Healthcare plan - not rocket science

[frogcycle]

The US has the best healthcare-delivery system in the world. However:

• Roughly 30% of "healthcare costs" in the US go to coverage-avoidance bureaucratic activities - forms, denials, paper-pushing ad nauseum.
  
• HMO's make huge profits, which go to stockholders and huge executive bonuses.
  

Eliminate both of those facts and we have an enormous "windfall" to use in covering everybody for everything.

That can be accomplished quite simply. Don't try to break them up, regulate them, audit them, etc. Just freaking compete with them. Offer an expanded Medicare-like not-for-profit program that does not quibble about pre-existing conditions and argue over whether you got permission for that ambulance ride and see how long the private giants stay in business in their current model. They can adapt and be competitive, perhaps offering some slightly-better premium service the affluent are willing to buy, or they can offer similar service and find a way to do it even MORE economically, thus making a profit where the government program does not*.
Three issues then remain:

• There will be people seeking treatments that are both inappropriate and expensive. A "denial of coverage" mechanism must be in place to contain this (not eliminate, just contain).
  
• Medical school costs put MD's some $250k in debt when they hang out their shingle. This drives them to high-profit specialties in big market areas which generally are not the most critical areas of need. This can be addressed through a publicly-funded scholarship program similar to what the military does now. Go to med school under the program, put in six years or so on assigned duty (domestic "peace corps") and then you can go into private practice wherever you want. This does not have to be Harvard Med school - there are plenty of state universities with fine med schools. They can provide education with federal-scholarship compensation at competitive rates. The federal program can negotiate deals with those schools interested.
  
• As it stands now, the US funds drug companies' research through high prices and the rest of the world benefits from moderate to low prices. Decouple research and sales. Let government grants fund research, not just for "popular" disease but with a reasonable need-based prioritization. Companies can compete for such grants as universities do now. The fed should be able to negotiate prescription drug prices. The research funds would come from taxpayers who will be benefiting from the reduced costs. The companies could probably increase foreign-sales prices slightly, improving our balance of payments. They would benefit from being able to fund development of drugs for "niche" diseases, which might never be huge short-term high-ROI items like viagra but could be good long-term "cash cows" worldwide.
  

This does not require enormous "revamping" of the entire system. It could be a bill you could read in a couple of hours. It would not be a "takeover." It would just be "We the People" entering the marketplace, using our collective buying power to bargain for better goods and services like the old farmer's co-ops organized to get rural electrification.

*FedEx and UPS compete successfully with the US Post Office, but if you need to send something somewhere you needn't argue with them over their particular rules; you can go to the post office. If you WANT to and can pay for their additonal features you can, but you have an alternative. It is not free, but it is affordable to (nearly) all. Healthcare would have to deal with the (nearly) qualifier with a "safety net"

[frogcycle]

1. Meanwhile the President of the USA can still end all human civilization by pressing a button.

shameless self-kick to distract folks from the evidently more urgent issues...