Coveny’s plan for health care

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Coveny's picture
Coveny’s plan for health care

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-pri...
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.

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watchman's picture
@Mark Coveny....

@Mark Coveny....

Don't take this the wrong way.....

This is an international forum .....

those of us living in Europe have ,in the main , a mere passing interest in what you Americans choose to do with your health services.

and how your opinions on this subject will affect those in Malaysia ,Bangladesh ,Turkey ,the Middle East ....etc. etc I can't imagine.

mykcob4's picture
Too long didn't read much of

Too long didn't read much of it. What I did read was absolutely ridiculous. IMO

algebe's picture
Religion should definitely be

Religion should definitely be kept out of hospitals. Never allow a Catholic nun to use a hypodermic on you. If you see your surgeon praying before your operation, get the hell out of there. If someone offers to pray for your recovery, whack them with a bedpan. Laughing gas can give you a genuine religious experience.

LogicFTW's picture
Some interesting thoughts in

Some interesting thoughts in there. I read the whole thing as this subject is one I think about quite a bit.

To me I boil it down to this:
1. Take capitalism/profits out of the entire medical/drug/health industry. Basic economics 101: supply and demand rules fall apart when the good is highly inelastic. You cannot get more inelastic than life saving care and drugs.

2. Insurance, especially the US health insurance industry has morphed from a simple idea into a many headed monster. Insurance is supposed to be a simple hedge against risk leveraging a large risk pool to bring risk down to predictable numbers. To make many small payments to prevent a sudden unexpected large payment that you do not have the liquid assets or access to cheap credit to cover. Health insurance in the US now is mostly seen as a "subscription" to health care, instead of a simple hedge against large unexpected expense. Health "insurance" has gotten way too complex. Take out the middleman, take out the profits, take out the complexity.

Answer to both? A strong, national health care system where every citizen has access to all the basic health care they need. If someone want only the best doctors in the very best facilities they can decide to pay extra for that. A large emphasis will be placed on preventive care and people being taught how to take care of themselves with sensible diet and lifestyles. If someone wants an MRI to be extra sure of a diagnosis that a cheaper cat scan can do nearly as well, that is an option available to them. If they want their own private room with high speed internet and premium cable tv, they can pay for that. But everyone has availability to a shared room for emergency overnight services. Etc.

-

Also want to point out low deductible insurance is essentially a tax/penalty on people that cannot save money.

Coveny's picture
@watchman The post addresses

@watchman The post addresses both the USA and many other countries healthcare. There are problems with universal health care just as there are with pure for profit health care.

@LogicForTW so long as healthcare requires an individual and is a service rather than a robot that can be mass produced, healthcare will be elastic. While on paper it sounds good to say "everyone gets healthcare" how do you provide the doctors to accomplish this? How do you compensate them? If you aren't willing to bend to deal with both sides of the problem you have an unrealistic expectation for a solution.

LogicFTW's picture
Elasticity refers the degree

Elasticity refers the degree to which individuals, consumers or producers change their demand or the amount supplied in response to price or income changes.

An elastic good/service is a product people can easily do without. Say a boat purely for recreation use when you live in the middle of a giant desert and would rarely have vacation time to travel and use it.

Inelastic is a good people will buy no matter the cost.

Inelastic is the opposite. Heroin for the heroin addict. Life saving medical services or drugs for someone very sick and dying. People will pay any price even if they are already broke. Highly inelastic goods ignore supply and demand. W/O supply and demand to control things sellers can charge whatever they like.

Coveny's picture
Per investatopia - Elastic is

Per investatopia - Elastic is an economic term meant to describe a change in the behavior of buyers and sellers in response to a price change for a good or service.

Read more: Elastic http://www.investopedia.com/terms/e/elastic.asp#ixzz4uyZhPOqt

As soon as there are multiple people providing the medical service it becomes elastic as the prices change.

LogicFTW's picture
We are both correct. More

We are both correct. More sellers (availability of close substitutes,) effects elasticity, as well as the necessity of highly essential goods/services. And extreme cases of both makes supply and demand break down where the buyers lose.

A total, monopoly is an extreme case, as well as goods/services that are considered absolutely essential.

Clean drinking water is absolutely essential, but as it is done on a government level, and protected by laws. We enjoy pretty much free drinking water, we took supply and demand out of the equation on such an essential good, (it also fortunately plentiful, unless the very expensive infrastructure that supplies easy access breaks down.)

Life saving drugs and health care are also essential, but sadly not ran at a government level, worse still the healthcare industry is plagued by monopolies. There is some regulation to prevent abuses to these monopolies, but lots fall through the cracks.

It becomes a perfect storm of monopoly over an essential good, making many parts of healthcare the ultimate expression of inelastic.

Coveny's picture
While i would agree that we

While i would agree that we could remove the scarcity for say basic food, basic shelter, and basic clothing, until we have a robot that can perform as a medical personnel, there will always be a scarcity of medical personnel as it's a service rather than a product.

As to the corruption that plagues this country, I'm not disagreeing, but that's not the point of this post so I won't dive into it.

SunDog's picture
I live in Canada where we

I live in Canada where we have national healthcare & it works just fine. Could it be better, sure - always room for improvement, but it's better than what the US has. Personally I've never had a problem with it & at my age I have some problems.

xenoview's picture
TLDR

TLDR

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jakejj's picture
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navarro's picture
Coveny's plan for health care

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