While I do not like government run institutions, there are a few things in life that the government has made our lives better while managing it.
Our government has the right to manage interstate commerce, and as I see it now, our Health System is an Interstate Commerce problem. Not only do companies have employees in several states, but people travel, move and have families dispersed all the time across our great nation. In addition, people who require help in an emergency, or people that have contracted a communicatable disease put a stress on all of us when their health care is not provided for. Either hospitals treat these people without getting paid, or they die, or worse they spread the disease to others.
As our country continues to grow to being more and more urban, we need to deal with problems as a set of communities rather than as a body of individuals.
So, in general I support a number of points of health care reform.
Early In my life I worked at a medical billing company and I know all too well how insurance companies skip out on paying bills, and how doctors inflate bills to get good payers to pick up the slack for other more dishonest insurance companies.
I urge those that are passionate about health care to help us simplify, streamline, and clean out the corruption in the healthcare industry. Our parents, and grand parents are at risk.
I propose several changes to the system.
1. provide leadership and standardize payment processing, require that health insurance companies pay 80-90% of claims. right now they pay less than half of all submitted claims.
2. provide a validation engine for said claims, such a validation engine has been built to determine if an HTML document is valid. I suspect such an engine could be built to validate a medical bill. this would validate the patients identity, the medical practitioners identity, and the payers identity. the system would also validate viable pairings of CPC codes ( medical care line items ). Items that are unusual could flag a review process by a board of medical practitioners.
3. record all bills and assemble a medical care census, and provide the data in aggregate, and autonomously to the public to crunch. with proper statistical records on care patterns people can dig into the information and get a good view on where innovation needs to occur, and where current innovation is not yet being used. right now only health insurance companies have this data, and this should be public data so others can help and map out solutions for our general well being.
4. provide leadership in sourcing funding for problems in the system that are identified through statistical methods. in some cases direct taxes might make sense to provide research funding, and in other contexts, businesses might rally together to provide said funding in a prize economics / ‘netflix prize’ sort of way. using the data from #3 we can very easily identify treatment pairs that are raising in cost and ones that need additional research done to better advance them.
5. require that insurance companies can not deny someone based on pre-existing conditions. this forces insurance companies to have a broad demographic.
6. allow young individuals some sustained benefit for purchasing health insurance at a young age and keeping it up. I think it’s silly to pay $2400 a year and visit the doctor once in 3 years. Paying straight cash for a $500 doctors visit is still cheaper. For people that invest in the system and don’t have health problems, some percentage of their payment should lead to reduced payments later in life. it should kinda be an investment vehicle, and if one pays additional dollars at a young age into the system one should get better care later in life, as health costs should always be more later in life than earlier in life.
7. build an infrastructure so that doctors can virtually review a patient together via video conferencing. reviewing patients with multiple opinions can reduce errors. In the programing space we call it extreme programing, or pair programing, and certain cases might be flagged for care that is prone to error.