I was watching the presidential debate last night and I came to one realization; either way, healthcare/coverage is going to remain extremely expensive.
Here's my plan to fix our entire system. I know this is an oversimplified plan but it is what it is.
Step 1. Eliminate JCHAO and any other government oversight programs.
There are hundreds if not thousands of private certifying agencies of health professionals in the U.S. For the lab two major ones are the A.S.C.P. and C.A.P. Both of these private/privately funded organizations have the expertise to do a better job of oversight and certification. The added bonus these organizations provide is that they don't use tax payer dollars. The only government oversight committee that would be needed would be a 25 member team that would review each hospital throughout the year and ensure they have up to date certifications from these private agencies.
Step 2. Allow hospitals to reject non-emergency patients with no insurance without fear of lawsuits.
There are far too many people that abuse the healthcare system and there is no good way to prevent them from continuing to abuse the system. We need to allow our emergency health workers, the EMT, the ER nurse and the ER Doc to make educated decisions based on the need for care. If someone comes in complaining of a cough x 2 days, they don't need to be seen let the triage nurse send them home without seeing a provider.
Step 3. Eliminate federal medicaid
Change the medicaid system to a state run system that takes federal money out of the equation. Maybe more people will be up in arms if they really see the abuse that happens and the associated tax hikes that will occur in areas that provide more un-insured healthcare per capita.
As a secondary solution; if you live in a city or near a city with a military hospital and you're uninsured you have to go to these government run facilities. The hospitals can run at a loss and still stay open. there doesn't need to be a profit margin because the workers in these hospitals aren't paid out of any health care based funds. The funds come from the DOD and they pay a brand new soldier much less to do the same job a civilian would do. There's even a possibility to expand the government run facilities and allow them to become specialized care centers. This could also entice the military to expand the education of some of these soldiers.
I can't make a decision to eliminate medicaid because of the fact that people have already put in a lifetime's worth of money before they receive benefits.
Step 4. Larger reimbursements.
With the federal savings from the elimination of JCHAO and other government oversight committees we can afford to offer full compensation for the few uninsured that do make it to local and rural hospitals.
With these larger reimbursements and lowered operating costs that would come from being able to get rid of thousands of middle management jobs whose sole purpose is to ready hospitals for JCAHO inspections hospitals can afford to offer services at lower costs.
5. Have a plan to recoup some of the money that is owed by the uninsured.
The easiest way to do this would be to take money out of any potential tax refund that the unisured may receive at the end of the year. I realize that it does nothing to help with illegal aliens/unemployed abusing the health system. However, if hospitals are given the opportunity to reject care to known abusers of the system these patients can be sent to federal/military hospitals once there, I'm sure something could be done about them being here illegally. If they reject care at one of these facilities our objective is still met. Keeping abusers of the system out of the system. I know the government has the ability to do this, when I got out of the Army I had a military credit card that had a balance of $2.03 that I thought was paid off. The year after I got out of the Army and filed my tax return I got a letter saying these funds would be taken out of my tax return before i would receive a refund. If they can keep track of $2.03 surely they can keep track of thousands that they're owed for health care.
My whole plan is based on trying to eliminate costs that hospitals have to eat, and pass along to patients. If we can lower the actual cost of healthcare services, insurance becomes more affordable/accessible to everyone. This potentially takes many borderline people out of the federal health system. The people I'm talking about are the ones that are close to being able to afford insurance but just can't seem to make the numbers crunch, The people that need help for a short period but are proud, and don't want to be on a free ticket for very long.
If we can start making federal/military/VA hospitals into facilities that can handle these uninsured patients the quality of care in these facilities may go up. If they don't, it may motivate people to find a way to afford insurance. The government isn't going to put up with people using the ER for a cough x2 days. Another benefit could be making some of these hospitals into specialty hospitals that could deal with chronic disease for patients that can't get insurance because of negative health histories. These "specialty" hospitals could also produce more qualified soldiers and soldiers with real specialties that can be more of a help in the work force once they decide to leave the military. The addition of a quality work-force with usable skills that have no student loans could benefit private health systems across the nation in numerous ways.