Real News in America
Federal Medical Programs
Note: As designer and part owner of this site, I am including some of my ideas. It is easy to say what is wrong, but I wish to make suggestions to improve things. All figures given, either dollar amounts or percentages, are just suggestions. Howard Cary Morris
Affordable Care Act: The tax penalty for those who did not participate was a mistake. It has been eliminated. The reliance on the medical insurance industry does not make sense. Essentially guaranteeing someone a profit is not the way to keep costs down.
Medicare: Also has problem of guaranteeing medical insurance industry a profit. Harder to eliminate.
Medicaid: Republicans are concerned too many people are eligible for it. The program was designed to be a last resort option.
VA Hospitals: To many veterans have a long wait to be seen. There are to many horrer stories that by the time the VA figured out what was wrong, it was too late to help much.
The government pay the first $4,000 of every adult's medical expenses directly to the provider. A 10% copay would be an incentive to the taxpayer to keep costs down. We could pretend that the copay is used to pay administrative and misuse (fraud) costs.
How it would help
Affordable Care Act: Everyone would now have minor health care coverage, something Donald Trump promised in the 2016 campaign but has not delivered on. The indigent will no longer have to rely on state or county hospitals to get medical care. Those same hospitals will have more money for more urgent needs. More people will be able to afford the cheaper major medical healt insurance. Major corporations will save money on health insurance premiums.
Medicare: Premiums will go down. Not mentioned before is the annual Medicare premium adjustment. Limiting the increase to the cost of living increase, percentage-wise, makes sense.
Medicaid:Most people will not need it. It can be limited to those who have extraordinary medical costs.
VA Hospitals: Veterans can go directly to a private doctor without the wait. Hopefully, they will get better initial diagnosis. Currently, there is a problem for some veterans finding an initial private doctor to go to. There is a federal government program for this, but has problems. Maybe the internet could help. However, I worry about sites that chargethe doctor to get them recommendations. Not all veterans have access to the internet. Yes, they could use the public library, if they can get to the library. Social workes specializing in such veterans are needed.
Paying for Program
Nothing is free. Currently we pay 1.45% of our earned income for Medicare withholding taxes. Since the new plan will cover everybody, that tax should be increased (and renamed). Since we also need to balance the budget, if I overdo it, that is OK. I am a fiscal conservative. Starting at $50,000, people will pay an additional 1% tax (2.45% total). Starting at $100,000, people will pay an additional 1% tax (3.45% total). Starting at $200,000, people will pay an additional 1% tax (4.45% total). Starting at $400,000, people will pay an additional 1% tax (4.45% total). Starting at $800,000, people will pay an additional 1% tax (5.45% total). Etc., capping off the tax at 10%. As currently, there will be an employee match. This might make some employees who don't currently have an insurance plan for their employees pay more, no need they should get a free ride.
The plan has no provisions for preexisting conditions. When needed, I think the reworked Medicaid should work out. For the major medical policies, having higher copays depend on how much the insurance company paid in the prior year, would make sense. The plan may cause medical costs to creep up. I decline to give specifics in order to avoid self-fulfilling prophecies.
Attacking medical costs
Nothing but talk so far. Here are some ideas that might work.
Rise in medicine prices: Some pharmaceutical companies are raising the prices of medicines that they produce by more than the cost of living increases each year. This can be controlled legislatively. Some medicines are produced cheaper overseas. We can allow import companies to get them. The import companies would be required to verify the medicines before reselling them to drug stores, hospitals, etc. The manufacturers of the medicines would be barred from having any part of the testing.
Ambulances: Rides in Memphis, TN go from $800 to $1,000 each. That seems high. At least when transferring a patient from one facility to another there should be a cheaper way. At most the patient needs little more than to be able to lie down.
Hospitals: Something has happened that has forced most doctors to associate or belong to a hospital. That seems to drive up administration costs with no real benefit. A hospital should not be dipping into a doctor's pocket. The patient the doctor sends to the hospital should be enough remuneration.
New Medicines: As new medications hit the market, they seem to be overpriced. Not much we can do except when the government has (in part) funded the research of the new medicine, the government should get some of the royalties. Similar to how a business owns patents produced by its employees.
Doctor's salaries: Off hand there isn't much we can do there except for doctors on the government payroll. I am inclined to draft new medical doctors to reduce costs, but I don't think that idea would fly. On the other hand, there are more potential interns each year than there are openings. We can have governmental intern program. For the interns, we can help pay off their loans for medical school. To avoid this becoming a way for medical institutions using this to lower their costs, we could require they lower their charges to patients.