Health Care: WAKE UP WASHINGTON!

Ok, so President Obama once again wants to act like he's still running for office instead of inhabiting the Oval Office.

I get it.

My objection is simple: Neither the Republicans or Democrats have put forward a plan that actually addresses the structural problems we have with medical coverage in America.

I am going to reprint and expand on my actual fix for Health Care, for the following reasons:

It will work and control costs by dramatically increasing competition.  Today, employed persons typically have one choice for insurance coverage.  This plan will bring them dozens to hundreds of choices at competitive prices.  You wouldn't accept a system where there were a dozen stores but only one where you could shop because of the company you worked for, but if the grocery business had such restrictions a gallon of milk would cost $20, because the store you could buy from would know that you couldn't go next door.

It will end cost-shifting and cost-hiding, which is bankrupting millions of Americans and is the core problem underlying the imbalances in the system today.

Finally, it will not increase the budget deficit one nickel.

Here it is; you can read the original as well if you want:

Let's reprint the key points, simplify and expand on them:

If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.  If an insurer has a "we accept anyone at the same price" policy for a business, you must be able to buy into their plan for the same amount of money that the employer is charged on a per-person basis.  That is, all plans must be "open enrollment" for everyone within the state - period.  This immediately gets rid of the "tie" between employment and health "insurance", and it also removes one of the biggest issues that small business and self-employed people face - the inability to buy insurance at any reasonable price if there has ever been anything wrong with them medically.  The solution to the "adverse selection" problem is identical to that which exists in corporations - you typically can only elect out or in of a policy or plan on an annual basis - that is, you're obligated to participate for a full calendar year.  Enforcing the same terms (you can only opt in during one month, and are obligated for the entire year) solves the problem of someone deciding to buy only when they get ill, as you would have to wait for the enrollment window to open.  For acute conditions where adverse selection becomes most important this restriction resolves the problem.  This also resolves the pre-existing condition problem that the self-employed have today.

All health providers must publish a price list and may not bill or accept payment at anything other than that price; doing so becomes a violation of Robinson-Patman and exposes the provider to civil suit for treble damages.  This instantly stops the practice of billing the uninsured or privately insured at a higher price than Medicare, for example - a practice that is rampant, particularly among hospitals.  Every hospital has a detailed price list for every function and thing in their health care panoply - this enforces even billing and even pricing for everyone, without discrimination.  The complaint that health providers cannot make a living at Medicare's reimbursement rates does not give that provider license to cost shift the expense of government-subsidized care to privately-insured or uninsured patients.   Everyone would raise hell if your car was three times as expensive if you worked for Ford than if you worked for GM, yet it is accepted that if you're not insured by Kaiser (for example) your heart bypass surgery costs a different amount.  If Medicare's "price schedule" is inadequate the solution is for providers to refuse to provide the service at that price and thus negotiate for a higher price for that procedure, not cost-shift the care of older Americans onto younger.  This is a more than $200 billion dollar a year rip-off of working-age Americans, it bankrupts the uninsured or those denied coverage after a health event, and it must be made explicitly unlawful.

If you show up without insurance or ability to pay with a life-threatening condition, you will be treated, but the hospital cannot cost-shift the bill - it instead bills The Federal Government.  We have created an expectation that if you show up needing emergency treatment you will get it, irrespective of ability to pay.  This creates a monstrous problem for hospitals and results in the $30 aspirin, among other outrageous distortions.  The solution is to have The Federal Government receive all uninsured and unpaid bills, with the debt being immediately paid by the government.  Said debt then becomes a collection item against the citizen - a debt to the Treasury, administered by the Internal Revenue Service.  If you cannot pay cash, that's fine - the IRS will be happy to take payments (at interest.)  If you're an illegal alien the Federal Government will be mandated (by statute) to collect from the other nation, and if they refuse to pay, to deduct any such amount from foreign aid of any type and source on a dollar-for-dollar basis.

We must reform the tort system.  The trial lawyers will hate it.  So what. The simplest proposal is this: you may sue only for gross negligence.  If the wrong arm is amputated, you have a lawsuit.  But we, as a society, must admit and accept that we call it practicing medicine, and by the very name - "practice" - we therefore admit and accept that outcomes will neither be perfect or predictable.  But while we must accept that medicine is not a perfect science and outcomes cannot always be predicted, every person has a right to know their physician's record.  In exchange for this partial immunity from suits all outcomes and counts of procedures performed, by the patient's own evaluation as to degree of success or failure, are to be published online in a searchable database for use by any person at any time in making medical decisions, and the intentional concealment or tampering with such reporting shall be made a felony.  The patient's evaluation shall be an absolutely protected form of speech.

If you want a health care solution, there's one that will work.

Four points that will:

1. Bring instant competition to the health care system, enabling citizens to choose between dozens if not hundreds of competing insurance plans for the precise same price that an employer pays to cover the same person were they working for that company.
2. Allow you to keep your current plan and doctor if you wish.  Since this does not tamper with any existing insurance program there is no impact for those who like their current health care plan.  If your plan is particularly good, in fact, it is likely to get cheaper as more people join it.
3. Stop the pre-existing condition problem dead in its tracks.  No large or mid-sized employer accepts this in their plans.  You shouldn't have to either.
4. Prevents illegal aliens and the uninsured from shifting their care onto your wallet.  You're free to be uninsured but you will get billed by the government if you need emergency care.  Illegal aliens will get emergency care but the government of their citizenship will be billed.  The day of the $30 aspirin will be over.
5. Prevent gouging for cash-paying customers. Level billing will stop the abusive cost-shifting that bankrupts tens of thousands of Americans every year.
6. Not cost the taxpayer a nickel.  No budget impact - period.  In fact forcing the uninsured and illegal aliens' bills back onto the responsible parties will almost certainly decrease costs for Medicare and Medicaid, thereby saving money.

In the current debate why isn't a plan like this part of the discussion?

If you have a Tickerforum Login ID please vote on which of the three proposals you would like - no changes, the Obama Plan, or what is outlined above (if you are not logged in you cannot see the poll choices.)  The entire thread will be faxed, with results, to Congressional Leaders and President Obama when the poll closes in 7 days.  Registration on the forum is free and while you must wait 2 days after a new registration to comment, you can vote immediately.