by PLAYER57832 on Sun Aug 23, 2009 7:56 am
Simple --
1. have the government set a base line level of care available to everyone, covered by increases in taxes roughly equivalent to the average premium now paid, for middle income people. Wealthier people would pay a bit more, poorer people a bit less. Employers removed from the system.
2. Insurers can offer premium policies. Employers will have the option of providing this, but the benefit will be taxed. Because care is covered by taxes, premium care (not covered by state insurance) will no longer be deductible.
3. Set up a system to collect data on the true effectiveness of various treatments. Use this is form reccomendations
4. Along with #3 set up an on-line disease "key" complete with photos, video when appropriate. It will be modeled after keys used by biologists to help doctors diagnose various issues. Just as in biology, some education will be needed to be able to effectively use the key. However, in time, doctors will spend less time diagnosing and more time curing/preventing.
5.Set up a no-fault insurance system to cover medical errors. Treatments would be fully covered. Some additional funds for things like job losses would be included, but based on a formula set by an independent board (independent of hospitals and patients, but including medical people, ethicists, economists, etc.), not juries.
6.Pay primary care doctors more of a flat rate. Have tests, etc done and processed externally (doctor does not profit). Do pay the doctor a little extra for referrals to specialist. Tie the payment to early diagnosis. If the patient is referred very early, the doctor gets more money. Also have penalties, but reasonable ones (don't blame the doctor if you refuse to see him for 3 years and then wind up with end-stage cancer). They need to be tied in legitimate ways to failures to diagnose, but leave room for the fact that no one is perfect. The idea is to pressure/encourage doctors to improve, not to make good doctors leave or order extra tests because they fear being penalized.
7. Reward doctors, nurses, rather than penalizing them for finding problems.
8.Leave it to the profession to establish what constitutes true negligence and criminality. Those people should be run out of business/ put in jail.
9. Tax certain items directly tied to medical problems. Tobacco, of course. However, also sugar and certain fats. The taxes should be low. The idea is to provide a balance so that the taxes paid help compensate for the costs those items encure. ELIMINATE all subsidies for these products.
10. Expand #9, in some cases to industrial outputs, vehicle emissions, etc. Again, the tax needs to be tied to the damage caused.
There is more, but list is long enough already.
