Congress and the Administration are busy tweaking the existing system, and calling it reform. They are crowing about 47 million uninsured as evidence of a crisis, when a huge number of them are prime of life people who do not need health care. Republicans are attacking costs, increased taxes proposed by Democrats, while claiming that the for profit insurance system is great, begging the question if they’ve woken up from the Bush years yet. All of it is in a crisis mode – must be reformed this summer. Or what? I think we’ll just have another summer next year.
Now I do have some ideas for real health care reform. It starts with the simple premise of a single payer. I don’t care if it is the Social Security Administration or Halliburton. Stop wasting billions on multiple billings, useless accountants, claim processors, rate negotiators, and of course, CBO, GAO and untold other studies. The Government should simply open it up for bids. Companies could partner, agencies and companies could partner, agencies and agencies could partner. I would not care. Just two basic criteria: single payer, meaning single book-keeping, and lowest operating bid. Health insurance is not brain surgery – it is just moving money from the left hand to the right hand. So the winner should do it cheaply. That would take care of my health insurance claim processing reform.
Now for actual health care reform? Well we are in a pickle, one that neither Democrats, Republicans, AMA or BCBS want to admit. The baby boomers are going to clog the are demographics arteries. The number of Americans over the age 64 will double for the next 40 years, and these old codgers consume 6 times the health care that a young person does. Our infrastructure, you know the one with Indian immigrant doctors, Philipino immigrant nurses, and hundreds of closed hospitals, cannot serve their numbers. So we will have metered health care. The rich will go to through the side doors while the rest of America will queue up at the front desk. Inevitable. How can Congress ignore this? Perhaps because most will be dead and gone by the time it becomes obvious.
The way to get out of the pickle is to resort to the great American ideal of self determination and self reliance. My suggestion is that every American be endowed with a voucher of $1,000,000, for life time health care. Each time they go to a doctor, the single payer will pay the doc, and reduce the balance of the voucher. Once a person runs out, they are on their own. If they live right, maybe the voucher can last a long time. If they live smart, they won’t rush to the doctor for every sprain and strain, much less for Viagra. If at the end of life, they only have enough for a hospice, rather than the inhuman cruelty of being kept alive on tubes for months, who is to judge which represents better quality of care. How do I suppose to pay for this. Well, the startup cost is minimal. Even old people only average $8-10,000 in annual costs. That’s the only part of the voucher that has to be covered initially. The full million is like life insurance – you pay, perhaps into Medicaid (what a novel idea) to build up the “future value” of you endowment. The younger you are when you start, the lower your monthly payments. I think it is doable.
Now to complete my tour de reform, I would allow the unused balance of a voucher to be transferred to heirs, as part of the estate. I know, it sounds odd, but it really makes sense. The genetics will ensure that in the long run, the healthiest of the breed will end up getting the best of care.
Sorry folks, but when one is looking to reform reform, one has to strain the gene pool to achieve real savings in health care.
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