Time for Dems to be for something other than against Trump
It’s time for the Democrats to be for something other than just against Donald Trump (as important as that is). That something might be an improved health care plan, call it what you will. This could be an opportunity for a bipartisan effort to reach a plan that would cover everyone at lower cost. What is needed includes: Affordable coverage for everyone including those with pre-existing conditions. This is an easy one since The Donald already appears to embrace it. Besides he wants to keep Medicare untouched. He also likes the idea of insurance companies working across state lines. The Democrats can probably support these positions. Cost savings would have to be arrived at elsewhere, as follows:
Lower drug costs. This is a large contributor to cost and must be addressed in spite of drug company opposition and heavy lobbying. A suggestion is that prices already negotiated in other countries be set here. We could buy our drugs in Canada, for example, as a backup position (threat?). Maybe the pharmaceutical companies would quit spending on advertising for prescription products (which used to be considered unethical) in order to preserve their profits.
Coverage of heroic procedures. A large part of cost is incurred by end-oflife care and by very expensive methods to save lives. Such cost could be avoided by triage, i.e. rationing, but this would be very unpopular as well as immoral. A solution would be to set a dollar limit that the insurance companies would be required to pay, say $100,000. The federal government would take responsibility for the overage. Insurance costs would be dramatically reduced for everything else.
Preventive care. There is a lot of medical opinion that more attention to this would avoid much of the heroic procedure costs. We need to attract more doctors and other health care workers to primary care, especially in poorly served areas. A start would be to loosen immigration rules to allow in already trained professionals in exchange for willingness to fill the gaps at the lower salaries than the high-cost specialists receive. In addition, the tuition at community colleges and state universities could be reduced or eliminated for training in these fields when the students accept work in the poorly served areas for a required period of time.
Better malpractice insurance. This is a burden that doctors must pass on to their patients. It may be that there would be savings if this could be adjudicated by specialty courts. For example, three-person courts with at least one medically trained member would be set up. Juries would not be involved and awards would be limited to actual damages. This would eliminate the overly large judgments that lawyers often obtain from sensitive jurors.
Better documentation. Time and effort would be used more efficiently if all medical activities were standardized on a common computer system. Imagine knowing when you leave the hospital or doctor’s office exactly what you owe after insurance. Now, one waits months before seeing a Medicare report.
Perhaps we could persuade leading Democrats to join with the Republicans to come up with a bill that would incorporate some or all of the above suggestions. Call it Replaced Care if they must, although it might be better called Repaired Affordable Care Act Care, or simply, Repocare. Bill Maxon, Ph.D., is retired from a long career managing research in a pharmaceutical company and now lives in a lifecare community and continues an active interest in making art.