Healthcare PolicyOpinions about healthcare policy, and proposals for reform
Joe Biden isn’t calling, but if he did….this is what his healthcare platform should be.
Note that this is not an endorsement of any political party or candidate (sheesh, we are required to do this, in our society these days).
a. Medicare school free. Physicians can elect to pay back via service. Medical schools object? No more research dollars, effective immediately.
b. Long-term care. New Medicare Part L. Looks and feels like Medicare Part D. Carriers are required to offer, and if they don’t, they don’t get to offer Medicare Advantage or Part D, either.
c. Medicaid must go to carriers, all of it, in a competitive bid, per location.There is something called “dutch auction,” where the highest acceptable amount is paid to the 2 accepted bid per location. This is how US Treasury bonds are auctioned now, I am not inventing the idea.
d. Rx: zero side deals. Most Favored Nations as soon as a prescription leaves the pharmaceutical. There are wayyyyyy too many toll-takers involved between the time the drug is produced to the time that the patient takes a medication (long-time subscribers know that I have been pleading Amazon to get involved in Rx distribution, they could single-handedly solve this in about a month).
e. Medicare Optional Buy-In at a younger age (50 is my guess, so that the AARP doesn’t continue with its wrongly-placed, academically wrong, and distorted slogan “No Age Tax.”). It is the case that Medicare is superior to the individual market, the employer-sponsored market, every other health insurance in the U.S.
If the employer isn’t smart enough to get employees to take the Optional Buy-In, it is wasting money, that happens today. That said, if the horse doesn’t want to drink superior water, so be it. Can there be exceptions? Yes, in which case the employees stays on the employer-provided plan.
f. States can elect to create re-insurance pools, and the CMS matches the amount. One way to lower premiums is to encourage risk by the carriers, by providing a “backstop” in case they start losing money. Note that this was inadequately funded under the original ACA, and on top of that, the federal government is trying to not make payments, after the fact (boo). The concept however is sound, because we need some way to lower health insurance premiums. The issue that every location is so different with respect to healthcare costs, so the health insurance premiums vary from state-to-state, wildly. So every state can choose to fund a re-insurance program, and the CMS matches the funding, to effectively double the re-insurance pool, for those locations that have voted to enact this path. Note: there are a couple of states that have enacted something similar to this, without my feature of “dollar matching.”
g. A twist to point f is that we can get financial markets to solve this overnight, with the government as the backstop, if an only if required. It’s complicated, but Wall Street investment bankers will figure it out. The reason that they have not done so already? There has been no viable backstop.
h. Make health insurance premiums tax-deductible. This may help appease the AARP. While I have been sharply and openly critical of the way that the AARP has campaigned as stated in point e, there is political and demographic reality.
Sigh, Joe Biden isn’t walking through that door….