We need one of the following two options for nationalized health care …
a) Two Tier System
- The government provides catastrophic insurance for EVERYBODY. This would cover minimum health coverage such as basic primary care. ED visits would have hefty copays to discourage overuse.
- Voluntary insurance would exist for those who wanted to have protection against fee-for-service (outpatient) office costs. The rest of people would have to pay cash.
b) Insurance Mandate
- EVERYBODY must purchase insurance. No insurance company can reject an applicant – although the rates could be quite high depending on their medical history. There would be both private and government-sponsored insurance plans available.
a) Two Tier System
- The government provides catastrophic insurance for EVERYBODY. This would cover minimum health coverage such as basic primary care. ED visits would have hefty copays to discourage overuse.
- Voluntary insurance would exist for those who wanted to have protection against fee-for-service (outpatient) office costs. The rest of people would have to pay cash.
b) Insurance Mandate
- EVERYBODY must purchase insurance. No insurance company can reject an applicant – although the rates could be quite high depending on their medical history. There would be both private and government-sponsored insurance plans available.
I am against a government run Single-Payer health care system. Currently, we have two federal Single-Payer health care programs (VA, Medicare) and one state-run health care program (Medicaid) to critique. There are many counties that also offer health-care programs as well. If we focus a critique on Medicare, we will quickly see the problems with having a Federal Single-Payer health care system. The Medicare Board of Trustees estimates that within 10 years there will not be enough money within their coffers to cover all the medical costs for those over age 65. Medicare represents 14% of the entire federal budget. The US government has been unable to reign in the costs ever since its inception. From my perspective as a US physician, it seems the government has been trying to develop a system to force hospitals and doctors to provide feedback to the government. This will allow the government to monitor how the money is being spent (or misspent). In theory, this should reduce waste. Unfortunately, what I envision is a lot of administrators and auditors. This will lead to more wasted time and money for hospitals and doctor’s offices as they continue trying to adjust and accommodate to the whims of these auditors. If a hospital or doctor does not do it the way – as interpreted by a particular auditor then they do not get paid – ever. This becomes Socialized medicine (think USSR).
I am against the voucher program proposed by Romney-Ryan. The voucher system is far too complicated. We need a nationalized health care program. I think Medicare can remain financially viable if real cost-saving measures are enacted. I envision a continuation of Medicare for those over age 65. Medicare should be able to negotiate lower costs on pharmaceuticals – just as the VA does. The government will need to establish and enforce ‘best-practices’ protocols. These would prevent many expensive tests and procedures from being performed until certain criteria had been met. The US population will have to become comfortable with the concept of rationing – not every procedure can be covered. Quite likely, the very wealthy will purchase ‘supplemental Medicare insurance’ which will allow them to have carte blanche while the remainder of the elderly have good healthcare. Basically, a two-tier system will be in place – even after age 65.
The benefit for establishing nationalized health care is that it frees small and large businesses of the obligation of providing costly healthcare to their employees. Employees no longer have to remain at jobs they despise – simply to keep health insurance. Hospitals no longer will be forced to provide emergency care for free simply because a person arrives in their hospital. Currently, hospitals argue that their charges are so high for those with insurance so that they can shift the coverage for these patients who arrive in the ED without any insurance. With a nationalized health care plan, hospitals should be able to drop their inflated charges and everything will become more transparent.
I am against the voucher program proposed by Romney-Ryan. The voucher system is far too complicated. We need a nationalized health care program. I think Medicare can remain financially viable if real cost-saving measures are enacted. I envision a continuation of Medicare for those over age 65. Medicare should be able to negotiate lower costs on pharmaceuticals – just as the VA does. The government will need to establish and enforce ‘best-practices’ protocols. These would prevent many expensive tests and procedures from being performed until certain criteria had been met. The US population will have to become comfortable with the concept of rationing – not every procedure can be covered. Quite likely, the very wealthy will purchase ‘supplemental Medicare insurance’ which will allow them to have carte blanche while the remainder of the elderly have good healthcare. Basically, a two-tier system will be in place – even after age 65.
The benefit for establishing nationalized health care is that it frees small and large businesses of the obligation of providing costly healthcare to their employees. Employees no longer have to remain at jobs they despise – simply to keep health insurance. Hospitals no longer will be forced to provide emergency care for free simply because a person arrives in their hospital. Currently, hospitals argue that their charges are so high for those with insurance so that they can shift the coverage for these patients who arrive in the ED without any insurance. With a nationalized health care plan, hospitals should be able to drop their inflated charges and everything will become more transparent.
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