07/07/2018
Here's my working draft outline for sensible healthcare reform. Would love your input...
1. Consolidation
a. Consolidate all four federal health care bureaucracies into ONE universal primary care system. The federal government will divest it’s responsibilities in the disparate needs and requirements of special populations and complex medical care and focus on an efficient, consistent, and fiscally stable universal primary care system that covers all primary care services for everyone in the United States from birth to death.
b. Services covered may include:
i. Routine Prenatal Care
ii. Routine Labor and Delivery
iii. Primary Pediatric Care
iv. Primary Adult Care
v. Routine office based procedures
vi. Routine Vaccinations
vii. Home Health
viii. Long-term Skilled Nursing Care
ix. Outpatient Mental Health Care
x. Long-term Institutional Mental Health Care
xi. Routine Pharmacy Benefits
c. Federal reimbursement models for those who are unable to pay for catastrophic health insurance may cover emergency services, complex medical care, and hospital care.
d. In addition, a safety net of regional medical centers would rely on multiple funding sources, including local, state and federal support as well as subsidies for medical training programs.
2. Realignment
a. Medical education, research institutions, allied health professions, hospital systems, pharmacies, and outpatient facilities must stay in their own lanes to optimize healthcare delivery efficiently and effectively.
i. The ACA encourages consolidation to “coordinate care for improved patient outcomes, better quality care, and cost savings.” Unfortunately, this consolidation often reduces competition, limits services and raises costs.
b. Redesign and realign the Medical Industrial Complex (MIC) to meet the needs of our population, not the needs of investors by prioritizing value-based products and services over profit-based products and services.
3. Regulation
a. The Health Insurance Industry (HII) must be outlawed from practicing medicine and be reined in and tightly regulated. Future health insurance products should exclusively focus on covering patients’ catastrophic health care financing.
b. Healthcare management must be severely restricted and focus on customer service rather than denial and delay of care.
c. Compliance and healthcare certification of clinical standards and quality must be streamlined, relevant and useful. Reimbursement must be divorced from certification.
d. Publicly traded, investor-driven, for-profit medical systems would be outlawed. Predatory profit schemes without regard to service or utility or purpose would be outlawed. The primary role of antitrust law is to protect consumer welfare through low prices, high quality, efficiency, innovation, and choice. The FTC and the DOJ must aggressively enforce our antitrust laws.
e. We must create industry wide billing standards and price transparency.
f. Stop the undue influence of the pharmaceutical industry on providers, researchers and government agencies. Allow for federal negotiations of wholesale drug prices.
