Sunday, January 25, 2009

Physicians for a National Health Program? For pity sakes

Physicians for a National Health Program (PNHP).

Oh, good grief. What do these guys want?

Physicians for a National Health Program is a single issue organization advocating a universal, comprehensive single-payer national health program. PNHP has more than 15,000 members and chapters across the United States.

Since 1987, we've advocated for reform in the U.S. health care system. We educate physicians and other health professionals about the benefits of a single-payer system--including fewer administrative costs and affording health insurance for the 46 million Americans who have none.

Our members and physician activists work toward a single-payer national health program in their communities. PNHP performs ground breaking research on the health crisis and the need for fundamental reform, coordinates speakers and forums, participates in town hall meetings and debates, contributes scholarly articles to peer-reviewed medical journals, and appears regularly on national television and news programs advocating for a single-payer system.

What are the key features of a single payer system?
  • Universal, Comprehensive Coverage
    Only such coverage ensures access, avoids a two-class system, and minimizes expense
  • No out-of-pocket payments
    Co-payments and deductibles are barriers to access, administratively unwieldy, and unnecessary for cost containment
  • A single insurance plan in each region, administered by a public or quasi-public agency
    A fragmentary payment system that entrusts private firms with administration ensures the waste of billions of dollars on useless paper pushing and profits. Private insurance duplicating public coverage fosters two-class care and drives up costs; such duplication should be prohibited
  • Global operating budgets for hospitals, nursing homes, allowed group and staff model HMOs and other providers with separate allocation of capital funds
    Billing on a per-patient basis creates unnecessary administrative complexity and expense. A budget separate from operating expenses will be allowed for capital improvements
  • Free Choice of Providers
    Patients should be free to seek care from any licensed health care provider, without financial incentives or penalties
  • Public Accountability, Not Corporate Dictates
    The public has an absolute right to democratically set overall health policies and priorities, but medical decisions must be made by patients and providers rather than dictated from afar. Market mechanisms principally empower employers and insurance bureaucrats pursuing narrow financial interests
  • Ban on For-Profit Health Care Providers
    Profit seeking inevitably distorts care and diverts resources from patients to investors
  • Protection of the rights of health care and insurance workers
    A single-payer national health program would eliminate the jobs of hundreds of thousands of people who currently perform billing, advertising, eligibility determination, and other superfluous tasks. These workers must be guaranteed retraining and placement in meaningful jobs.
I have a better idea of how we can decrease medical costs and increase medical care efficiencies:

1. Discipline bad doctors. Some doctors are just plain bad. Just because they received a medical degree from some college does not mean that they have any business touching a human body.

The discipline must involve:

(a) Doctors being allowed and in fact encouraged to report and testify against doctors who screw up.

(b) Lobbying organizations (like the AMA) need to be prohibited from intimidating doctors from testifying against bad doctors.

2. Demand transparency in medical costs. How much does an x-ray of a leg cost? Why does Cigna have different contracts with Duke, Carle Clinic and Northwestern to pay different dollars for the same leg x-ray? Why do medical institutions charge the uninsured premium dollars for that same leg x-ray? It just does not make sense.

3. Stop allowing corporations to buy up local hospitals. Keep the accountability local.

4. Stop pharmaceutical companies from merging and colluding. The cost of pharmaceuticals just keeps increasing.

5. Demand ethics in the Medical system. If a supplier of Durable Medical Equipment (DME) has cheated the Medical system and government and made a practice of filing false claims then the government should absolutely stop doing business with these suppl,iers. This means you, Apria.

Medicare tries to save money by not checking all of the claims. Medicare just pays the claims. That's fine so long as the DME suppliers are honest. Some companies (like Apria) are serial cheaters. And the government knows it!

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