SOLUTION: Real Health-Care Reform, But in Steps

  Merry Christmas everyone.  I hope you are having and will have a great holiday season up to and including New Year.  With that said, the pages, assistants, secretaries, and other helpers of Senators have been putting in ridiculous hours this past month – they don’t get a Christmas this year.   They are doing tis because the Senate wants to pass  its version of the health-care reform bill before Christmas and the holiday break.

Well, despite all the terrible and amazing shortfalls and bad policy, Senate Democrats and two independents are going to get their wish.  The passage of their bill is all but guaranteed.  Its just a matter of voting on it late in the day on Christmas Eve, and they have the votes. 

I could lament about how the cost estimates are grossly undervalued and the savings are overvalued. 

 I could rail about how the for profit companies involved have not been reigned in to stop them from raising your health-care costs. 

 I could even go as far as to go into detail about how the new bill will stop companies from denying coverage for pre-existing conditions, but it doesn’t stop them from making treatment of pre-existing conditions be  4 times higher than what that treatment would be compared to the charge for a previously healthy person who did not have the pre-existing condition.

I won’t.  I’m just wasting my breath.

What I do want to do is give you a solution, not lament on the problems.  Below is how I would reform health-care.  Let me qualify this by saying that I believe this is a good idea, but most likely wouldn’t get passed eve though it is a temporary experiment.

My solution is to make an elective health-care trial for citizens of a certain state footprint.  Pick six states in the Mid-West or all of New England or something like that and have the program last somewhere between three and five years.  Where and the exact length isn’t as important as the trial being large and long enough to create enough participation and enable collection of good data.

What I propose is to create an independent yet temporary health-care system for families and individuals that want to participate in the footprint.  Similar to how China created special economic zones (SEZs) for business.  I am taking that idea, but making it temporary and for health-care instead.  It would be a whole new system that incorporates employers, hospitals, insurance companies, and drug manufactuers/importers. 

The first thing I would do is throw out EVERYTHING you know about health-care.  Cut out all the government red tape, rules, and all but the most basic protective regulation to minimize the impact and cost of government involvement.  Create incentives for entrepreneurs and small health-care related businesses to be formed or participate in the process.  They will be the market for consumers to participate in.  Big companies can explicitly NOT participate.  The only exception is that big hospitals obviously can participate, but to garner the incentives, they have to use separate billing and accounting independent of the normal business.  They would have to set up corporations inside their current structure so that the books are separate and transparency can be maintained.  Big pharma can participate too, but only when their drug is the cheapest.   In theory, this would only happen when their cutting edge drug is still patent protected and has no competition.  Otherwise, FDA approved imported drugs from Canada and other countries would most likely beat out the over-charged prices big pharma charges today.

The idea is to return to capitalist ideals when it comes to your health-care.  Let the free market decide.  If a company CEO wants to rake you over the coals for the product they give you so he can drive his stock price up a quarter point, you have the option to go somewhere else where the prices are cheaper.  If he doesn’t change his pricing structure, he goes out of business because he loses all of his customers.  It is self-correcting.  That is the free market.

 Government is not there to make the process more expensive or prop businesses up with protectionist laws.  Laws should be there to protect citizens, not corporations, and only then at a bare minimum.  Caveat emptor.  Let the buyer beware.  It is your responsibility to do your homework.  You spend 15 minutes and shop around for car insurance – why can’t you do the equivalent for your insurance, prescriptions, doctor’s fees, etc?   Also, take your place of work being the sponsor out.  They still pay the bill, but this program would be cheaper  for them.  That would make them more profitable, be able to give you a raise, expand, hire more workers and grow the economy, whatever.  I think you understand my vision.

IBottom-line, you would get better care for less cost and less profiteering.  Companies would have to charge fair prices, be lean, and focus on continuous improvement to successfully compete. 

Doesn’t that sound like a good way to reduce your health-care costs? 

Almost any other industry does this already.  It is what makes Wal-Mart so successful.  They still make money hand over fist and they give the customer what they want. 

What if you don’t like the Wal-Mart of health-care?  Well, you can have the equivalent of Target.  Or Macy’s.  Or Sax Fifth Avenue.  The point is, you have a choice when you shop for anything else, why can’t you have the same for health-care? 

You can.  You simply need to get rid of the back-room, sweetheart deals that come from the collusion of government and lobbyists that represent big business in the health-care industry…and that is why my idea is unrealistic in the current set-up in DC…but it WOULD work.

In the second phase,  I then believe that this program could expand.  It would be inexpensive enough to apply for Medicare and Medicaid.  It would actually be so efficient and cheap that we could once again start adding to the coffers instead of taking from them while at the same time providing better and easier care for our seniors and needy.  Under this provision, THEN you could offer subsidized expansion to the uninsured as long as they are working to get off of welfare.  If you don’t contribute, you get cut and have to go back to the old, alternate system that still exists.  There is no free-ride in this system because there are no government protections or loop-holes for the litigious or disengenous to exploit.

In theory, it would be so successful, that the experiment would become permanent in the footprint because everyone would be so happy with it.  Demand for ‘Gadsden’s Plan’ would swell and it would expand across the country.  Eventually the ‘big’ health-care players would either have to come clean or perish. 

And what if I’m wrong and my program backfires?  It was temporary and limited in scale for a reason.  No matter what, we could learn a lot from it.  Is it better to spend some public money creating new business opportunities that create jobs and promise to be so much more and solve the crisis once and for all?  OR do we keep funneling money to the same broken programs and continue to bemoan how we are not really changing anything?

The Gadsden Plan is real health-care reform.  Its backbone is capitalism and democracy by dollars.  The final product we will be getting in January is neither.  The same players, the same back-room deals, and the same special interests do not represent reform.  Why would they change a system that works so well for them?  An apathetic populace pays the tab because it is too burdened and ignorant of the issues to hold these big health-care companies or their ‘representatives’ in government accountable.

Think about it, give me feedback, and help me fill in the weak spots of my plan.  I know it is not perfect, but I think you get the gist of where I am going with this.  My plan is far from perfect, but even with its flaws, be you on the left or the right, it does sound a lot better, doesn’t it?

– G.S.

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