My title is an anticipation of the likely response to this post. Okay. Very few issues are so “simple” that they can be dealt with in a few paragraphs. Still I persist:
Trump better hire some genius medical economist to come up with a healthcare plan and simultaneously explain why Ocare did not work. (Which it really hasnt) McConnell has said he’s not gonna help, which swells the music of the Dems’ chorus:”They have no plan!” We gotta get one.
I think we should go back to private insurance, but regulate it. Make it illegal, period, to deny coverage based on pre-existing conditions. Make the insurance market nationally competitive. There: we’ve leveled the playing field, let the vying for customers begin.
Also would somebody break it to middle-aged America that Medicare is not free? Maybe it is you’ve got nothing, but if you do have assets, you’re penalized and they’ll take it outta your social security.
But that isn’t even the biggest thing. We should be concentrating on care, not insurance. Instead, Ocare has made it more difficult to even get to the actual hands-on treatment stage. You can’t get into a clinic without photo ID. You can go to an ER without it, but such “facilities” are authorized to charge a “facilities fee” just for entering the door, exactly like a cover charge, in addition to and possibly in excess of the fee for treatment. (But independent practitioners cant impose such a fee.) And, is it still possible for a medical school graduate to set up his/her independent office? I doubt that. When my husband left his practice as a family doctor in 1998 as we moved to my mountains, it had already become impossible to pay the overhead. He was prohibited from performing most medical tests like EKGs and throat cultures and drawing blood in his office: patients had to make a separate trip to the hospital lab, pay for that, and w.a.i.t…both to undergo the test then to obtain the results. He was prohibited from charging more than insurance would pay for work injuries and car accidents, regardless of the services he rendered beyond those remittances. He was prohibited from charging for the total cost to him of immunizations. Let those rich doctors just absorb the costs!
Yeah, so,let’s scrap all that and start selling medical students again on how great it is to exercise their professional skills in an environment where, yes: they are god. (WTF was wrong with that? If you have ever been through, or been terrified by th prospect of, a deadly illness, you know that what you want from your physician is, precisely, a god-like certainty and confident prognostication. ) Then they’ll compete for patients, who will flock to the ones with the best results, the most accommodations in services, and yes, the best bedside manners.
Such competition was fierce! we used to joke about our fellow residents who set up an office in some fairly remote area, and were instantly “busier ‘n’ a one-armed paperhahger” ( i dky, But thAt was the invariable cliché)— until one other doc moved in, and the new practice was instantaneously halved! It was riskier and harder, but much better in the long run, to go to an already saturated area and carve out a space. If you could make it there, you’d make it anywhere.
People had no idea what they used to get outta their doctors. Oh, BC (before Clinton, Hilary I mean) they did respect and kinda idolize them. But they didn’t know how much work docs did FOR FREE. Weekends “on call” where the doctor was tethered to his practice area, likely to be interrupted at all hours of the day and night. Hours on the phone after office hours ended, explaining lab results to patients, answering their questions, calming their fears.
They didn’t charge for all this time, and the cost of the office visit, what, like, $30-35? surely didn’t begin to cover it. IF the patients paid even that, which many regulars just..never did. But I never once heard of any of our peers asking a patient to leave his/her practice because of failure to pay.
Hilary, and then the era of the HMOs ( capitalized mecicine) convinced America that doctors weren’t on their side, they were just greedy,self-important charlatans in white coats. Well, when you knock a profession off its pedestal, don’t expect its members to keep up the monumental standard.
If Trump can’t win 2020 without a healthcare revamp, then come on! Find the right architect, now! The man who rebuilt lower Manhattan can handle that!