Letter to the Editor: Healthcare Reform

Hi, Joe

I've come up with some rough ideas for getting health care once the Obamacare monstrosity implodes. I know you are an astute businessman and a clever fellow, and I would love to hear what you think of these ideas.

Under this plan, folks would buy insurance, or be self-pay with catastrophic coverage available (or perhaps some combination of those).

Insurance companies would offer insurance by categories (think 'modules') of coverage/services, usinguniversally-defined category options, like:

Primary care (basic)
Specialist care
Basic testing (X-ray/lab work)
Advanced testing (basic plus MRI, CT scans, etc.)
Preventative (Colonoscopy, etc)
OB/GYN
Prescriptions (including pharmaceuticals and nutraceuticals)
Cancer coverage
Vision
Dental
Long-term care
Catastrophic coverage only (various levels) -- mainly for self-pay individuals.

All insurance providers would sell policies nationally, either as for-profit or mutual.

All services and categories would be thoroughly defined as to what is to be covered and how, so that everyone is doing it the same way.

Standardized forms used for all claims and record keeping by all companies and providers.

Choice of deductibles at various levels that are specific (ie- $1000, $2000, $5000/yr., etc.) and well defined as to what is a deductible expense.

Elimination of contracts between providers and insurance companies, including any type of agreement that hinders competition or penalizes patients or physicians.

Providers may offer whatever discounts they choose to self-pay patients, especially since no claim needs to be filed. Any attempt by an insurance company to interfere in the relationship between doctors and self-pay patients should be a criminal offense. (This allows physicians to compete using discount offers as they see fit.)

Cost-sharing entities/ministries would operate as an organized group of self-pay individuals, perhaps with an option to pre-negotiate discounts from providers.

Tax-exempt medical savings accounts could be used to pay premiums, deductibles, and self-pay fees, and any subsidies can be given through such accounts.

And on the legal side, come up with a definition of what constitutes reasonable expectations of outcomes. With the 'practice' of medicine not really being an exact science (often trial-and-error), providers need to be shielded from unreasonable patient expectations. As long as providers are keeping up their education and doing their due diligence in providing care, they would be shielded from most lawsuits.

Perhaps a board of physicians and patient advocates could review questionable issues and make a determination as to whether the issue could/should be litigated.

There would also be a need for a national-level agency to monitor insurance companies for compliance. This would no longer be done at the state level. Policies would be the same regardless of the state where they are sold.