Additional Comments/Solutions for Health Care Crisis

From Debbie K:

Thank you for your editorial.  I fully agree.  I am an L.V.N. who 
has not practiced in years but, when I did, I most always acted in 
an R.N. position. I sadly used this to rationalize not going back to 
school. I also second assisted on C-Sections, Abdominal and Vaginal 
Surgeries while the M.D. who was assigned the case,  sat in the doctors 
lounge for liability purposes.  I worked at Methodist Hospital taking 
care of Dr. DeBakey's (Heart Surgeon in Houston TX) post-operative open 
heart surgery patients and know the nurses are the ones who wrote all 
the prescriptions and orders for those patients for the medical students. 
When I worked as an office nurse for a busy OB-GYN, I would treat all the 
patients with prescriptions for their complaints they would call in with 
as I knew the treatment for their symptoms.

The problem is, I am sure  this is still happening there is just no adjustment
 of the fees as the doctors make all the money and the nurses get so little 
 pay.  I do not see M.D.'s giving up fees to "inferior" ranked staff 
 regardless the fact that they are in fact doing their work.  Their ego's are 
 in the way.  The fact that Medical Students have to work for minimum wage is 
 a disgrace. 

Secondly, I am an independent business owner with a company who markets 
Dental and Health Discount Plans to those who simply cannot afford insurance, 
have been denied insurance or dropped due to medical illness.  This company 
is 13 years old and has saved over a million Americans over a billion 
dollars on their Dental and Health services.  This not being insurance 
does not carry the restrictions that insurance does.  This is something 
companies can afford to offer their employees
-----------------------------------------------------------------------
** Health Care Vouchers **
From Don Stenberg, Jr.:

In point 15 you recommend going to high-deductible only healthcare, 
and that is a very good idea for restoring good market principles to 
healthcare.  There is, however, another way.

What if instead of insurance covering your expenses (beyond a point) 
regardless of the cost, they gave you a healthcare voucher in an amount 
based on your diagnosis.  You would be able to spend this voucher at any of 
the medical facilities listed in your article, and you would be able to 
personally pocket between 20%-40% of the value of the voucher if you were 
able to find providers who would treat you that inexpensively.  Of course, 
if you wanted more expensive (and theoretically better) health care than 
covered by the voucher, you would have to come up with the difference 
yourself.  Insurance companies would probably also have the incentive to 
give you 'check-up vouchers' to catch problems early, when they are much 
cheaper to deal with.

A perhaps slightly more radical version of this idea is to use it as the 
basis of a government-funded healthcare system.  With the government funding 
vouchers, you get the ultimate in medical choice, market forces are still at 
work reducing the cost of treatment, and no one is uninsured.
-----------------------------------------------------------------------
From "Concerned":

I thought that you had some good ideas and some bad ones. It's pretty 
late but I had to comment on your last suggestion of "*Design new 
insurance plans that shift more costs from premiums to out-of-pocket 
costs."

*Joe, this would never be good as this would so enormously hurt those 
who need the medical field the most....those who have severe illnesses. 
It is already very difficult for them in life and most of these people, 
due to their severe health, have little income and usually do without 
more than most as it is. They already have to pay so much more in the 
existing out-of-pocket due to more medical visits, tests, procedures, 
drugs, etc.  
Of course there are also just those who have little income and can not 
afford  the increased out-of-pocket you are talking about. This is why 
so many low income (those who fall between the cracks and don't meet the 
very low poverty requirements to qualify for any type of medical 
assistance) are usually the most unhealthy or more likely to die due to 
inability to pay the deductables and co-payments as it is and therefore 
don't get the important screenings that are advised along with waiting 
to see if they get well without going to the doctor or hospital or 
getting that test.  Many people who can't afford the out of pocket as it 
is will try to wait chest pains out, or severe head and neck pains that 
just don't seem to go away like the more common pains. Also women who 
feel lumps in their breast will just hope that the lumps are non 
cancerous and hope that their going without pap smears and other 
important check ups will not end up a deadly choice to either pay for 
such or pay the oil bill. Joe, this is already going on due to such 
people hardly being able to pay the present out-of-pocket charges....if 
they're lucky enough to even have enough money to have a policy.

What your suggestion would accomplish is to make it even more difficult 
for those who are very limited as it is and basically would mean that 
only those with higher incomes could afford to have an insurance policy. 
Again, there are also those with severe illnesses and who require much 
medical care which your suggestion would put so much more burden on them 
than they already have with the hardships including extra expenses and 
these people would just not be able to pay for such and would become 
worse or die. Remember, this group already is in general, forced to pay 
more as it is because they have a serious illness and their payouts to 
insurance is much steeper let alone all that their illness costs them 
that insurance refuses to pay for.

Some may respond to the above as, well life just isn't fair. But most 
people would have something else to say, I'm sure, if they suddenly 
found themselves severly ill or injured or one of life's other surprises 
that you never plan for or expect.

I do believe that I have some good solutions but these would be 
unpopular with those who make millions in outragious saleries and fringe 
benefits, along with those who like to fraud taxpayers and ......
-----------------------------------------------------------------------
From TIM R:

You have very interesting Ideas. I have one idea I 
know will work for all americans. We create a national bid board system in which 
qualified insurance companies would bid on your district to provide coverage for 
everyone in your district working or not. Every family would have a family plan 
and every single person would have a single plan. Everyone who works would pay a 
premium as we most do now. Every buisness would pay a health care tax. We would 
need to regulate the health care industry with health care standards like we do 
with our defense military specifications. Every hospital every clinic would 
follow these standards. For heavens sake if we can regulate the paint we use on 
a military vehicle, weapons and so on, we can regulate health care.