JP Wilberforce’s Ideas on Healthcare Reform

TheIndyVoice.com would like to welcome our newest columnist, JP Wilberforce.

There has much talk lately about deficits and governmental spending.  Believe it or not, increased taxes are not the scariest thing that could happend to this country.  National and not just federal bankruptcy is a very real possibility and it could occur for a reason not usually spoken of as a cause.

Simply put, healthcare costs could lead to economic disaster if this nation doesn’t do something radical to contain them.  Many people today rail at federal deficits that are in the 3% range of Gross Domestic Product (GDP) but by 2017, just 7 years from now, healthcare will devour 20% PER YEAR of our GDP.  Our economic competitors presently spend just 7% (or less) of their GDP while we spend 15.6% right now.

TAXES ARE NOT THE ISSUE –> COSTS ARE!

And they are literally eating our country alive.

The goal with health care reform and the introduction of a public health insurance option is to drive down these costs while improving outcomes for patients (greater choice, etc.). It seems that the reform emphasis thus far has been on the uninsured and the underinsured, but the only way that we are going to drive down costs is if employers and their employees are given an incentive to move from their private for-profit insurer to a public non-profit one. After all, government run programs like Medicare do with 3% administrative costs what the so-called “efficient” private for-profit insurers do with +20%. Reform must start with the insured to lower costs.

However, there is very little political support to raise taxes to accomplish this. The good news is that taxes do not need to be raised to insure those that are already insured.  The money is already held within the system - we are already paying the costs - we just need a way to use this money to incentivize both the employer and the employee to choose a public health insurance option.

So how do we create an incentive to have a major shift from private to public insurers? We legislate a voluntary system whereby employees can opt-in to the public plan by having their employer send 3/4’s of the money that is already paid to the private insurers, into the public plan, while a mandate requires the employer to payout the remaining 1/4 to the employee.  Of course, that 1/4 is taxed at the employee’s current income tax rate.

Employers would see this plan as a way of containing the costs of certain future insurance rate increases, not to mention the decreased costs and hassle of having to maintain and administer an employee health benefits plan.  With this option employers will be able to concentrate on their business, instead of the insurance business.  The employee would see it simply as a raise, a way to pocket more of the money they already earn.

There are of course other concerns. Private insurers would essentially be put out of business so we would create an incentive for businesses to get aboard early in the process by offering lump sum buyouts of shareholder equity (by a deadline of course).  At the same time, we offer assurances to employees of these insurers that the public health insurance plan would employ as many of them as possible (with public health insurance benefits of course!).

Doctors will also have concerns.  They can simply be addressed with a compensation structure equal to what Medicare presently offers plus 20%. Doctors choosing to move to the single payer, public insurance option would see a nearly immediate decrease in operating costs by moving from a complicated, multi-payer system that often denies or prolongs treatments and payment, to a streamlined single-payer system that speeds electronic payment to doctors. Superfluous staff presently used in doctor’s offices to administer insurance billing could also receive assurances that they would be brought into the fold of the public insurance provider.

And the national, congressionally charted and overseen, non-profit public health insurance provider would be guided by a Patients Bill of Rights to insure everyone that health and the welfare of people is the ONLY bottom line.

Doctors and patients would be the only people involved with making health care decisions and anyone could use any doctor they choose, anywhere and at any time.

Doctor compensation could be structured so that there would be doctor availability at times convenient to their patients, who usually have jobs and families to take care of.  Healthcare should work on patients’ schedules and doctors should be compensated for working long hours.

For instance, a doctor billing for a patient seen either before or after work on a typical 8-6 schedule would be compensated at Medicare +30%. House calls could be billed at Medicare + 35%.

Most importantly, GOVERNMENT WOULD OWN NONE OF THE MECHANISMS OF HEALTHCARE DELIVERY.  The doctors, hospitals, pharmaceutical companies and technology providers would ALL remain private.

Given that our country uses healthcare dollars so inefficiently and patient outcomes in many ways are worse than nearly every industrialized country in the world, there is plenty of room and $$$ for improvement.  Failure to make these radical but necessary changes WILL result in changes to this country to the extent that your quality of life will certainly be affected.  Inaction or even worse, mediocre action, will lead us down the path to national bankruptcy.