Practical Ideas for Health Care

In my last post, I outlined my thoughts on a more ideal health care system. I recognize that these thoughts describe a system which is much different than what we have today. Justified criticism is often directed towards such ideas for being too ideological, theoretical, or impractical. So, I'd like to close my series on health care (for now) with some ideas which may be more practical. I do recognize that some of these ideas may be politically untenable at this time and also concede that true health care reform requires hours and hours of research beyond what I'm able to provide. Here is my six-point plan for reform.

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1. Authorize and Promote the Establishment of Health Care Subscription Programs

As noted in my thoughts on a more ideal health care system, the idea of a health and wellness subscription service seems like a great idea. Such a service may not be technically illegal today (I have not researched this), but the regulatory system and network of insurance providers are not aligned with such a model. This is not fundamentally different than prepaid health care which is a more accurate description of today's health "insurance" products. I would allow Medicare, Medicaid, and Medicare Advantage plans to use federal dollars towards such programs if the patient chooses to do so.

2. Provide Significant Tax Incentives for Private and Corporate Donations to Non-Profit Health Care Providers

Medicare and Medicaid face significant funding issues in the near future. Our federal budget problems are well known. I think it's important to put more choice in the hands of the taxpayer. As part of a larger plan to create a more democratic and free market system of taxation, I would implement a revolutionary tax credit for health care funding. Individuals and corporations would be eligible for a 50% tax credit for every dollar donated to an authorized, non-profit health care provider. This would include free clinics, non-profit hospitals, medical research centers, universities, and more. I would expect billions of dollars to flow into such institutions. The government would use this flow of funds to offset Medicare and Medicaid spending with the ultimate plan of eliminating the need for direct government aid to these programs.

3. Reduce the Patent Life for New Drugs and Streamline the FDA

Pharmaceutical companies have made major advancements to develop drugs which help patients all over the world with all sorts of ailments. They've made a lot of money doing so which provides the incentives to hire the best chemists and invest in research and development. But, I believe that we must level the playing field a little more. Patents support monopolistic practices and the FDA helps establish a de facto cartel in the drug industry. Both of these lead to higher medical costs. We need a quicker time to market for generics. We also need the FDA to increase competition by encouraging and regulating the expansion of natural medicine. If this requires the establishment of an independent agency to compete with the FDA, then so be it.

4. Implement Tort Reform

Defensive medicine clearly adds cost to the system. The expansion of more inexpensive care via free clinics and other non-traditional health and wellness services may only serve to encourage malpractice suits. This needs to be cut off before it constrains such expansion.

5. Allow Interstate Competition for Health Insurance and Implement Health Exchanges

Insurance products are regulated at the state level which has led to inconsistent rules and low levels of competition. Using the federal power to regulate interstate commerce, we should allow insurance to be sold across state lines with consistent regulation. This is not enough. The current plan to establish a health insurance exchange (with or without the public option) is a good one; however, I have a different twist on it. We have seen the Internet provide great tools to help consumers find what they are looking for. We should provide ten large grants to prospective health exchange providers set up as quasi-government corporations. After a term, they will be spun off as private corporations. As an example, imagine if Google provided a search service to find the best customized health program that meets your needs. The health exchange should help consumers find both traditional health insurance (today's prepaid health care) and local health subscription services as described above.

6. Phase Out the Health Maintenance Organization Act of 1973

The HMO Act of 1973 mandated that employers of 25 or more employees must offer health benefits to an approved HMO. This solidified the link between employment and health care coverage. This should be repealed in a responsible manner so that individuals seek their own health care coverage via the aforementioned exchanges. This could start with applying income taxes towards employer-provided health care benefits while providing a tax deduction for costs incurred by purchasing individual plans. Employers would not be allowed to rescind existing health care benefits without a certain percentage of employees opting out, a two-year notice period, and payout incentive to those who have not transitioned by the end of the two-year period.

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I'm sure there are other good ideas which would fit in this framework which is intended to support the evolution of today's health care system to one which I feel would be more effective. Having watched the Senate Finance Committee debate the Baucus plan, I appreciate the complexity involved in drafting reform legislation. I hope you have found this basic set of ideas to be interesting and practical.