Dr. Deane Waldman brings clarity, understanding and a workable solution to our sick U.S. healthcare system
We can fix healthcare
To have a system that actually works for We The People, we must start with WHY the current system consistently fails: The government controls healthcare.
To have a sustainable system that works for us, we need to take back control of our health care — and the control lever is, of course, money. My proposed Direct–Pay USA system is simple to understand, eliminates millions of regulations, dramatically reduces fraud and abuse, and most important, Direct–Pay USA puts the choice of doctors, hospitals and other health providers back into the hands of individuals.
The government will put $5000 per person every year into a Health Savings Account (HSA) with your name on it. You control this money, and it can accumulate indefinitely.
By law, every person must purchase catastrophic (“stop loss”) insurance to cover money spent greater than 25 percent of the HSA in any one year.
The individual spends his/her money for health care goods and services. The consumer can shop for that care and spend wherever he or she chooses on any legitimate medical expense.
Sellers of medical services like hospitals must compete for your consumer dollars based on both their price and their results. You do your own cost/benefit analysis, something the government never does.
Washington has no direct control of you or your health care decisions. Government has only two roles in Direct-Pay USA.
(a) Federal government monitors the medical results advertised to the public by hospitals, doctors and other sellers to assure accuracy; it also authenticates licenses for medical professionals.
(b) Washington manages a new medical malpractice system called OMIN (Office of Medical Injuries), which compensates ALL patients injured during medical care.
This system will cost MUCH less than what we are now spending. Here is the math:
The estimate for U.S. healthcare spending in 2014 was $3.4 trillion.
320 million Americans multiplied by $5000 each into their HSAs equals $1.6 trillion/year.
Add, say, $400 billion/year for the government activities listed above, and you get $2 trillion a year for Direct-Pay USA, which is just over HALF of what we are currently spending.
Best of all, YOU are in control of your healthcare money and your own health care!
THAT'S IT. No regulatory burdens. No billing and coding manuals. No fraud and abuse (as virtually all fraud and abuse occurs during the billing process). No spending on HIPAA, Medicare, Medicaid, EMTALA, UMRA, etc. No unfunded mandate. No Denial of Care. No pre-authorization forms. And no 25-year old Washington bureaucrat telling your 55-year old doctor what he or she is not allowed to do for you.
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