GreecePwns wrote:The Republican Ideas
Number one: let families and businesses buy health insurance across state lines.
Not in the passed bill. Republicans went to this after the other things they griped about were added.
First, this would be a nightmare to regulate because insurance is dictated by states, not the federal government. No one could tell who would even be in charge if a company issued a policy to someone in a different state.
Also, would not result in better insurance. This was a scam perpetrated by the big companies, to allow THEM to locate themselves in the states with the "most favorable" plans for THEM. Nothing at all would encourage companies to offer more or better coverage. Further, since the primary "purchaser" of insurance is not the one who uses it, quality overall DOES go down, unless laws are put in place dictating minimums.
This is the case in PA. Much of the "insurance" offered here is so much worse than Medicaid or ChIP (government plans) that those systems are now heavily overrun. The numbers of uninsured have grown. And, I mean WORKING people, not deadbeats. Particularly people with ANY pre-existing conditions.
GreecePwns wrote:Number two: allow individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do.
I'm not exactly sure, there wasn't much of an issue made of this. Probably in the passed bill then, but for argument's sake we'll say no.
This can already happen to a point. It is the main reason people join these groups.
GreecePwns wrote:Number three: give states the tools to create their own innovative reforms that lower health care costs.
In the passed bill, although through federal government, not through states. This is the whole deal about death panels. We'll call it half.
States ALREADY individually regulate insurance. Not the same as the panel idea. The panel was because right now,a LOT of research and data is collected by insurance companies who do not have to share it. Therefore each company has their own "equation" as to cost-benefits and so forth. Of course, since historically insurance companies have not had to carry people forever (only up to lifetime limits), the real onus has been to cure essentiall healthy people/those with minor issues and to force others off the plan through various means.. or just dilly dally approval of treatments until the person dies.
The panel was to be an independent group that would assess which treatments are effective, what is warrented. A particular point of concern is/was hospice care of elderly. Anyone having a loved one in that situation knows a LOT of reform is needed there. The fact is that there comes a time when doctors plain need to accept that a person will die.. that this end is not a "failure". Not when the person is a frail 90 year old facing terminal cancer, not when the person is an 84 year old man with heavy dementia and serious pain... at some point, families want/ask for and have the right to know about pallitive care as opposed to lengthy and painful procedures that cost way too much and do little or nothing to enhance the quality or length of the person's life. THAT, however, got misrepresented as "death panels" by idiots such as Palin.
GreecePwns wrote:Number four: end junk lawsuits that contribute to higher health care costs by increasing the number of tests and procedures that physicians sometimes order not because they think it's good medicine, but because they are afraid of being sued.
Tort reform - In the passed bill.
I don't know if it was or was not included. I will say "no". BUT, here is the thing. Simple tort reform isn't the solution because doctors and administrations intendionally screwing up or just being laxy are not why accidents happen. Accidents happen becuase no human is perfect and doctors are put under INTENSE pressure to succeed.
I looked into this very, very seriously. What we need are several things.
#1 ALL of these limits and definitions need to be set by an independent panel including doctors, administrators, ethicists (including religious representatives), patients, etc.
#2. Step up criminal penalties for the very few truly criminal doctors.. those who truly intend harm or are so obviously negligent that it amounts to "intentional harm" (similiar to driving drunk amounts to "intentional harm") Definitions of what that means is up to panel. Anyone harmed by these people will be fully covered by a "criminal coverage" plan.. sort of equivalent to "unisured motorist coverage". Because the cases are few, a lot of coverage should be automatic for very little money.
#3. Gross negligence. Again, defined by panel.
Patient damage will be fully covered, included a SET limit for various injuries and employment damage. The limits should be quite high. This will be somewhat similar to "underinsured coverage" for motorists.
Again, these cases should be relatively few, but when they occur, the impetus needs to be on fellow doctors and administrators to pick up the problems. It should not be up to the patient to just sue. This will happen several ways. First, by random checks and a rating system. Hospitals and such that rate well will get bonuses or some positive benefit (perhaps a slightly higher rate of pay, priority for new equipment, etc. ... leave the details up to the panel). Self-reported problems will NOT count "against" the group. Problems caught by outsiders will, though panel can "weight" issues somewhat. The goal here is not to penalize the hospital, the goal is to encourage them to find problems. As an example, a doctor that presents credentials that initially seem OK, but the school is later found to be deficient... will not count against the hospital as much as a doctor that has no credentials at all would. (again, panel can work out details).
Bulk of investigation shall be into preventing future occurances. The panel will investigate fully how this happened and make reccomendations. They might include things like more training requirements, better supervision of staff or just plain more sleep. Might also include implementing better systems.
#4 Almost everything else will be "human error". This will be covered by universal "no fault" insurance. If an accident happens, patient's problem is covered. As above, system is put in place to correct. (won't go into it all to save space).
In addition:
--A computerized illness "key" similar to biological identification keys. It would evolve over time until eventually it would take very little direct skill for a doctor to diagnose problems. Just as in biology, skill will absolutely be required to identify and properly use the key. However, more attention can be paid to actually treating and preventing illnesses, rather than just identifying them
-- collation of data concerning effectiveness of all treatments. Insurance companies have a lot of this information, but don't have to share it. It should be available to all. Certain treatments will inevitably "shake out" as effective, others not. Doctors should have the option of choosing amongst various working options (things that work well in one situation might not work in another). However, over time, those treatments that just don't work will be eliminated. Within this will be allowances for experimentation (properly controlled, designed), trying "last ditch" stuff for cases considered "hopeless", but with attention to above hospice guidelines. For example.. if a 90 year old woman has a brain tumor considered hopeless, it probably is best to just "let nature take its course" (probably.. could be exceptions). If its a 24 month old, and all other options have been tried, it might be worth trying that drug that has only a 30% chance of success, even if it could mean pain and so forth. Such decisions cannot be made by any computer program or set system. They can only be made by individuals.
GreecePwns wrote:You can't get everything you want when you're the minority party. One and a half out of four things - a conservative estimate, one could really say three out of four - is a good enough compromise effort from the Democrats to base their Party of No accusations.