Universal Healthcare? YES, we CAN!

OK, ATS... today is your chance to really try to do something. It might not work, but... I've had enough so I'm going to try something really, really stoopid.

I am fed up with listening to idiots trying to drum up support or demonize these silly healthcare proposals. Not a single one fixes things. Not one. Not Obamacare, which made things worse, not the House plan which could be described as Obamacare lite without teeth, and not the Senate bill which is Obamacare with sprinkles.

The simple fact is that Obamacare made a major change in the way healthcare works in the US. It took the power from an uneasy alliance between doctors and insurers and gave it to the insurers. Instead of keeping the promise of healthcare for all, Obamacare made it healthcare for those who could afford expensive insurance at the cost of healthcare for those who could only pay for insurance with such high deductibles and copays they can't use it. It also legitimized and in many cases created monopolies among insurance companies... actually, worse, it created monopolies with the force of law maintaining a captive customer base.

And it did so at an alarmingly high price.

So I decided to finish something up that I had been thinking about for a long time. I have mentioned my idea of how to get universal healthcare several times, but I had never sat down and put pen to paper (make that fingertips to keyboard) and wrote it out completely. Now I have, and I have printed it to pdf and uploaded it to a filesharing service. It's not the thousands of pages we seem to be getting used to; it's 13 pages of legaleeze (as best as I can speak it), and the first one is a cover sheet and explanation of intent. I am going to send this to the White House and every Congressman I can find an email address on, and might even try to get an audience with my Congressmen (Shelby, Strange, and Brooks). I might be ignored, probably will be ignored, but by damnation, I am at least going to speak up! I might even send it in to some of the pundits (Hannity, Carlson, Gutfeld) if needed.

But before I do...

I am one person. One lone redneck. For any bill to have the slightest possibility of success, it needs to work for the majority. I am (virtually) in the midst of some of the sharpest minds I know of... liberal, progressive, conservative, libertarian... but all sharp and inquisitive. I want to publish my plan here, in its entirety, first to get feedback and suggestions. I am human (sorta, redneck) and can make mistakes. Find them. Point them out. Give this proposal a good thrashing. I plan on keeping a little quieter than normal in this thread, but I will be reading, and commenting on suggestions from time to time.

I will also add: this is a mutli-tiered proposal. All the various aspects work together. The point is to make healthcare so that everyone has access, and while people must pay for their services, no one should be thrown into abject poverty for being ill. And the whole thing must not break the US budget (although any such plan will be expensive).

One thing I find absolutely necessary to point out. This is not posted in the Mud Pit. It is not a Republican proposal, nor a Democrat proposal. I am not affiliated with either party, primarily because I don't like fleas and I'm allergic to stoopid. If you want to jump in and start bashing Trump or belittling Hillary or crowing over Pelosi... please take it somewhere else. I will ignore those types of opinions, because they have at their root nothing but hatred for others. This is not about hatred; it is about fixing a problem.

Another thing: I know, far too well, that I have a better chance of finding a pot of gold at the end of a rainbow and being struck by lightning reflected off a unicorn's horn the moment I find it than I do of getting an actual proposal through Congress. But I am tired of just whining. I'm going to at least stand up and say my peace, whether the rats in the swamp want to listen or not. I plan to send my proposals out in the next week; you have that long to make suggestions.

And now, without further ado... My Plan for Universal Healthcare

A new version incorporating some of the changes suggested (and correcting a few errors discovered) has been uploaded to here as of 7/18/2017.

TheRedneck

a reply to: TheRedneck

Going to take time to read this... be right back


Back! I must ask, where did you get this as this looks very familiar......

OK, missing a few key details....

Pharmaceutical Domestic Responsibility: Patent Law and Orphan Drug Reform making it illegal for any company to gain "exclusivity" to production of a common drug and boosting the prices 10,000 percent. Generics must be allowed within reasonable timelines. No entities may patent medical (or any) technology and or drugs and not develop said products or their patent will be voided to public domain.

