There are quite a few measures to take but will work.
1) Have individual hospitals and providers set fixed price per code for all (cash, insurance etc.) and for insurance add fixed or xx% over the fixed cost for the paperwork to be done. If the bill has to go through collections add xx% for the process cost. In effect separate actual cost from process cost of collections.
- What does this do ? Right now the market is a scam. If you go to hospital for a procedure and let's say they charge you $100. But hospitals have to give discounted price on their lowest cost to insurance let's say $60. Hospitals are not allowed to discount you if you don't have insurance as the insurance companies negotiated on the lowest price. So if hospital charge you $60 then next time insurance will pay only $36 (60% of $60) so it's a losing proposition to the Hospital. By not allowing this practice same lower rates will be applied to everyone. This scenario allows premium doctors/hospitals set their premium pricing but will be same for all. Naturally insurance will steer patients to lower cost hospitals reducing the overall pricing in the market. Those how are willing still can get to premium services.
2) Drug pricing must be same in all regions of similar per capita income. Allow standard tier pricing.
- What this does is if Canada or UK negotiates a better price then US will get the same pricing. Some medicines are 1000% more expensive in US than in Canada. By allowing standard tier pricing hospitals do not need to engage in negotiations and also will eliminate the added group purchasing/negotiation process cost out of system.
3) Increase number of medical schools in US.
- At present we have very low number of US medical graduates per population than several other countries, rather than trying to use existing doctors efficiently to the point the quality degrades increase the supply.
4) Take out the bureaucracy of individual states. An MD/RN license should be valid across the US.
- Providers have to spend upwards of $2K to $5K just to maintain the multiple licenses and added AMA/Board unnecessary bureaucracy. Which allows providers to see patients across state lines.
5) Allow individual market to purchase insurance across state lines but not for group/employer purchasing.
- Allows individual users to pick the best plan for them. On the other hand if group/employer purchasing allowed there is a danger of employers picking least cost, effective insurance for employees.
6) Have Federal Government Properly reimburse for uninsured emergency patients.
- They put the rule that hospitals can not refuse service for emergency patients but with no strings attached to them. This cost is being added to other paying patients.
7) Last but not least, legal issues
- It costs $10 to file a lawsuit but 100's of 1000's to defend it. If the case will get tossed then make filer responsible for legal cost of defendants. Limit Punitive awards to 50 times current yearly income of the patient (consider any potential increase in earning if the patient is in school or on path to a better career) + Any medical/care expenses. This will reduce the overall cost of malpractice insurance that can run from $30K to upwards of 200K for individual providers and into millions for hospitals.
8) Have MD residents commit 5 years of public service (VA, Public hospitals etc.) in exchange for removing student loans. Apply at least 1 year of public service to get into highly desired specialities.
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