CORRECTING HEALTH CARE IN THE U.S.A.

Correcting just the end product of health care is not the answer to America's health care "problem". Health care is indeed a problem, but the problem is systemic and must be attacked at all levels, not just at the hospital level. However, in order to correct the system we must first correct GREED at the individual and corporate level.

How do we do that? In reality, we probably cannot/will not because everybody likes money. For me, personally, I have never made so much money that I ever had an excess of it. I have owned some nice cars in my life, but they were bought used, owned one at a time, and financed for YEARS. I do not own any stocks or bonds, nor do I belong to a country club. I have been fortunate enough to live indoors all my life, but never in opulence (unless you compared my domicile to the ones in some 3rd world ghetto... a Somali native might consider my abode to be opulent by comparison to his). I have never really known "want", but like most working-class Americans, I have always had sufficient. I have always been able to afford everything I truly need, and most of the things I have wanted but could have lived without. I suppose you could call me "content" with my lot in life. Don't misunderstand me though - I am not the reincarnation of Mother Teresa - if I were to win the lottery I would not refuse the money, but I rarely buy a lottery ticket, and I don't worry about not winning. I like to think of myself as "Joe Average" in most respects. Now let's get to the GREED problem...

For many people in this world there is no such word as "enough" - it simply does not exist in their vocabulary. This is a big part of the health care problem, and many other "social ills", but we do not correct it by redistribution of the wealth. That which an individual has earned (through honest and noble means) as the fruits of his/her labors entitles them to enjoy that wealth, however massive or paltry it may be. On the other hand, what honest and noble human being walking the face of this Earth produces fruits worth $10,000,000 or more per annum, other than perhaps the founder of his/her own corporation? There is no level of hired management worth that kind of money! But our major corporations pay that much and more for CEO's, CFO's, COO's and other executives, ostensibly because "they can't get the best and brightest for less" . On top of their obscene salaries, they get expense accounts, stock options, bonuses, company cars/limousines, (and in some cases drivers)/airplanes, and health, dental, life and vision insurance as part of their compensation packages.

If the government feels the need to get involved in something in industry, that would be a good starting point, but the government's job is to regulate industry, not manage it. Therefore the Congress would need to pass legislation something to the effect of:

1. No executive compensation packages worth more than $2,000,000 TOTAL - in any industry. That would eliminate the possibility of one industry "raiding" another for top executives, and anybody should be able to live very nicely on $2,000,000 per year!

2. No "Golden Parachutes" for any executive who is terminated for cause, or who fails to live up to the terms of his/her contract, or who has not increased the market value of the corporation by at least 15% during his/her tenure. Naturally there would be no "Golden Parachutes" for executives who left or were discharged from a failing corporation. We do not reward failure!

3. Corporate stockholders would receive a fair return on their investments, of say 20% - not to exceed $1,000,000 per year in total cash value regardless of the amount of corporate stock held. It would be against the law for American corporations or private investors to invest outside the United States of America.

4. Manufacturers of durable goods items, such as automobiles, appliances, and medical equipment, would have a restricted wholesale markup of not more than 20% of the total manufacturing cost. Retailers of those items would likewise be held to a 20% markup over and above their acquisition cost.

5. Union labor compensation package rates would be reduced to the average level of non-union workers performing the same work within the state where they are employed, plus 20%. A union member may be terminated at any time for just cause, as would any non-union employee, and a union member will enjoy no more recourse than that which would be available to the non-union worker.

6. Successful corporations would pay bonuses equal to one weeks earnings to all employees twice a year. Corporations posting losses during the fiscal year would correct those losses by replacing marketing and sales personnel beginning with executives - unless the product was found to be defective. If sales were down due to defective or inferior merchandise, Quality Control and responsible production workers would be replaced.

7. Outsourcing American jobs to foreign countries would be eliminated, thereby reducing our unemployment rates. Any corporation with existing foreign operations would be allowed to maintain that operation for 5 years, however those corporations would be required to pay to the state(s) in which they have production facilities, full U.S. unemployment benefits for each job created in those foreign countries on a worker-for-worker basis. One hundred employees in Sri Lanka would mean that Corporation "X" would have to pay full unemployment compensation for 100 unemployed Americans in the USA, even if they do not have production facilities in the USA.

