurance illegal. It never adds more value than it takes out. This includes government health insurance(Medicare/Medicaid), private/personal health insurance and employer-based health insurance.
OMG whatever will we do then? Easy.
Let's take them in order:
2a. Kill Medicare immediately and allow the elderly to set up local co-ops which they fund directly with their would-be Medicare $. I can give details, but local Medicare-to-Co-Op transition is the way to go. They are part-owners of their Co-Ops and thus have an interest in how they are run.
We either do this, or, we bankrupt the country, or, we default on our current Medicare obligations. Take your pick.
2b. Replace Medicaid with block grants to the states, which in turn block grant to the county. Only do this long enough to transition completely to county-level Medicaid. Again, I can give point by point details, but, county-run Medicaid is the way to go. Grants for poor counties come with auditors. Again, I have all the details if you require. We can't keep throwing national money into local black holes like Detroit, Chicago and Baltimore, seeing no return on our "investment", seeing disease run rampant, and poor care be the standard.
2c. We need to allow local doctors run their own business models again. Health Care is only costly because of Health Insurance and the government. There is a doctor in NYS right now charging a flat fee of $50/month which includes all basic care, including lab work. It's totally worth paying the Obamacare penalty, seeing this doc, no premiums, and signing up for temporary catastrophic insurance. You pay $500-2000+ less a month. Of course, NYS is trying to shut him down. What they don't know? I know of about 20 other docs who are doing the same, and I know it's spreading. One guy is getting around NYS by making...wait for it...house calls! He has no office. He treats patients with his camouflaged "ambulance". He's like an Uber-doctor.
People that haven't gone to the doctor in years use these guys regularly, and they are obviously catching things sooner, because it's so cheap. It seems we are months away from a full fledged health care rebellion. On this one: the doctors/patients are already killing private insurance/Obamacare markets this way. It's just a matter of time.
2d. Employers/unions are the original bad actors here: both seek to avoid payroll tax by paying benefits. Killing insurance not only forces employers to cough up cash, it also can lead to lowering of payroll tax RATES, and it also forces employees to be accountable for their health, as well as to have some $ in the game....by forcing them back into the 2c model.
This WILL lower cost, because once every provider has to compete for each patient, they have to get serious about the cost of each patient.
3. Tort-reform. Period. We can't have bad doctors. But, we also can't have a culture where getting injured == winning the lottery. This is why de-centralizing makes sense. If you get treated poorly by a small-practice doctor, you get whatever his insurance has. If you get treated poorly by a Health South doctor? They will overpay you to go away.
The big $/consolidation of health care ONLY means higher cost, and, bigger fish for lawyers to attack, which means more settlements, which means even more cost.
Start here. There's plenty more. But, let's see how you feel about this.
Edited by OCinBuffalo, 15 May 2017 - 09:46 PM.