16

Jul

by Moonage

When Bill Clinton was in charge of things, he gave his wife the dubious task of reforming health care in the United States.  When it was all said and done, lots of rural hospitals had closed, 75% of all home health agencies quit, 75% of all national health insurance providers got out of health insurance, and the price of health insurance tripled.  When I started selling health insurance in 1991, I had my choice of providers to choose from.  Aetna, Travelers, Allstate, you name it, I had it.  When I finally gave up on selling health insurance was when there was only one provider left in Kentucky, Blue Cross.  Since Blue Cross didn’t use independent agents at the time, I was just out.  My clients were just screwed.  The state of Kentucky forced Human to compete with Blue Cross, it failed.  Kentucky then formed a high risk pool to “compete” with Blue Cross.  The net result of that was Anthem Blue Cross of Kentucky dropped its non-profit status so it could pay dividends on the fortune it was reaping thanks entirely to the health care reform of the 90′s.  The net result of reform in Kentucky, and nationally was less competition, fewer options, fewer services, profoundly more expensive insurance, fewer people covered, and most importantly, more people relying on government programs.  In simple words, it was a disaster.  Today, amidst Anthem’s request for an additional 30% premium increase in some areas, Anthem is spending millions of dollars lobbying for protection, it’s CEO’s are making tens of millions, and their policies are becoming even more restrictive, if you can get it.

Bottom line, government reform was a disaster.  We were much better off without it.

Now, we’re looking at a new reform push.  So far, this is sort of what’s on the table in DC:

Democrat Health Plan

I see a problem with this.  I hope you do too.

I have a better suggestion for health care reform:

Mooned health care reform

Pretty droll huh?

This is where it gets exciting.  In 2008, the Federal Health and Human Services agencies employed 64,750 people and cost over $700 billion.  Now, keep this in perspective, this is just the federal agency.  Every state has their own health and human services division.  In California, they are requesting $7.9 BILLION just to balance their budget.  That’s your money.  And, more importantly, that’s my money.  Now, in the case of California, their HHS agency is broken down into various divisions:

Going back to the federal chart, as it is now, you have these agencies:

  • Office of the Secretary
  • Administration for Children & Families
  • Administration on Aging
  • Agency for Healthcare Research & Quality
  • Agency for Toxic Substances & Disease Registry
  • Centers for Disease Control & Prevention
  • Centers for Medicare & Medicaid Services
  • Food & Drug Administration
  • Health Resources & Services Administration
  • Indian Health Service
  • National Institutes of Health
  • Office of Inspector General
  • Substance Abuse & Mental Health Services Administration

Each agency has many divisions or programs.  Just picking one at random, Indian Health Services has the following programs:

Some agencies are bigger, very few are smaller.  Now, here’s my rub on all this:

Every single federal agency has a large administrative staff.  Every single program has an administrative staff.  Everyone wants to blame the private sector, ie insurance companies and doctors on the inappropriate cost of insurance, but I think the biggest direct impact is being completely ignored.  And, in the case of this latest reform measure, pandered to.  Now, IMO, medically, an Indian is treated exactly the same way as a Veteran.  Someone suffers the same injuries in Miami as they do Portland.  There is no difference in what Head Start should be teaching an Indian student than a student in Appalachia.  And, most importantly, a federal administrator of a program that is again administered on the state level is a complete and total waste of money.

How’s about this idea?  Eliminate HHS entirely?  Then, eliminate 90% of the state level programs entirely.  Instead of HHS duplicating all the functions that are performed at the state level, create a funding stream in its place with a hand full of auditors, several very good computer programmers, and, a few data support staff to make their lives bearable.  We don’t need that level any more.  If you’re billing the feds for medical services by paper, you’re toast.  The data collected by the provider is more than enough to get the job done.  All HHS needs to do is verify the data is accurate.  That most often can be done by cross-referencing existing data.

