1. There should be a single payer system. Frankly, health insurance companies cannot be trusted to treat anyone fairly and ethically. I’ve been observing healthcare insurance companies for too long in my career, and I am convinced. However, they can stick around to provide high priced supplemental insurance to those who want and can afford it. Because they will have to compete for this business, market forces will force them to provide high quality services. This healthcare insurance should be available to everyone living in the United States, irrespective of anything, including immigration status. To pay for this system, each will be taxed in an amount similar to their monthly healthcare insurance costs, with those at higher incomes paying a higher percentage of their income. It must be fully funded.
2. To remove the worst parts of the Medicare and apply it to a new system, a medical board should determine the formulary for drugs and devices (and to establish exceptions), to approve new procedures and treatments, and finally, to determine what the payment levels should be to hospitals and other healthcare providers. And no, I do not think it’s appropriate for a medical board to decide on a case by case basis, although there should be a legitimate, speedy, and fair appeals system.
3. The new healthcare plan should have the ability to negotiate rates with providers, manufacturers and anyone else involved in the healthcare system. Think of it. Negotiating with these companies with the buying power of over 300 million US citizens. Now, I’m a pure capitalist, so will the pharmaceutical industry go bankrupt? No. They should prove, clinically and scientifically, that their products work, and then negotiate in good faith with the government. And if the government doesn’t want it on a formulary, I’m still willing to bet that the supplemental insurance industry will be a lucrative area for the wealthier to get their erectile dysfunction drugs. Managed Care Organizations, which can bundle provider services to either a single payer organization like Medicare or to private insurance companies, can prosper in this environment by providing high quality of care and by negotiating with government to reduce costs. This gives a more direct relationship between the Payer (the US government) and the patient.
4. Do not pay for woo. Acupuncture, homeopathy, naturopathy, and whatever else that hasn’t shown safety and efficacy in a clinical trial accepted by a peer-reviewed journal won’t be reimbursed or included. We can’t afford to pay for junk medicine that hasn’t done anything to improve the health of any human. We need to keep Senator Tom Harkin’s money-wasting ideas about healthcare far away.

Tags: Healthcare policy, Healthcare reform, Obama and healthcare, Sarah Palin, Alternative medicine, Acupuncture, Homeopathy, Naturopathy, Evidence based medicine