Health Industry Specific Requirements
Items 1 through 3 and five through 7, as outlined above, would apply throughout the Health Care Industry. Additionally:

8. A cap of $500,000 maximum payment per medical malpractice lawsuit would be established.

9. Doctors working in a hospital/clinic/urgent care environment would be salaried. General Practitioners would be compensated at the after-tax rate of $1,250 per week and would work no more than 50 hours per week. Specialists would be compensated at the after-tax rate of $1,500 and work no more than 50 hours per week. Nursing Staff would be compensated at the after-tax rate of $875 per week, and work no more than 50 hours per week. Support personnel would be paid at the prevailing rate for their employment type within that state.

10. Medical Schools may charge no more than $150,000 for any training provided, to be repaid by the student over a period of not less than 20 years.

11. Health Insurance will be made available nationwide - from any state to any state. For example, all health insurance companies will be able to offer coverage in any of the 50 United States, thereby increasing competition to give the consumer the best value for his/her money.

12. Health Insurance companies may charge, based on reliable actuary data, at a rate not to exceed $10.00 per month per $1,000 of potential annual loss, based upon all physical contributing factors, such as age, sex, weight, race, general physical health at the time of application, pre-existing conditions, use of tobacco, alcohol or non-prescribed drugs, and the potential for loss over the length of the contract.

13. All prescription medicines offered for sale by pharmaceutical companies will be sold at a global rate, not to exceed the rate billed to the poorest of nations.

14. Corporate R&D costs will be recouped over a 5 year period via a tax credit of 20% of the total R&D cost per year, per new product. R&D costs will not be passed along to the consumer.

15. Hospitals/clinics/urgent care facilities providing over the counter (OTC) medicines or medical supplies (i.e. - aspirin, band-aids)can charge for those medicines and/or supplies at a rate not to exceed five times the per unit cost for said medicines and/or supplies.

This is certainly not meant to be the "be all and end all" of health care system regulation, but it could provide someone more intelligent than I with a "jumping off point". And, by the time our legislators - 95% of whom are lawyers - got through rewording and earmarking it, these 15 items would have been transmogrified into 1500 PAGES of government regulation!

There is certainly a remote chance that I could be "fulla" in this area, since I am neither a health care professional nor a lawyer. It just seems to me that something that appears to be so simple doesn't have to become Labyrinthine as it passes through the House and Senate!

HEALTH CARE REFORM FOR DUMMIES!

I may not be the sharpest knife in the drawer, but this "health care reform" seems a bit out of kilter to me. If it was made by Bally's the "Health Care Thrills" pinball machine's TILT light would be flashing and the buzzer would be blaring loudly! Here's what I see as the best way to get health care costs under control - with very little actual government control:

We begin at the source of skyrocketing health care costs - the pharmaceutical companies, and the medical equipment manufacturers -

1. Pharmaceuticals (prescription drugs) in the US cost anywhere between 3 and 10 times what the same drugs are being sold for in both the northern and southern parts of North America (for those of you who failed geography, that's Canada and Mexico). And, in 3rd World, or "developing" nations, the disparity becomes even greater! Why is it that the USA gets to pay the premium price for necessary medical supplies when they are created within our own borders? Because the PharmCo's think we can afford the outrageous prices, and that we should pay for all their R&D. Granted, Research and Development of medicines is an expensive proposition, but why do Americans have to bear those costs alone? And why do the PharmCo's seem to believe they should recoup those expenses in the first 6 months of sales? Those costs are passed on at your neighborhood pharmacy as well as at your local hospital. Why does the same Band Aid, or USP formula aspirin that sells for $4.00 per hundred at Rite Aid or Wal-Mart, cost you $5.00 per pill on your hospital bill? Because those of us who actually pay our medical bills (with or without medical insurance), pay our medical bills... and we foot the costs for those who do not!
2. Medical equipment costs are horribly expensive, and no hospital is considered a hospital these days if they don't have a CT Scanner or MRI Scanner. R&D costs to develop safe and effective medical equipment are at least equal to those of the pharmaceutical industry. Where is it written that being a manufacturer of anything is cheap? A "decent" Magnetic Resonance Instrument (aka Magnetic Resonance Imager) costs your hospital anywhere from $1 million to $3 million, and a top of the line MRI is even more than! How much profit is in those prices, after including R&D and marketing costs? I could only find one figure on that, and it was $800,000... but there was no posted figure on at which price-point the system sold.
   
