One reason that Republicans snatched defeat from the jaws of victory was that they chose the wrong slogan for elimination of Obamacare. The idea of replacement is framed by Democrats as replacing a failed monstrosity with a new replacement monstrosity. As with everything else, Democrats demand a single comprehensive healthcare plan. The Republican failure to have a united front on a clearly articulated Obamacare replacement plan provided fuel for Democrats and the media on both the left and right to oppose Obamacare repeal and replacement. Consequently, doubt and speculation rather than clarity prevailed. Going forward the question remains, “Will Republicans ‘snatch defeat from the jaws of victory?'” Can Republicans solve the nation’s healthcare issues?
In my opinion, the Republican slogan concerning Obamacare should be Real Healthcare Solutions Now. This would place the important issues at the forefront. The slogan, “Real Healthcare Solutions Now, would provide emphasis for a campaign to verbalize exactly how healthcare should be improved and perfected both in relation to the pre-Obamacare healthcare environment and the healthcare failures caused by Obamacare. A monster bill or law covering all the ills of healthcare would be counterproductive and ineffective in solving all the pre-Obamacare and Obamacare caused issues.
Two critical issues that plagued healthcare before Obamacare are transparency within the medical profession in relation to quality and cost of healthcare and tort reform. Providing the people of the United States with high quality, economical healthcare would require that each of these issues be effectively addressed. First, the medical profession should be totally transparent or patients will never have control of their own healthcare. Patients should be able to easily determine and compare the quality and cost of care that they would get from every doctor, analytical procedures, and clinics and hospitals where they will receive care. CBS News reported that clinics, hospitals, and their emergency rooms utilize some specialists and practitioners, like anesthesiologists, that are out of network and not covered by the same insurance plan. The report noted that the patients were not informed about the situation and were billed for the entire cost. Such a situation should be illegal. If a hospital or clinic is covered by your insurance, all of the practitioners at the facility should be part of each plan. The cost and quality of prescription drugs should also be easily comparable for the general public. Unfortunately the medical profession has succeeded in getting state and federal laws that make this type of information difficult for the public to access so that they can ensure the quality and cost-effectiveness of care they receive.
Secondly, tort reform is essential to control healthcare costs. As a former big truck driver, I am a perfect example of this issue. After a fairly severe heart episode, safety laws required a physical annually rather than biannually. At that time, laws specified that the annual physical include a $700 stress test, treadmill. However, my cardiologist would not approve my physical without a $3,500 myocardial stress test where the law simply specifies a treadmill. The difference, charged to insurance, was necessary, from my cardiologist perspective, to mitigate potential litigation if I was subsequently involved in a heart related traffic accident. I also have two all metal artificial hips which, in a small minority of patients, can cause surrounding tissue damage and prosthetic replacement. The daily barrage of attorney advertisements seeking clients for litigation regarding medication side effects and in my case the artificial hip side effects demonstrate the great potential increase in costs associated with litigation. It is not difficult to imagine how much this tort environment increases the cost of healthcare. Healthcare laws should address these issues.
In my opinion, every individual and family in the United States of America should be legally responsible for payment of their healthcare costs. This could be accomplished by my proposal for “The Healthcare Responsibility Act.” Admittedly, it is a wild and crazy idea to think that everybody should be legally responsible for their healthcare and the healthcare of their family. Under this concept, there would be no healthcare insurance mandate; but individuals and families would secure healthcare insurance if they knew that they would be legally responsible for all their healthcare costs whether or not they were responsible enough to secure healthcare insurance and/or fund a healthcare savings account. To ensure their financial future, the young and healthy would secure state or federally defined legal minimum health insurance coverage. This concept would help insure that the insurance provider pools had adequate funding to cover those with pre-existing conditions and children under 26 years of age with their parents insurance.
As a young, 70 year old geezer, my pre-Obamacare healthcare experience was extensive. Before we lost her, my wife and I were never without family healthcare insurance which covered ACL replacements on each of our son’s knees, surgeries on both of my knees and two fingers, my initial heart care, and her cancer care which exceeded $250,000. Subsequently, in New Mexico, while attempting to start a ministry/business, my heart condition precluded private individual healthcare insurance. My premium through the New Mexico Health Insurance Alliance (NMHIA), a state run program for uninsurable entrepreneurs, was nearly $700 a month. Premiums were high because the pool was limited to uninsurable entrepreneurs with businesses in New Mexico, a rather small group. Monthly copays for three branded prescriptions totaled $120, and practitioner copays ranged from $10 to $40 per visit. In my opinion as a citizen, healthcare insurance was my responsibility. Both of my hip replacements, abdominal hernia repair, and prostate cancer surgery were covered under this Insurance totaling less than $1250 in copays. Without this insurance these procedures would have cost between $250,000-$500,000. NMHIA is an example of a state licensed healthcare insurance co-op or pool limited to an individual state resulting in very high premium costs unlike the suggestion for insurance co-operatives discussed below.
The best way to ensure high quality cost effective healthcare is an open, transparent, free market healthcare system. Establishment of the rules and regulations, as well as cost administration, should be a state by state responsibility because the population health status, cost of living, and business costs vary in each state. Suggestions abound to achieve this goal. In the individual and single family healthcare market, allowing healthcare insurance policy coverage without state by state restrictions and allowing every provider to sell policies in all 50 states, is one suggestion. To accomplish this option, the national government would need to mandate uniform regulations among all 50 states. In a mobile society like ours, this idea would also allow complete transportability between states. In addition, allowing individuals and single families to form interstate insurance co-operatives would allow these groups to compete more effectively in the insurance market place. The same rules should also apply to employer provided health insurance which would probably reduce employer costs for large multi-state corporations with high interstate employee transfer rates.
In my opinion, the solutions for our healthcare issues being proposed will never create a truly patient doctor centered free market healthcare system. Currently, each component of healthcare has different rules and regulations. Only a small portion of the total healthcare market was covered by Obamacare. The total healthcare segment of our economy includes employer based healthcare which is over 50% of the market, Veterans Administration healthcare, Medicare and Medicaid, and the uninsured. Each has it problems and patients do not control their care in any. Until problems of the whole system are addressed by a true free market solution , problems will continue.
A healthcare plan that includes the requirement for healthcare cost and quality transparency, tort reform, creation of interstate insurance purchasing power, insurance co-operatives, and legal requirement for individual and family responsibility for all the costs of their healthcare would provide significant steps toward providing healthcare that is patient based rather than more costly, ineffective government mandated healthcare plans. Passage of legislation covering each component of healthcare should result in a more perfect healthcare system than a single healthcare omnibus bill, an Obamacare like disaster. Republicans in Congress and the Trump Administration must quickly settle on a unified, patient centered healthcare plan, or they will snatch defeat from the jaws of victory.
We the People need
Real Healthcare Solutions Now.
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