Healthcare For Americans

A healthcare bill everyone can support.

Repeal and replace socialism

THE PROPOSAL

Typically bills such as a healthcare bill is sponsored by one or more congresspersons. The congresspersons need not be the actual author of the bill. Any American may draft a bill and submit it to be sponsored by someone in congress. The proposed bill is referred to one or multiple committees or subcommittees based on the context of the bill. Here, the proposed bill could be "killed in committee" and never make it for a full vote. It's possible that proposal isn't even addressed by the committee. If a committee addresses a proposal, they will usually review and hold "hearings" with supposed experts on the content of the proposal.


The proposal may be "marked up" or have changes made to it in subcommittee or committee. If it moves on, it will be placed on legislative "calendars" for a "floor" vote by the full Congress or Senate. This is the reason we often hear that Congress or Senate adjourns session (goes home) before it completes voting on all of the items on the calendar.

CONCURRENCE

If the proposal is passed in the chamber (house) of the Congress or Senate, it will go to the other house where it often restarts at the committee and subcommittee level within that chamber. Whether changes have been made during the initial vote or not, both houses attempt to concur or agree on a unified proposal. There often can be a back and forth "fight" over what is cut or added to a proposal that may have never been part of the original. This is sometimes called "pork" because it is "fat" that often does not have anything to do with the original concept of the proposal, such as providing funds for a local park in a road building bill.


Once the proposal is approved in the identical form by houses, it is sent to the President where it can either be; signed into law, go unsigned by the President for 10 days which acts as a default Presidental approval, or it can be vetoed (rejected) by the President. If both the House and Senate vote a 2/3rd majority, they can override the President's veto and the bill becomes law.

INPASSE

In the case of the repeal and replacement of the U.S. healthcare bill, often called Obamacare after President Obama, while the Republicans have majority control over both houses of congress they have been unable to meet concurrence and often after changes lose votes to move the proposal along for passage by both houses. There is talk about repealing Obamacare without a replacement. This may have a better chance of passing both houses as it would remove the impasse of whether the replacement cuts too much or not enough from the original Obamacare.

NEW WAY

As stated in the first paragraph, technically any American can propose a bill. In this case, perhaps President Trump should convene experts in the health and insurance fields along with a good dose of free market thinkers; or even the people who have set up the Priceline airline and hotel accommodations systems to help design a free market, buffet style healthcare system that allows individuals to choose plans even across state lines. The monopolies of insurance companies and the restriction of in and out of network plans tends to limit free market and artificially increases rates.


Further, the problem for poor Americans isn't whether or not they have insurance but when, how and where they can obtain care. If they are truly too poor to pay for even the insurance, then they don't need insurance. They simply need care. In this way, we remove the propensity of health providers to overcharge because they think they will be paid by government funds. Instead, people unable to afford insurance should be provided with "free" care at special training facilities which are funded not by government reimbursement but by the tuition paid by the students in training. The training facilities are not to be operated by any university but by the government, otherwise the potential for free market increase and variance would ensue. Licensure and certification will happen after the student has graduated from the training program.

PRACTICING MEDICINE

Currently, people seeking to become a doctor or other types of medical practitioners, go to medical school which amounts to universities coordinating with clinics and hospitals to allow students to intern at the facility. Instead, physicians in training should be required to train and study only in designated training facilities. The only people treated at these facilities are people who cannot afford health insurance. People who could otherwise afford insurance but have chosen not to carry insurance will be redirected in non-emergency situations to free market facilities where care will be provided and compensation collected directly from the patient, via garnishment if needed. While there should be regulation to prevent negligence and malpractice at all training facilities, all persons receiving "free" care should be required to sign a waiver releasing the training facility from responsibility for obscure error...after all, the person is receiving "free" care.


Only after the student has served a time in a training facility and proved their ability, can they then apply for residency in a free market facility.

FREE MARKET VS FREE

Free market medical facilities should not be considered "private" and training facilities should not be considered "public". Each kind of medical facility is public yet the free market facilities are open to direct competition and immediate technical advancement. In this way, the quality of care provided in free market facilities may be superior to the training facilities. However, the training facilities will be one step behind for all advancements, since students will need to learn new and improved methods and technologies to graduate to the free market.