Artificial Health Practitioner Shortages: The standard practice of severely limiting the number of Doctors and Specialist must end immediately. Anyone receiving a score of xxx on the xxx test battery will be accepted into advanced medical classes which will end the artificial quotas.

Posted Pricing. All Medical establishments must post prices for all tests, drugs, and procedures utilizing a "universal common code" so that the patient may choose where to receive these tests, drugs, and procedures from any vendor of their choosing.


I am sure there is more but I am tired today.

What happens to Medicare?
Medicaid?
Employer insurance?
Can you buy a policy on your own?

Who sets prices for procedures and office visits?

But should we? Wouldn't prices go down if government was not involved in healthcare?

a reply to: TheRedneck

There were some on the left, not this namby pamby liberal left that many conservatives think represent the left, but real leftists who never supported Obama''s sell out to the insurance companies. Real leftists have been just as opposed to ACA as so many on the right. We can all see it was just as you say, not a health care act but rather a vehicle for insurance companies to stick their noses where they do not belong.

I'm sure your proposal will be met by Tom Price with open arms!!

a reply to: infolurker

Back! I must ask, where did you get this as this looks very familiar......

This is my own creation.

I got the idea when Obamacare was being talked about. All you need for universal healthcare is to make it illegal for doctors to deny service based on ability to pay. That was simple. But then you have the issue of how doctors make a profit... that's where the collection idea came in, because mandating insurance is just a cost increase to the patient without additional income for the doctor (not to mention it doesn't work for everyone). So we're back to the payment issue... and since poor can't pay but doctors must be paid, the government has to step in. Who in the government is in the best position to determine payment status? The IRS. Who in the government is best at collections? The IRS.

The MFC and FMRB ideas I came up with as a way to get bad doctors out of the industry and to lower malpractice settlements. Patients can get compensation for injuries/mistakes without having to hire a lawyer, which nets them more actual damages while decreasing the cost to doctors. The fact that a certain number of lawyers and doctors and nurses/orderlies are on every jury means all sides of the issue are represented. A doctor will want to make the award enough to satisfy the plaintiff, to prevent a fellow doctor from being drug through a much more expensive court, but will also want to keep the damages as low as possible. A lawyer will be biased toward getting the plaintiff to appeal so lawyers can get involved. You have checks and balances in the very makeup of the jury.

Now, your suggestions:

Pharmaceutical Domestic Responsibility: I agree. I am not as intimately familiar with the processes, though. Care to write up an addendum to address this?

Artificial Health Practitioner Shortages: Not sure how to correctly implement this. Are you suggesting that colleges are purposely limiting enrollment to create shortages?

Posted Pricing: Agreed. I also would like to see a maximum price for administration of OTC drugs, say 100 times the minimum price that the drug can be acquired for within a 25-mile radius. If I can buy 300 aspirin for $3.00 at WalMart, the maximum price that a hospital can charge for an aspirin would be $1.00. (I'd actually like to see it more like 25 times, but I'm not sure that would actually cover administration costs.)

TheRedneck

a reply to: DontTreadOnMe

What happens to Medicare?

It still can exist. It's a government-subsidized insurance for the elderly.

Medicaid?

Not needed. Everyone has health care and if you can't afford to pay, the government pays. JUST LIKE MEDICAID.

And it's automatic... no need to apply.

Employer insurance?

It existed before Obamacare; it'll still be an incentive for potential employees after this.

Can you buy a policy on your own?

Absolutely! That way you just file a claim like always, and the collection part never kicks in. And to boot, the doctor can't even bill you until your insurance pays, and the insurance company has to jump through hoops to deny payment for treatments they won't pay for now.

Who sets prices for procedures and office visits?

Doctors. Of course.

TheRedneck

a reply to: Blueracer

Government is already involved. That was the biggest problem with Obamacare.