   Now, consider that registered nurses (RN) nationwide with 2-9 years experience, on the average, are being paid between $22 and $32 per hour, and the average MD earns $171,000 per year. These factors all drive the cost of health care upwards. Medicines are necessary, and when you really need medicine it's probably worth whatever the cost, as are the hospital equipment and personnel. However... when the practical value of something exceeds it's affordability, most people are caught "on the horns of a dilemma". Among the uninsured there are generally only three options:
   1. Do without treatment and suffer the consequences.
   2. Get the treatment and pay the bill off at $10 per month for the rest of your life.
   3. Get the treatment and say to yourself, "Illegals don't pay for treatment, why should I?", and then don't pay the bill - making the cost of treatment for those of us who DO pay our medical bills even more expensive.
   
   Those of us with private medical insurance are generally thankful for it when we need it, and most of us can - and will - handle even the most expensive of deductibles when given a reasonable period of time in which to pay it off.
   
   Then we have those who don't worry about health insurance - the rich and famous. For the most part these people (the Rockefellers, Morgans, Tom Cruises and Elton Johns of the world) can afford to be "self-insurers" - sitting on their hordes of money until they find a practical need for it.
   
   Finally we have that group which breathes the rarified air of Washington D.C. - our elected officials. They have no vested interest in reforming health care, inasmuch as they pay for nothing when they become ill. Our Congress has the sweetest health care plan in the world... and WE pay for it! Don't we all wish we had jobs where we could vote for our own pay and benefits packages like our Congress does? Why would they be concerned about "what is best" for the rest of us?
   
   Do we really need our government, which failed in their attempt to operate a combination brothel and bar in Nevada a few years back, to run our health care system? Seized by the IRS for tax delinquency, our government geniuses managed a previously very successful and well-known brothel into bankruptcy. How incompetent must one be to fail at selling sex and alcohol?
   
   If you have read this far you may be asking yourself, "Okay, Mister Smartypants, what needs to be done?" And my Pollyanna-ish answer would be (here's where the government gets involved, but in a structural sense, rather than an administrative one), let our Congress pass legislation requiring that :
   1. If you want to "cap and trade" something, cap the costs of medicines. Global pricing would be a good first step, rather than Americans paying anywhere from three to fifty times more than people in other parts of the world. Why should we, alone, bear the burden of paying for Pfizer or Lilli's R&D costs? And "because we can afford it" is an unacceptable answer!
   2. Medicine and medical equipment must be made available to the community at a reasonable cost. My "law" would require that profiteering in medical supplies and equipment end immediately. The profit margins on medical supplies, equipment and services would be held to the generally accepted retail figure of 40% of production and delivery costs.
   3. The government would NOT be involved in the day-to-day administration of any health care plan, much less create a national health care plan. (Our government has ruined the Social Security program into which we all pay, and now they want us to let them run another program into the ground with our money? I would guess that the majority of us are stupid enough to let them get away with this BS "pie in the sky" dream of Obama's.)
   4. Immediately eliminate any and all taxpayer funded medical treatment for non-citizens! If they don't belong here legally - other than in jail for violating our border - they are entitled to exactly nothing.
   
   These ideas would be just the beginning, not the be-all and end-all answer, to reforming our health care industry. Everything needs a starting point - I'll leave the details to somebody smarter than I.
   
   I could be wrong about this... but it just seems like common sense to me.