
If we can just step away from the Is it Socialism? argument for five minutes and consider some interim measures, we might have a prayer of slowing down the health-care avalanche.
Some things to consider while we watch Congress roll in the mud:
–Accept the reality that many Americans will always get care from ER and doc-in-a-box settings, and invest in that model. Create a wellness counterpart, where drop-in consultation is available for preventative, nutrition, counseling services.
–If obesity is so expensive, why don’t we offer universal, free Weight Watchers-model health care? And if Wal-Mart can sell $89 drugs for $4 a pop…well, you know the rest of that sentence.
–Establish universal standards of care and fee ranges that consumers, not just providers, know going in. If we already know that if it takes a $50,000 machine and a $30/hour tech to run it for 2 hours per patient then we can pencil out the cost for a place that sees 100 patients and the place that sees 1,000. (Oops! Took longer for that guy…good thing there’s a price range.)
–In that previous vein (pun intended), establish a consumer-protection model as the industry norm. Hey, funeral directors had to do it and it works just fine. And people said it would be impossible to regulate prices of services/goods that are purchased during a time of great stress and grief.
–Tax people at a higher rate when they have financial interest in any facility or related insurance or medical company to which they can refer patients;
–Provide real educational-cost incentives for future docs, nurses and medical personnel. This doesn’t mean deferred loans. It means real cuts and practical support for older people who have aptitude to switch careers;
–Speed up the inevitable move of coverage away from employer-based system, although encourage employers to offer coverage as a perk to attract workers;
–Encourage private health co-ops (through tax breaks and other supports) which are organized
by neighborhood, profession, alumni groups, ethnic/fraternal groups. A sort of upscale revisiting of the settlement houses that served immigrants in the 19th and early 20th centuries;
–Stop pretending that “basic health care” means TB screens and annual physicals. It means wellness education; mental health and addictions treatment; full blood-panel testing that screens beyond the basics; birth-control services; vision/hearing services; and pain management clinics;
–Encourage cooperation between medical-government-law enforcement communities in order to begin to get a real handle on use/sale/manufacture of drugs that create huge problems (and costs) for family stability, public safety, business and health;
–Allow medical-care “credits” to be accrued and shared. If I don’t spend mine this year, you can have ‘em. This move alone will shut up a lot of the arguing over Right to Die laws. If I want to opt out of treatment that prolongs my life, I can leave health care credits to my family. So there! And finally…
–Require that all members of Congress sit in an ER on a busy weekend night for 8 hours once a month.