A plan for healthcare

The post below was lifted bodily from "doc Russia"

There is likely to be some talk in politics about healthcare coming up. Ironically, Edwards, who made a career and a fortune out of suing healthcare providers is likely going to advance his own ideas about what I can only assume will be a Universal socialized healthcare system. So, before I start tearing the socialized medicine model to shreds, I am going to offer my own alternative. I often castigate the left for decrying a conservative plan, while failing to offer an alternative, and I will not fall into hypocrisy.

Part I

Professional insurance caps. We must drive out the lottery system from malpractice litigation. If a doctor has erred, hold them accountable, but do not allow for fraudulent and expensive allegations to consume the time and resources of the courts and physicians. It has been my experience that perhaps nothing else is more cost producing for healthcare than litigation. It manifests in a number of ways, beyond the raise in professional liability premiums, which drive away physicians, and force physicians to recoup the loss by seeing more patients in less time, or working longer hours. Neither of these improve the quality of care. It also causes a ripple effect where physicians practice defensive medicine. We run more tests than are reasonable, driving up costs, and detrimentally affecting the patients experience with healthcare. Also, we keep them hospitalized longer in order to completely Cover our Collective hindquarters. This drives up costs further, as well as facilitating hospital acquired diseases and superbugs, both of which require more expensive care than the community acquired diseases.

Part II

Right to refuse. Allow physicians to refuse services except in the most emergent of situations. This means that unless the patient presents with something emergent (lethal in less than 72 hours), hospitals can turn them out, either right from the start, or once a reasonable level of confidence has ruled out an emergent condition. This means that Chest Pain gets serial EKG and enzymes, with a Chest X-ray on top, and if nothing is found, you turf them to their PCP. If they have no PCP, then they had better get one, or pay for their own care starting immediately.

Part III

Make government care shitty. That's right; make it the absolute worst. As it stands medicare and medicaid provide a very high level of care for free to people who would rather spend their money on disposable items than on preventative care. Medicare has become an enabler for bad decision making by not making people accountable for paying their own bills. I know this sounds very harsh, but it is key to citizens taking responsibility for their own health. If we cannot get the private individual to be a proactive agent in their own healthcare, then all the government programs and funding in the world is going to be incredibly undereffective. We do not malevolently downgrade care, but we institute the cheapest programs reasonably possible. This will reduce the taxpayer burden, and impel patients to stay out of the public trough.

Part IV

Make Healthcare providers being reimbursed by medicare/medicaid immune to civil litigation. This will do the following: Patients who are not paying for their care will no longer be able to sue their way to financial independance for care which was provided to them free of charge. Also, it will give the salaries of medicare/medicaid doctors a competitive advantage, and help drive down the cost since the docs will not need such a high salary to maintain their standard of living since they will no longer have to factor in the overhead of professional insurance. Lastly, those less adroit physicians, after being sued enough times will have to seek refuge being a government provider. This will mean that government healthcare will be substandard, and people will try harder to get off of it, and pay for their own bills.

Part V

Allow for wage garnishment starting at the time of service. This will allow hospitals and doctors to recoup losses over time by having amounts deducted from the patients income directly for services rendered in an emergency situation. Also, allow for a healthcare equivalent to Bail. In this way, patients can put up their home or automobile as collateral for their healthcare.

Part VI

Provide for itemized price lists to the patients. It is a small measure, but it will have great results because those things which patients can provide themselves (pillows, blankets, gowns, bandaids) or can buy on the open market are going to bring down the cost of healthcare. Hand in hand with this, we need to allow private vendors to compete in the hospital. Part of the way that the hospital meets their overhead is by overcharging for items that are used. A $1 oxygen mask will be billed to you for $50. Stuff like that. I think that hospitals should get a percentage of the vendors take as kind of a privelage for access to the patients, and that this percentage should be hammered out between the hospital and the vendor, with one important caveat: there must be more than one vendor available for any sort of supplies. Hospitals also can make money from procedures performed. So, I think that there is still plenty of profitability to be had to keep our hospitals running.

Part VII

Allow for open bidding. Allow doctors and hospitals to bid for the care of patients. Also, we should allow for charity hospitals to bid for medicare/medicaid patients.
This seven point plan does have a number of overlaps. It is supposed to. This is because it runs under two basic concepts:

Publicly funded healthcare must be as cheap as is possible. It is there to save those who cannot save themselves, not for those who will not.

Private incentive, mixed with professional pride, will inspire more excellence, efficacy, and efficiency than professional pride alone.