According to the OECD we spend twice as much as other countries on healthcare and yet not everyone is covered, and the results are we don't even live longer than ppl in countries like Australia, which spends half what we spend on healthcare yet live upto 3 years longer on average. Australia has similar obesity statistics to the US.
We think the main cost is healthcare providers not being sure they'll get paid so they increase their prices so if one in four people can afford to pay, they'll still be able to live. As a result a two week stay in ICU could cost $200K which only the very wealthy could afford.
One story I heard recently was a guy working for a corporation needed chemotherapy and the corporation had fully paid up his healthcare. The health insurance corporation refused to pay for the chemotherapy yet continued to take premiums from the corporation he works for.
Then the health insurance corporations who agree to pay and then change their mind leaving the patient to pay for the treatments instead and if the patient or family can't pay they have to go bankrupt leaving the doctor without income. This is heinous.
Doctors spend hours on the phone wasting time trying to get tests approved by the health insurance corporations only to get a different test approved. I've seen it happen in person.
We at ADKOMS??? think doctors know what they are doing. We also think they are better off treating patients rather than wasting their time on the phone with health insurance corporations.
The healthcare system we are proposing would guarantee to pay healthcare providers. If they provide a service to our clients we'd pay them.
We'd issue you a card which you take to your health insurance provider, they use it to access your medical records and then update your medical records, and we then pay them once a month for how as many of our clients they treat. We would also endeavor to make sure there was no co-pay for our clients.
And no, we don't care if you have pre-existing conditions. And what you pay us will based purely on your income. We haven't done all the calculations on how much it'll cost yet though.
We'd means test you to see what you pay. Even if you ineligible for Medicare, Medicaid/CHIP but if you are living below or around the poverty level it would be entirely free.
If your favorite healthcare provider is not on our system, if they provide you with an itemised list of what they've done, we'd refund you the amount we'd have paid your healthcare provider if they were with us. If you want to retain health insurance youre welcome too.
The patient files are stored on a server, so if your doctor thinks you need to go to hospital, the hospital can check your records directly.
Working for us we'd have a team of doctors advising us on what is essential treatment, new treatments.
At all times your medical records are safe. No one can see them except the healthcare providers you give them too. To protect our clients our doctors would review patient records, although they'd never see your name, just your number, and then it is to make sure you are getting the right care you need and to make sure you aren't getting unnecessary treatments. We'd continue to pay the healthcare provider but we'd ask them some questions about the treatments and why they are requesting them, they may have a very good reason for requesting such tests. We do this because we know doctors are human but can make mistakes. However we think this will bring down the healthcare providers malpractice insurance at least the patients they see on our system.
We'd employ unemployed people for as much as possible.
So what would we cover? we'd pay for all emergancy, life threatening treatments. We'd pay for visits to your local doctor, consultation with specialists, if necessary, hospital stays, we'd pay for cancer screening & treatments... And we'd endeavor to make sure there'd be no co-pay for you. All you pay for is an annual means-tested fee.
Eventually, we'd like to offer things like: Optional: If you need help around the home if you or a member of the household is sick we'd pay. Optional: We'd even like to provide mental health services. optional: free home inspections for sources of allergens, health & saftey risks... optional: free annual checkups optional: free help with kids...
We wouldn't pay for post-e-vac & other erectile treatments, hair replacement, hair removal, unnecessary plastic surgery. (We'd pay for restoration of face after, for example, a car accident though.)
source material for first couple of paragraphs http://www.tavlesh.com/health-care-systems-bang-for-your-buck.html other stuff is mostly from nytimes, except the story about the guy with chemo- met him on twitter. the rest is mine.