One of the problems of Obamacare is that often people just shrug and think the whole system is too much a mess and there’s nothing that can be done. That’s nonsense. One thing that IS important is to go to the root of why health care in America is so expensive and work on fixing it.
1) Doctor’s salaries are very very high. $700,000 a year for a neurosurgeon or cardiologist, $250,000 for an anesthesiologist. A general practitioner at a HMO makes the least at $200,000 a year. These are still very high entitled salaries, members of congress only earn 172,000 for gods sake. Salaries are high because of the shortage of doctors and the very long process (4 years of college, 4 years of medical school, 2 years of specialization residency) before doctors earn very much money. They have huge loans to pay back and often also are responsible for their malpractice. After all that, when they do get to finally bill they are more than willing to gouge and get that porsche.
2) Lawsuits drive up the cost of medicine. Too many lawyers descend and get too high rewards. This is a complex question of what a life is worth.
3) Hospital emergency rooms and beds are flooded with illegal aliens who never paid a cent into the system. Worse, we get all the Mexicans who need dialysis or long term expensive care. Dialysis for just one Mexican costs over 200,000 a year. And federal decisions mandate that hospitals treat them and not turn them away. Other shock cases are of indigent mexicans living in hospitals for decades because they have no home to be discharged into.
4) Citizens who pay for insurance are very much footing the bill for everyone else
Ok now will Obamacare change any of this? No nothing at all. So of course Obamacare prices are going up astronomically.
What we need is some common sense. Something that actually attacks these REASONS for the trouble in the healthcare system with some common sense. I call this the G-Clinic system. It is a two tiered system of clinics (band aids, chest colds, broken arms, prescriptions, basic medical care) and hospitals (for life threatening trauma, surgeries, and other complex procedures).
Step One: More and Cheaper Doctors
We need to make it easier to be a doctor without sacrificing quality. The solution? Hold a national test for high school grads. The top 5,000 would go to one of five government run medical schools spread around the country. As state schools are to the ivy league, these schools would have larger classrooms and break out sessions into smaller labs for hands on. And they would be totally free including dorms and living expense stipends. After four years, at the age of 22, the doctor would be ready to work at the G-Clinic. They would commit to working there for five years at reduced but decent salary (80,000 a year). Their fourth year they would apprentice one day a week at a hospital working on a specialty and their fifth year they would apprentice one day a week working with a private practice doctor as an apprentice. After all of this, they would be free to open a private practice or work in a hospital (although a hospital may require one year of residency depending).
Step Two: Prioritization of Patients
Citizens always go to the front of the line. Next patients who can afford the small co-pay (25) to visit the clinic. Destitute illegal aliens will have to wait until everyone else has cleared. Illegal aliens who abuse ambulances will be taken to clinics not hospitals and repeat offenders will be refused treatment altogether. If an illegal alien stormed into a hospital ER with a chest pain they would most likely be re-routed to a nearby clinic. If they came in with a ice pic through their head and were really in a dire emergency then the hospital would admit them. Clinics would take appointments for routine care. Finally lawsuits would be extremely limited in dollar amounts at a clinic.
Step Three: On Site Labs and Diagnostics
A lot of the cost for medicine is to get a lab or diagnostic done, a chest x-ray, a MRI. Clinics should be well equipped in all the basic diagnostic tools to run blood tests as well as scans.
Cost: How much does the G-Clinic Cost? Nothing. It would be completely free to use except for a small ($25) co pay.
OK what if you are poor and need to use a big hospital for a surgery (or have insurance)? Medicaid would be required to submit out to all local hospitals a bid for the work and see who submits back the best price and schedule. Insurance would be structured NOT THROUGH WORK but individually bought and policies would be written so that they pay a percentage of hospital or private visits. The big problem with a hospital visit today is that you have little idea how much it will cost. Compare that to a private self paying procedure like a boob job and you can bet that patients shop around for price quotes and know exactly how much something costs before entering the facility. Why can’t we do that with hospitals? If one has a top reputation but costs 10,000 more, if a patient wants to pay the difference thats up to them, thats why it must be structured that the patient pays a percentage. Getting the patient directly involved in the cost and charges is the only way to return a real capital marketplace for hospital billing and specialist billing.
0-5000 – pays 10% or 25 dollars whichever is more
5001 – 25000 pays 8%
25,000+ pays 5%
One advantage of the G-clinic system is that it would be a parallel system. People would slowly begin using it as it was cheaper/better than the existing system and as it grew with enough clinics and hospitals supporting the system. So unlike Obamacare we don’t have to shut things down all take a deep breath and pray it will all still work and be affordable in the morning.