Coveny’s plan for health care

[Coveny]

This is going to be a fairly long post about what I believe is the solution to health care in America. I’m going to touch on the scientific reasons, the economic reasons, and also discuss the emotion impact. I’m going to try and give goals for each of my positions, as well as explanations on how this position is going to achieve that goal. As a for the record thing I’m not getting anyone to review this before posting it so it likely will have spelling and grammar errors, and may not be as organized as it should be, and while you are welcome to criticize those parts my hope is that you will look past them and discuss the various points and how valid you feel like they are.

The problem
Our current system is too costly because of regulations which prevent small at home type hospitals from operating, as well as the lawsuits against medical personal. These regulations also prevent new drugs from being brought into market, and increase the time and costs involved to bring the drug to market. On the flip side the patents or copy rights to drugs keep drug prices very high in this country because once a drug is created only that company can legally produce it for many many years. This is all designed through corruption of our state and federal government to benefit the few at the cost of the many.

Universal healthcare cuts back much of company’s corruption, lowers medical and drug costs. It is not without its problems though as it removes much of the incentive to become a doctor, which leads to less doctors, longer wait times, or patients not qualifying for needed treatments. This again remove options of the poor to get healthcare.

The goal
To create a system where everyone can get healthcare, provide an incentive for people to become medical professionals, and lower healthcare costs.

The solution
1) Deregulate medical buildings
2) Lower patent and copy right terms
3) Making being a medical personal easier
4) Regulate the amounts of lawsuits 
5) Bringing it all together

1) Deregulate medical buildings
Did you know that in an abortion clinic it’s required to have hallways big enough to fit two gurneys side by side? Did you also know that they don’t use gurneys in an abortion clinic? The point being there are many laws in place that regulate what a medical building must have, and these laws double if not triple the cost require to build these facilities. By removing these regulations, we could have doctors who saw patients out of their homes completely removing the overhead costs of having a hospital at all. Obviously, this opens concerns about infection and hygiene but if we want to lower costs and allow more people to make money in the medical profession we need to be able to treat it like any other profession. If you want to pay the extra money for a nice that is always an option, but for the poor this gives them other options to get the treatment they need. And as with everything else, as the demand in the hospitals drops, the cost of going to the nicer facilities will drop as well. This is what capitalism excels at. Once we’ve done that we can setup classification of facilities by standards.

2) Lower patent and copy right terms
Many drugs are patented and copy righted for life, and they have a monopoly on the market so they can charge through the roof. Other companies have to wait years before they are able to make generic versions of the drugs. Companies spend a LOT more on marketing than they do on research. The government is doing most of the research. “75% of so-called new molecular entities with priority rating (the most innovative drugs) trace their existence to NIH funding” source: http://www.latimes.com/opinion/op-ed/la-oe-1027-mazzucato-big-pharma-prices-20151027-story.html
Government pay for the research (as with the case of the epi-pen) and then private company buy the patient, regulated all the schools to use it, and then increased the price by 5000%. We need to break the patent/copy right monopoly sooner, and force drug companies to invest into research rather than milking what’s already been created.

3) Making being a medical personal easier
One of the best ways to lower the cost of something is to have a better supply. Currently to be a doctor you need over a decade of school, from which you will exit with a mountain of debt, and there are no half measures here. The closest being a nurse practitioner who is still over a decade in the making. Also let’s be clear, medical malpractice is the 3rd cause of death in this country (at over 200 thousand a year) so it’s not like the people who go through all those classes are providing. So, let’s make it easier to break into the medical profession. Let create tiers like what we do with emergency personal. EMT is the first, paramedic is the second, ER nurse is the third, doctor is the fourth. My suggestion is to have 5 tiers for both general and surgery. The higher the tier the more schooling that’s required, and obviously testing and certification for each of level. I purpose to do the tiers in two year increments so Tier 1 = two-year degree, Tier 2 = four-year degree, Tier 3 = six-year degree, Tier 4 = eight-year degree, and Tier 5 is what we have today. Now this could mean 75% in class and 25% on the job, or whatever the industry feels is best, but the amount of time it takes to get to the point where you can see someone needs to be shortened. Also, the ability to prescribe drugs would be attached to the various levels as well.

4) Regulate the amounts of lawsuits 
If we put tiers in place then there needs to be an understanding that the less you spend on a doctor the less you can sue them. This could be regulated based on the tier of the individual who saw you or the amount of money you spent to receive care. For instance, if you saw a tier 1 then you couldn’t sue him for more than 10k, tier 2 30k, tier 3 100k, tier 4 200k, and tier 5 unlimited, or it could be something like 100 times what you spent so that if you had a $20 doctor visit then the most you could sue that doctor for would be $2,000, but if you spent $300 then you could sue for 30k. Accidents are going to happen, and if you want to take a higher risk to save money then the person trying to provide you care needs to have the incentive that one mistake isn’t going to bankrupt him. 

5) Bringing it all together
Once we have a system in place where medical care is much cheaper and more available we can cheaply subsidize it. For instance, it wouldn’t be expensive to cover 100% the cost for tier 1 medical professions in a tier 1 building, 80% for 2/2, 60% for 3/3, 40% for 4/4, and nothing for 5/5. Insurance companies could easily adapt to this system, and allow for MUCH more flexibility in healthcare plans that cover the difference, and work on top. Making it affordable to even see tier 3 medical professionals. Doctors have the freedom to build their own practices without having to worry about the regulations of the facilities, and our society would likely even have doctor house calls again. If we can stop trying to remove risk, and stop trying to force people to work for less I think we can easily provide healthcare for everyone.  

[CharonY]

Not going to address all the points but :

28 minutes ago, Coveny said:

Did you know that in an abortion clinic it’s required to have hallways big enough to fit two gurneys side by side? Did you also know that they don’t use gurneys in an abortion clinic?

This regulation was made by GOP lawmakers to specifically shut down abortion clinics. It was not made with health issues in mind. Conversely, there are many meaningful regulations without which we would put patients in danger. I also contest that theses regulations are what drive costs up, as in the UK, Canada or Germany hospitalization costs are much lower and their regulation is at least every bit as strict. If propose to get rid of legislature that were implemented for political rather than medical purposes that should be on the chopping block.

See: TRAP laws

Edited October 6, 2017 by CharonY

[Coveny]

47 minutes ago, CharonY said:

Not going to address all the points but :

This regulation was made by GOP lawmakers to specifically shut down abortion clinics. It was not made with health issues in mind. Conversely, there are many meaningful regulations without which we would put patients in danger. I also contest that theses regulations are what drive costs up, as in the UK, Canada or Germany hospitalization costs are much lower and their regulation is at least every bit as strict. If propose to get rid of legislature that were implemented for political rather than medical purposes that should be on the chopping block.

See: TRAP laws

Regulation are requirements, and to meet these requirements additional funds must be used. This means additional costs as you can't request something made of the best materials, and expect it to cost the same as something made of the cheapest materials.

 

The UK, and Canada have universal healthcare which has issues with lines, and a lack of incentive for doctors, so yes you do have lower costs with the same strictness of regulation, but you have a different set of problems that goes along with it.