TheRedneck

a reply to: TerryMcGuire

So what do you think of my plan?

TheRedneck

originally posted by: TheRedneck
a reply to: Blueracer

Government is already involved. That was the biggest problem with Obamacare.

TheRedneck

You are partially right. Government involvement is the "biggest problem with" any plan. Yet your plan does not get rid of government involvement.

No Medical Insurance Policy shall require a Medical Professional to initiate a Claim. Pg 4

This is going to cause 9 kinds of fraud.
It's going to give every shyster of quack medical procedures license to make claims. Along with relatives of ill people, I'm betting it'll make the pill-mills and medical device people look like the "good 'ol days" of fraudsters. I can see this being abused in ways undreamed of, but lucrative once some thought has been put into it.

2. Upon receipt of a request from a Medical practitioner or Medical Institution, the IRS shall investigate the financial status of the Patient(s) identified in the request and shall make a determination of ability to pay. a. No Patient shall be held liable for medical payment collections if said patient is presently living below one hundred percent (100%) of the Federal Poverty Guidelines b.No patient shall be held liable for payments that would reduce their income to below one hundred percent (100%) of the Federal Poverty Guidelines. c.The Department of Commerce shall annually create and publish a set of further repayment guidelines with the approval of both the President of the United States and the United States Senate.

This on pg 8 is also gonna be a potential nightmare.
Altho the idea is awesome! I don't think you can legislate a company be forced to operate at a loss. Which given the amount of folks under the poverty line it will bankrupt insurance companies. Not like I'm defending them, I just see this as problematic and something they will scream about.

Plus...we can't get a yearly budget passed in this country, so getting the Senate an Prez to sign off in a timely manner on pay scales is going to mean, it won't happen and everyone will be in limbo. I can see plenty of Doc's getting out of medical practices if their being paid is dependent on the govt timeline.

It's a good plan, I just can't see it being executed the way you intend.

Sorry this seems abrupt, I was caught in the posting freeze for maintenance, and lost 4 posts and one pm to you. This is the quick version before it happens again!



I grabbed a souvenir!! From 1/2 hr ago.

a reply to: TheRedneck

I've read your posts...you're a pretty straight-shooting moderate conservative.

I'm not falling for another conservative's healthcare plan! :-P

We already did that with Obamacare/ACA! That was a Heritage Foundation idea, implemented by Mitt Romney as "Romenycare".

Obamacare took a boat with holes all over the place and kicked more holes in the damn boat. All it did was make the problem worse.
My premiums and co pays tell me so.
My wait times tell me so.

The only way to fix Americas healthcare system is to eliminate the insurance-Doctor connection.
My doctors have horror stories about dealing with insurance companies after Obamcare took effect. More paperwork, this drug isn't covered but that one is..etc, etc, etc

The costs from the bottom need attention first and then work up to insurance companies.

a reply to: TheRedneck


Yes we 'can'. No, we don't want to. Simple.

a reply to: TheRedneck

The goal of your plan is admirable. But it creates new hurdles. The simplest way to get universal access to care is to enable everyone who doesn't want, or can't qualify for private health insurance, to enroll in one of the programs that already exist. (Medicare and Medicaid) Medicare for those who can afford it. Medicaid for those who can't afford Medicare.

Naturally, the government will need to "beef up" both program's funding and staffing, but that would be far easier and efficient than creating anything new.

a reply to: Blueracer

ISIS was created due to an invading army which shouldn't have been there in the first place (us!) leaving too fast without repairing the damage they had done to the social infrastructure.

If government were to withdraw overnight from healthcare, there would be no healthcare, at least for a while until the market stabilized. Just like we shouldn't have gotten involved in the Middle East, we shouldn't have gotten the government involved in healthcare. And just like we shouldn't have simply walked away from Iraq and left a vacuum, we shouldn't just walk away from our healthcare mess and leave a vacuum there.