Having freed up several hundred billion dollars, send that directly to the states.  In turn, the states will set up county clinics in the fashion of the health clinics of the 60′s and 70′s.  In these cases, they will be staffed by hourly staff and provide the most rudimentary health services such as flu shots, boosters, and other routine medical services not requiring any specialty.  These clinics will be staffed almost entirely by registered nurses.  The heart of this proposal would be the fact that these clinics would be free to whoever walked in the door.  No discrimination of any type.  Black, white, illegal immigrant, felon, business tycoon, man, woman, child, it makes no difference.  If you feel sick, go to the clinic.  If you really are sick, they’ll send you to either a hospital or a specialist.  This would replace the mandated health insurance coverage proposed currently.  The money saved in this scenario is unfathomable.  I can not even begin to imagine where to start in trying to figure out how much it would save.  Start by scratching the cost of administrating medical cards, medicare, and medicaid on the federal, state, local, and private sectors.  They’re all gone in this scenario.

In the case of hospitals and specialty services providers, a single payor on the state level will establish rates and services to be paid for.  This allows for regional preferences in services.  If one state wants to provide substance abuse for glue sniffers, that’s their decision.  However, because one state chooses to provide services for glue sniffers, it’s not forced on the states that don’t have a problem with glue sniffers as the current system does.

I could go on and on and on for hundreds of pages.  But, I hope you get the concept already.  The basic intent of this, which I think is obvious, is to eliminate the ridiculous expense of wasted administrative costs.

But, it gets even better.  Say you don’t like the services offered under the state plans.  Simple enough.  Private insurers will be allowed to offer any coverage they want over and above the state level services.  You want annual botox injections, find an insurer who pays for them.  You want semi-annual lypo?  No problem.  I’ve got the policy for you.  This would actually expand the avenues insurers could offer, and allow them to generate more profitable policies since the everyday expense of processing expenses for headaches and hangover visits to clinics are gone.  Their would be no limits at all on the health insurance industry.  They could charge what they want, where they want, and for what services they want.  Over and above the minimal clinical level services, free market would dictate the cost and services offered.

Rather than delving into every single aspect of the current public health care model, the same philosophy would apply to them all.  Rather than pandering to almost every conceivable population sector, the entire population would be treated equally.  There are populations with special needs, such as the infirm and mentally handicapped.  The states would administer those programs without the redundancy and burden of incredible documentation required to appease federal funding.

Now, as with any scenario, there is room for, and there will be, some fraud.  That would be handle as each state sees fit.  However, I’m quite certain that under this scenario the room for fraud is reduced profoundly as most of the people working within the clinics and public services will be paid simply on an hourly/contractual basis.  There is no way to overcharge for individual services provided as there is no individual billing.

And, another big upside to this is I won’t charge $1,500,000,000,000 to implement it.

The reason this will never happen in my lifetime is equally simple.  It’s political suicide.  At least 100,000 people would lose their jobs.  A democratic society can’t make that choice.  That’s the reason you have that garbled mess at the top of the page.  Once a program is started, it never dies.  The politics of taking services away from people is too lethal.  Until we as a society accept the fact that something has to be given up in order to keep it at all, we’ll just keep watching health care eat up our budgets and infringe on other things we could be doing such as cleaning up our environment and pushing more efficient and greener technology that would make our environment safer, and our lives healthier.

And, until a leader such as Obama is willing to sacrifice everything for what he believes in, people won’t buy into their own sacrifices.

Bottom line, this mess proposed won’t pass as it is now.  It’s too expensive and does too little.  Even if it does pass, it won’t solve a single problem.  The price of health care will just be $1.5 trillion more expensive than it is now.  To put that in perspective, that’s $5,000 for every single person in this country.  That’s $400 a person a month.  May as well just keep things as they are and expand Medicare.

Tags: , , , , Filed Under Entitlement Programs, Fed Policy, Health Care Debate, National Debt, National Politics, Political Correctness 

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