Obama wants to do a massive, major overhaul of our medical system - grabbing up to 16% of the entire economy and putting it under government control. Now, that's an unusual thing for anyone to want - considering that the hallmark of government programs is that they usually underperform and cost a heck of a lot more than expected. The current estimate is from $1 to $1.6 trillion over the next decade, morphing health care into something not at all like what we've got now.
And this would be seen as a radical improvement by some. I'm kind of puzzled at how - but then, I tend to look at things with an eye to a workable solution - not an ideal solution. Ideal - well, when the unicorns start pooping gold then we'll be able to afford everything. Until then, let's do the best we can with what we've got - not throw trillions out on some undefined plan that will supposedly make everything better. (For a really, really nebulous definition of 'better', too...)
So what's my solution? Well - it's not complex, it's not expensive (at least, on governmental terms - Bill Gates could likely fund it, but only for a couple of years.) and it doesn't massively grow government. I know - three strikes right there, but bear with me.
The first step in coming up with any solution is to define the problem. The ostensible problem is - 45 million people don't have health care. (Estimates are that up to 15 mil could be illegals, 10-15 million can afford it but don't want it, and the other 15 want it but can't afford it. But what the heck, let's just use 45 million as the number. Let the INS and IRS hash it all out...)
There are programs which provide welfare, WIC, unemployment and the like to folks who need it.
Add an additional one - a debit-style card to be used for health care payments.
Now, currently there are programs available at major chains like Walmart, Walgreens, CVS and the like, providing generic prescriptions for $4 for a 30 day supply. Coupled with that - in a lot of the Walgreens, Walmarts, CVS pharmacies are walk-in clinics staffed by nurse practitioners. They handle minor stuff - things like heart attacks and such would have to go to a hospital. At THAT point, it's gone beyond a minor problem, and it becomes something that would be taken care of through Medicare or Medicaid.
As I suggested, issue a medical debit card to those who need it.
Preload the card with $1000. That’d give you ten visits @$70 each and 5 prescriptions @$4 each for 12 months. (or shall we call it 240 prescription-months? Kind of like a man-day, in pill form...) For 45 million people that’d be… (let’s see, carry the 7, add the 5, divide by the square root of -7.441…) $45 billion a year. Add $5 billion for administrative overhead, and you’ve got a $50 billion program that covers the folks who need it most.
$50 billion. Heck, that’s practically petty cash for the government any more…
Now, make it so that money could ONLY be spent for health care visits at approved locations (which could include GPs that wish to be included in the system) and for generic prescriptions from approved pharmacies. Have the card’s account automatically refreshed each year - but keep the amount ON the card at $1000. If they don’t use the card, nothing needed to be put back onto it, so the money wouldn’t need to be spent.
We issue the cards out attached to the users’ SSAN. Three in the family? Three cards. And yes, it'd be possible to swap balances between cards in a family. But outside the three? No way.
Of course, such a thing isn’t foolproof. And it wouldn’t cover such things as ambulance rides, MRIs and the like - but anything that gets to that stage would likely be covered by Medicare/Medicaid in the first place. The thrust of this proposal is to get primary care coverage for the folks who need it NOW, quickly, for a low cost.
But you know - I don't think that's what is even really desired.
Just for grins, I posed the above solution up over on a leftward leaning blog. The objection wasn't that it wouldn't work - it's that it wasn't GOOD enough. 10 free visits, free prescriptions - and that wasn't good enough. It was second-class (never mind there was a decade when I'd have LOVED to have such second-class health care...) and thus wasn't even considered as being remotely acceptable.
'Perfect' rapidly becomes the enemy of 'Good Enough'. And what we need is something good enough to get health care to people who need it, and get it to them rapidly.
This would do it.
What do you think - should I write it up a bit more comprehensively and try sending it off to my senators and representative?
J.