Thoughts on Health Care Reform that Don't Require 1,000 Pages

Proposed Health Care Reform has created more interest and concern about what our government is doing than has been seen in a long time. One of the biggest problems with HR 3200 (and it's variations) is that it's unreadable, so no one (no, not even the congressmen who created the mess) can understand it. Basically, anyone can say something is in the bill or not in the bill. It's 1017 pages of gobbledy-gook, so who knows?

The bill should be scrapped and Congress and the President should start over. This time make reform efforts truly bipartisan. (Stop claiming Republicans are blocking reform. They don't have the numbers to do so.)

If the administration and congress truly want to solve the issues with health care, including out-of-control costs, they should tackle and implement changes in increments, instead of making one sweeping transformation that could cause huge problems and will be difficult to pass.

Here are a few ideas to consider for incremental, but real, reform:

Focus first on getting costs under control. If President Obama wants to cover more people while reducing expenses, costs have to be reduced. If he wants taxpayers to believe government can fix health care, he'd better prove government can run something-anything-efficiently first (given their track record) and controlling skyrocketing Medicare, Medicaid, and Social Security costs is a good place to start. Those programs are headed toward bankruptcy. They have to be fixed. Do it now.

Tort reform (malpractice suit reform) has to be high on the list of changes. While some congressmen insist tort reform is in the bill, Howard Dean, a physician, onetime DNC chairman and past governor of Vermont, admits it isn't. This one step would make a significant dent in reducing health care costs, and isn't dependent on other reform. Cap malpractice awards.

Help hospitals build attached clinics for those with minor ailments. (Hey, it's stimulus!) If someone (with or without insurance) arrives at the hospital with a minor injury or illness, triage him to the clinic. (I, for one, would have been happy to use a clinic when our child had an ear infection on a Saturday evening. The pediatrician wasn't available and I headed to the emergency room. Yes, we have insurance, but it would have been far less expensive for the insurance company to pay for a clinic visit instead of one at the emergency room.) This would immediately reduce the number of people going to the emergency room with minor ailments, reduce costs, and wouldn't require a 1000 page bill.

Limit or eliminate care for illegal aliens. We can't continue to provide health care for those who don't pay taxes.

Equalize the tax laws on health care insurance for everyone. Whether you buy your own insurance, are a small business owner who provides insurance for employees, or work for a large, self-insuring company, everyone should be treated the same in the eyes of the IRS. It shouldn't cost a small business owner more to insure his employees than a large corporation pays.

Repeal laws that limit the ability of insurers to provide policies across state lines.

Require catastrophic care for all, but let those who want more pick and choose the other types of insurance they feel is important-and pay for it. The government can pay for private insurance for catastrophic care for those who can't afford it. We don't need a public option.

There's no reason taxpayers should pay for anything other than catastrophic care for anyone. People don't buy insurance for oil changes or having their houses painted. Why should they have insurance for minor doctor visits and pharmaceuticals? If they want it, let them pay for it themselves.

Make health insurance deductibles high for everyone so people spend their own money for the first couple thousand dollars of health care expenses. Perhaps companies or individuals can fund health savings accounts with pre-tax dollars to provide the funds to pay for medical expenses until they meet the deductible. The unused money can accumulate every year year. Everyone needs to be aware of how much things cost and feel as if they are paying for it, even if it's from a health savings account.

My father-in-law, for instance, who's on Medicare, takes medication for Parkinson's Disease. The Parkinson's specialist doesn't think he suffers from it, but my father-in-law thinks he should take the medication, just in case. (There's no indication that it helps.) I doubt he'd take the medication "just in case" if he had to pay for it.

If people have to pay for their health care, even if it's from a health care savings plan with money provided by an employer-or the government for those with a low income-they'll be more responsible about using medical services.

Don't pay doctors on a "per procedure" basis. This, and the threat of malpractice, causes doctors to order unnecessary tests.

Simplify and create uniform insurance forms to reduce the time and staff necessary to complete and submit.

Make the new bill (yes, toss out HR 3200 and start again) short, (keep it to no more than 50 pages) and simple so that the average person can understand it. Right now, nobody-not even the congressmen who created it, claim to have read it, and are now trying to explain it-really know what's in it. It's just too complicated. If congress can't write a relatively short, understandable bill, keep tossing them out until they can.

Fixing health care isn't impossible. The President and Congress just need to stop politicizing the issue and start making the tough decisions that are necessary. After all, that's what they were elected for.