I have a lot to do today. But I wondered, if you (whoever happens to read this blog) and I were to design a minimalist health care package, single payer, what would it look like?
Just the basics:
From birth to death what would those be.
Prenatal care and basic delivery.
Shots and well-child visits.
Shots and well child visits through age 18.
Doctor visits for colds, flu, broken bones, those other ordinary mishaps of childhood.
Doctor visits that refer to a specialist for genetic disorders such as diabetes, etc.
Specialist care for actual medical disorders. (does not include prescriptions to thicken eyelashes & nonsense.)
Well woman visits at the appropriate age, including ob-gyn, blood pressure, cholesterol testing, std testing once annually.
Well man visits at the appropriate age, including prostate exam if needed, blood pressure, cholesterol testing, std testing once annually.
Doctor visits for colds, flu, broken bones, those other ordinary mishaps of adulthood.
Specialist care for actual medical disorders. (does not include prescriptions to thicken eyelashes, in-vitro fertilization and sterility treatments, viagra, boob jobs & nonsense.)
At or around age 40 – Initial cancer screening for breast / prostate cancers.
Continue with annual well man/well woman visits.
At or around age 50, Second cancer screening for breast / prostate cancers.
Doctor visits that refer to a specialist for actual medical problems that appear.
This looks pretty simple, and compared to the way we do things now, it doesn’t look too expensive. Preventative care is much cheaper than disaster management.
As a single payer entity for basics like vaccines, allergy medicines, bone-mending medicines, casts, testing whether for cholesterol or stds, the basic stuff, decent prices for the basic stuff can be negotiated downward.
One more thing. In the bad old days the guideline for the emergency room was: “Are you bleeding? Broken bone?” Separate trauma care from common cold turning into pneumonia. Small clinics modeled on Primacare could handle half of the load of the average emergency room on a Sunday. The cost of emergency room care is 10 to 100 times higher than a doctor visit for something as simple as bronchitis or a UTI. Don’t waste facilities on stuff that can be handled elsewhere.
Now for the tricky part:
We get older. We get fat. Knees give out, hips give out, heart valves give out. Replacement parts are very expensive. Start medicare at age 55, and negotiate as a single-payer with the manufacturers of the replacement parts. The cost of keeping someone over 55 healthy is reputed to be much higher than keeping a 20-something healthy. By the time I reach 55 I will have paid enough into medicare to offset some of the costs of keeping me going. In my case, probably most of the costs, I intend to stay very low maintenance and absolutely HATE going to the doctor.
Oh, and anyone that wants an abortion, in-vitro fertilization or fertility treatments, viagra, a designer drug to make their eyelashes grow, may either pay cash or take out an extended policy to pay for the little luxuries of life. No restrictions on that policy, no government money going into that policy, it is purely a secondary rider for the things that are not basics.
So, what do you think? I’m looking for comments that fill in the blanks. When we get the plan designed then we can figure out what it costs and send it off to the White House and Congress. Maybe if we present a fait accompli they can get something done.