Tuesday, November 21, 2006

Political Issues: Healthcare

Healthcare has been a big issue for a while. It's frightening to see how much healthcare costs nowadays. I don't have some super plan to fix everything but I have a few ideas that may help.

1) Court reform for malpractice suits - Malpractice insurance pays out millions, if not billions, for punitive damages and I fear that many people think of it as winning the lottery. So, in order to make it more just, less prone to abuse, and less of a burden on all doctors (who have to pay the awards out of their malpractice insurance premiums), I would make a few changes.
A) Forbid punitive damages from being paid for by insurance. The whole point of punitive damages is to punish the perpetrator and is it really a punishment if insurance pays for it? This would have the effect of lowering insurance rates for doctors as well as making punitive damages an actual punishment.
B) Make punitive damages payable to the state and not the victim. This may not seem fair at first but the victim and/or the victim's family is already getting paid for legal fees, all of the medical treatment, and lost wages (past and future depending on the nature of the lawsuit). They shouldn't be pursuing punitive damages as a way to get lots of extra money. If the doctor really deserves the punishment, then it should be pursued but not for selfish reasons.

2) Real Medical Savings Accounts - I think Medical Savings Accounts should be available to everybody. If you allowed them as tax free payroll deductions and then partnered with a major credit card company so that your MSA could be used by a doctor's office, hospital, pharmacy, etc. as easily as a credit card. This would be both convenient and very helpful. I would also make sure that the money never expired. It would sit in your account until used. I think this is an idea that would save people and the medical industry a lot of money in the long run.

3) Create pricing rules for medical services - Have you even recieved an insurance statement that give a charge amount of $150.00 and an allowed amount of $42.70 or something like that? That means the uninsured are getting charged three times more that the insured. That's just wrong. I would create some regulations that would have the uninsured and/or those not using insurance charged and the lowest allowed amount (the lowest price any insurance company would have to pay). Medical services should cut the most slack to the uninsured, not the least.

4) Create a unified medical records system - I think this is already being done to some extent but a lot of money could be saved if all medical services used the same computerized format for medical records. They could be sent and recieved without the office staff having to manually enter information, billing would be simplified, and records would be more consistent. This would reduce overhead saving offices money which, in turn, would save patients money.

5) A universal health insurance system? - I'm not sure about this one but I do see the benefits of making sure all citizens of the US at least have catastrophic insurance coverage (have a $2000 or so deductable that could be paid with a medical savings account - heck you could even have an private insurance policy that covers the deductable for you). If this were the case, those who need intensive medical care can get it without hospitals have to raise fees in order to pay for what their patients can't afford. I think if this were implemented well, it could be a very good thing, if implemented poorly, I think it could be disaterous. So, while it's a good thought, the jury's still out on whether it is practical and/or workable. I guess that's what feasibility studies are for...

Well there's my overhaul of the medical system. Some of the changes would have a fairly quick effect while other may take years to see the benefits. I don't know if my ideas would do enough to help with medical expenses but I think it would put us on the right track.

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