HealthCare Reform

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HealthCare Reform

• Rhetoric, Facts and Visions
• Mark E Green MD
• www.OurHealthReform.com

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We Already Spend Enough Money

• In 2007, the per capita expenditure for
  healthcare in the US was 7,500. 24 higher than
  the next highest countries.
• Greater than 2 Trillion dollars.
• US citizens spent the equivalent of 16 of the US
  GDP on Healthcare in 2006. 3 higher than the
  next highest country.
• Despite this spending, the US was ranked 37th out
  of 191 WHO member states.

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US Health Care System Earns Poor Marks

• Access problems due to costs
• Coordination problems
• Medical errors
• Medication errors
• Lab errors
• JAMA, December 24/31, 2008-Vol 300, 24

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Private Insurance Plans verses a Single Payer
System
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Dollars Available for HealthCare
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Insuring Health or Insuring Profit ?

• Growth in Wages 2007 3.7
• Overall Inflation Rate 2007. 2.6
• Average Premium Increase 2007.. 6.1
• Increase in Profits Big 7 9.7
• (United Health, WellPoint, Aetna, CIGNA,
  Humana, Health Net, Coventry, Kaiser)
• Northwest Federation of Community Organizations,
  July 2008

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HealthCare Reform is Coming

• Far Left-
• Tax-Payer born
• Unlimited Services
• Global Budgets
• Tax the Upper Segments Harder
• Government Control

• Far Right
• Maintain Private Insurance Co.
• Market Drivers
• Competition Between Insurers
• No Real Reform

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A Growing Sentiment for Change

• America does not need a socialized medical
  system.
• The current system is too fragmented with which
  to work.
• The biggest players in the current system are too
  vested in it to be impartial.
• The real value of private health insurance is
  being questioned.
• A single party payer system is becoming more
  attractive to many leaders.

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Characteristics of a Reasonable System?

• Affordable
• Sustainable
• Reliable
• Universal
• Portable
• Efficient
• High Quality
• Legally reformed

• Implementable in Increments or Stages
• Contractible (flexible)
• Scalable
• Maintenance of personal accountability
• Not solely born by the tax-payer

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Medicare as a Starting Point

• It is currently in place and functioning
• It is a near universal product.
• It has a functioning infrastructure
• It has a nationwide provider panel
• It is a one party payer
• It is not socialized
• It already represents about a forth to a third of
  US citizens.

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Bullet Points for Rational Reform

• Step One
• Start with the basic Medicare plan, as it exists
  today.
• Issue a unique ID number to each current
  enrollee. The current social security number will
  not be used.
• Eliminate the current yearly deductible
  payment.
• Maintain the current per visit co-payment, though
  adjust it for income/means, and build in a per
  individual/family maximum co-payment amount for
  any 4 week interval.
• Include drug coverage for common medications. Pay
  a fixed price for a given class of drugs,
  regardless of which drug in that class is
  prescribed.

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Bullet Points cont

• Construct a Medicare sponsored supplement plan
  and offer it to all traditional Medicare clients.
  Enrollees would pay a monthly premium for this
  supplement, as they currently do, though it would
  be means adjusted and generally less than they
  currently pay.
• Re-evaluate Medicares computer and manpower
  infrastructure and enhance it as needed.
• Dissolve the Medicare Advantage Plans and
  re-enroll those clients into the Enhanced
  Medicare Plan as above.

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Bullet Points cont

• Take the monies currently ear-marked for the
  Medicare Advantage Plans and infuse them into the
  Enhanced Medicare Plan above.
• Re-evaluate the infrastructure and correct as
  needed.
• Medicare would now be a decent and affordable
  insurance product for its clients.

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Bullet Points cont

• Step Two
• Enroll people 0 through 17 years old and pregnant
  women through, two years post partum, into this
  Enhanced Medicare Plan. A hodgepodge of private
  insurance plans and a multitude of governmental
  programs cover these groups currently.
• Examine the sources of monies presently used to
  pay for the health care of these population
  segments and, as appropriate, roll those monies
  into the new plan. This would include income
  adjusted premium payments from parents and
  guardians and possibly from the employers of the
  parents and guardians.
• Re-evaluate the infrastructure and enhance as
  needed.

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Bullet Points cont

• Step Three
• As seems feasible at the given current time,
  begin enrolling the rest of America in the
  Enhanced Medicare Plan, starting with the upper 5
  year age block first and working backward, as
  infrastructure allows, till all Americans are
  covered. Example Those persons 60- 64 years old
  then those 55-59 years old, et cetera.
• As each age group is enrolled, begin the
  collection of income adjusted premium payments
  from them, much the same way as they pay their
  health insurance premiums now, plus their
  employers contribution.
• Periodically the infrastructure would have to be
  expanded aggressively.
• Never proceed to the next age group if funding
  and infrastructure are not in place.

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Bullet Points cont

• Reformed in this way, universal coverage could be
  obtained, personal responsibility can be
  required, the expense could be incrementally
  accounted for, private health coverage could be
  suitably transformed, and the taxpayer could be
  spared the total burden of healthcare reform.
• All Americans would now be covered by an
  insurance plan. Any care issues could be
  monitored. Tracking of fraud, abuse, waste, and
  medical errors would now be possible.

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Conclusion

• Healthcare reform is coming
• It will be, or will evolve to be, universal.
• There needs to be levels of personal
  responsibility.
• It needs to be scalable and contractible.
• It has to be fundable and sustainable.
• It has to be fair to people of all means,
  conditions, and illnesses.

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Comments and/or Criticisms

• Mark Green
• 463 POB BMH
• Maryville, TN 37804
• 865-980-5360
• www.OurHealthReform.com
• MarkGreen_at_OurHealthReform.com