That said, the only additional involvement my plan entails is in the arena of prosecuting bad doctors and acting as a collection agency to keep doctors working. It's not like setting up an insurance exchange, expanding governmental insurance, setting unreasonable requirements for insurance policies, and trying to force people to purchase a product from the private market...

TheRedneck

This ones a good read and does it all without IRS getting up in everyone's business and minimizes government involvement.

A Bill to Fix Heathcare for All Permanently

Makes some very good points especially summary near end.

Maybe help you on what you're doing.

Fellow Alabamian, Phoenix

a reply to: Caver78

This is going to cause 9 kinds of fraud.
It's going to give every shyster of quack medical procedures license to make claims. Along with relatives of ill people, I'm betting it'll make the pill-mills and medical device people look like the "good 'ol days" of fraudsters. I can see this being abused in ways undreamed of, but lucrative once some thought has been put into it.

Maybe I could word it better?

The intent is to keep financial ability of the prospective patient confidential from the care provider. It would not be feasible to require any doctor to see any patient at any time; you'd have folks knocking on a doctor's door every hour on the hour all night long, and without exceptions no doctor would be able to continue for long due to exhaustion! But the downside of that is that, say, a patient comes in for care. The doctor has his patients fill out a form giving medical history. Now, assume that on that form he has a place to put insurance information. How easy is it for the admission nurse to look and see "no insurance," and simply deny the patient because "The doctor is about to leave because he has worked the required number of hours"? If the doctor's office has to initiate the claim, there is a good reason why the information could not be initially kept confidential.

It prevents a back-door method of discriminating against patients while skirting just inside the law.

On the other hand, there is nothing in there about doctors not being able to verify claims... only initiate them. I would expect that a doctor's verification would be required before payment is made, especially if the payment is made to the doctor. The only restriction is that the claim forms need not be so complex that a doctor is required to imitate them. The patient sees the doctor, gets the bill, makes a claim with the insurance company, the insurance company contacts the doctor, and payment is made. That's actually how it used to work.

This on pg 8 is also gonna be a potential nightmare.
Altho the idea is awesome! I don't think you can legislate a company be forced to operate at a loss. Which given the amount of folks under the poverty line it will bankrupt insurance companies. Not like I'm defending them, I just see this as problematic and something they will scream about.

I'm not sure how the number of poor will affect the insurance companies under this plan. There is no requirement for insurance or prohibition against insurance one way or another. A poor person who gets medical attention will simply not be able to pay. The doctor will contact them for the required three months, then turn the account over to the IRS. The IRS will send the doctor half of the bill, look at the person's tax returns and see they are below the poverty line, and the person will receive a nice, formal letter stating their medical bills have been satisfied. Done. No insurance company involved.

Someone who is not living close to the poverty level would get medical care, and the doctor would send them a bill. If they bought insurance, they would attach the bill to a claim form and send it to the insurance company themselves and things would work like above. If they didn't have insurance, they can work with the doctor or the doctor can send them to the IRS after three months. The IRS in this case would send a nice little formal letter stating that they have a due medical bill and if not paid within a reasonable time, their assets could be seized to satisfy it.

Personal responsibility, with compassion for the less fortunate.

Plus...we can't get a yearly budget passed in this country, so getting the Senate an Prez to sign off in a timely manner on pay scales is going to mean, it won't happen and everyone will be in limbo. I can see plenty of Doc's getting out of medical practices if their being paid is dependent on the govt timeline.

The poverty level is already established.

As for doctors waiting too long, it specifies ten days turn around for their 50% down payment. After that, I believe the IRS can easily beat the collection speed of a private collection agency. No one waits on Congress for anything.

TheRedneck

a reply to: Kettu

I see nothing conservative about Obama OR Romney... or any of the current healthcare ideas.

But in any case, I see even less sense in basing an argument on the personality of the presenter. Have you read and considered the plan?

TheRedneck