Medicaid and Medicare
Further, Medicaid and Medicare programs would cease to be funded and all persons unable to afford insurance would be enrolled in the medical training facilities program.


Insurance Companies
As stated under the New Way header, insurance companies will be required to offer to all across state lines, bundled and buffet plans which will be placed on a Priceline-like site run by an independent party, where the consumer can immediately compare and shop plans. This free market yet transparent method will allow insurance companies to find niche consumers and will allow consumers to buy the most affordable and relevant plan tailored to their needs.

OBJECTIONS

Objection #1
The immediate objection to this plan is that it will create a sort of "ghettoization" or subpar type of care for poor people. While this has certainly happened in facilities and programs run by for example the Veterans Affairs, the thing VA facilities lack is the training component where fresh students are trying to perfect their practice and that VA facilities are government funded rather than student/tuition funded. The environment of the training facilities will be markedly different than a government program that simply has money poured into it and forgotten like the VA program has often been. As a matter of fact, the training medical facility model may be used for veterans as well, thus ending the stale VA medical facility model.


Objection #2
This plan simply transfers financial responsibility to the student rather than the tax payer or government and will cause the cost of a medical education to increase. Actually the plan will most likely decrease the exorbitant tuition costs of a university based medical education. While universities may still guide a student in their medical education, a student will not be required to enroll in a specific university's medical courses since that will all be coordinated at unified facilities. A medical student will receive the same education no matter which university is chosen, thus incentivizing guiding universities to offer minimal tuition to attract medical students to their campus.


Objection #3
What stops a person with financial means from going to the training facilities for "free" care? Again, as listed under the Practicing Medicine header, in non-emergency situations, patients will be redirected to free market facilities where if the patient doesn't have insurance, they will be billed and required to pay even if through garnishment. A further objection with this would be that people with financial means but no insurance may forgo care. Yes, this is a possibility, but again they have financial means and chose not to purchase insurance. They will still receive care if they request but tax payers will not pay their bill. They will.


Objection #4
Medical Training facilities (MEDTaFs) may not serve areas where needed. It is possible that at the start of the program, the analysis of locations will need to be conducted. Instead of large "hospital" type facilities, MEDTFs are expected to be smaller and more wide spread. Not only will this allow MEDTFs to serve patients where they are but will allow students to easily train in their local community instead of transferring to another state. This eliminates the student's need to find near-campus housing since they will most likely be able to attend schooling in their local community. In rare cases, there could be government programs that compensate free market facilities that treat MEDTFs patients. These funds will be obtained from the tuition paid to the MEDTF program.


Objection #5
The MEDTF program will create substandard education since all medical education will be processed through these government regulated facilities. The government is notorious for not providing quality alternatives to free market concepts. Ah-ha! Yet the government wants to control our ENITIRE healthcare program. The government wants to control our ENTIRE education system. This objection admits that free market promotes competition which produces better quality and less expense to the consumer, whether we're talking healthcare or building better cars. The MEDTF program is not actually "run" by the government since it is not funded by the government. Taxes will not be levied. There is no incentive for the typical government corruption of diverting funds since the tuition goes directly back into the facilities to pay for instructors, utilities and supplies. The MEDTF program is merely regulated for consistency and uniformity. If one facility applies improvements, those improvements are applied to the entire program. Each individual facility shares in the financing of the entire program so that one facility that may have less students isn't less equipped or of lesser quality.

IMPLEMENTATION

Implementing the MEDTF program will require the congressional bill process. I submit this concept to all U.S. congresspersons and senators for sponsorship. The MEDTF program has the benefit of accomplishing everything both political parties want;

1. Covering/caring for people unable to pay for healthcare.
2. Decreasing taxpayer responsibility of non-payers care.
3. Removing all fines or penalties for not carrying insurance coverage.
4. Eliminating the in-debited/insolvent Medicaid and Medicare programs.
5. Removing the propensity for medical facilities to overcharge because they are paid exorbitant fees by the government.
6. Decreasing the insurance companies ability to dictate the level of care a person may pursue.
7. Removing healthcare as a political football used by politicians to scare up votes at election time.
8. Restoring healthcare responsibility to those with means and providing a safety net for those without.
9. Restoring free market benefits of better quality and competitive pricing in healthcare.
10. Creating an Information Age solution where choosing healthcare coverage is as easy as using a phone app.