House Calls / Dr. Michael Schwartz
Patients and physicians are both finding the health care policies implemented under the recent Affordable Care Act (also known as "Obamacare") confusing and concerning. While patients are concerned about health care costs and access, the new rules and regulations are forcing many doctors to consider leaving the profession and many potential physicians to not enter the profession. Older Americans are anxious about losing their Medicare benefits and the uncertainty of the effect the Affordable Care Act is placing on the economy.
Ideally, health care coverage should be accessible to everyone. However, many doctors and patients are discouraged by the implementation of more regulations and many do not think the entire system needs an overhaul. As such, I asked physicians and patients across the country for their views on how to fix the system; below are some of their suggestions:
The government should provide free medical care for every child until the age of 18:
1. Eliminates the need for families to worry about coverage for their children;
2. Reduces health care costs for individuals as well as corporate employers.
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Create competition by developing not-for-profit health care companies to compete with the current "for profit" model HMO/PPO:
1. Government should assist in the creation of "not-for-profit" medical insurance companies to compete with "for profit" companies;
2. Lower the premiums for individuals who choose "not for profit" companies for their health care;
3. Competition will decrease the amount currently charged by existing "for profit" insurance companies.
Lower the eligible Medicare age and add a co-pay, for example:
Age 62 -- Medicare pays 50 percent and patient pays 50 percent with a $30 co-pay
Age 65 -- Medicare pays 65 percent and patient pays 35 percent with a $20 co-pay
Age 67 -- Medicare pays 75 percent and patient pays 25 percent with a $10 co-pay
Age 70 -- Medicare pays 80 percent and patient pays 20 percent with a $5 co-pay
Age 75 and older -- Medicare pays 90 percent and patient pays 10 percent without a co-pay.
1. This will allow many Americans to enjoy the benefits of the Medicare program at an earlier age and will reduce costs for millions of Americans who will not have to pay for their health insurance for three extra years;
2. Preserves the Medicare program by reducing costs and discouraging unnecessary patient visits by adding a co-pay;
3. Will allow employers to save money by lowering or eliminating the need to cover insurance costs for many of their aging work force.
Lower the Medicaid requirements by 15 percent:
1. Will provide millions of lower income Americans access to the Medicaid system;
2. Yearly review of patient eligibility to reduce fraud and overuse of the program.
Create a national health system (NHS) by expanding the current VA system.
1. VA health care centers already exist throughout the United States making it easier to expand these centers;
2. Will provide everyone who does not have health insurance with a program to ensure quality health care;
3. The program would be discounted based upon income level;
4. Open additional VA (NHS) centers and include private physician offices and hospitals to insure access;
5. NHS patients will be required to visits NHS health centers for their health care.
Medical school will be paid by the government for physicians agreeing to give 10 years to the NHS:
1. This will encourage more individuals to enter the medical profession filling the void currently left by those doctors leaving the field;
2. Increase the number of primary care physicians serving the many under-served areas of the country;
3. Ensure that the NHS has a continuous and adequate amount of physicians.
Limit malpractice awards:
1. Tort reform could lower malpractice premiums and lower patient costs;
2. Create "malpractice panels" made up of specially trained individuals to determine appropriateness of cases and awards.
Tax all malpractice awards 10 percent off the top and add ¼ percent federal sales tax to help fund these health programs:
1. Use these collections to fund lowering the Medicare age and covering all children until the age of 18.
2. Assures that these monetary awards will ultimately improve the health care for others.
Eliminate all direct to consumer advertising by pharmaceutical companies:
1. Use the savings to lower drug costs and support additional programs to supply free or discounted medicine;
2. Will encourage the use of generic products whenever possible.
Regulate the insurance industry:
1. Children between the ages of 19 to 25 can be covered under their parent's policy;
2. Allow patients the right to control their own costs by expanding health savings accounts (HSA);
3. Allow insurance companies to contract with approved medical care centers in other states to lower costs through competition.
All Americans should have the ability to access affordable quality health care. In order to promote the best health care, qualified individuals must be encouraged to enter the medical profession.
With the confusion and uncertainty surrounding the effects of the Affordable Care Act, the number and quality of individuals eager to enter the medical profession has diminished. Over-regulation merely results in confusion and runaway medical costs. Creative ideas from doctors and patients may ultimately assist our legislators in ways to promote a better health care system for everyone.