Heath care restucture, reform, big savings.

[Dalestoltz]

What say you?
This idea (proposal) will restructure, reform, and cut cost, and provide greater care for Medicare and Medicaid recipients. I see this idea benefiting those of us outside Medicare, Medicaid programs by creating competition, maybe stabilizing and possible lowering our tax rate in the future. This idea will flood the market place in time with health care professionals. Creating competition, by educating our own Medical Professionals there by creating greater access to health care for all of us. Limiting liability claims for the health care industry a must.

We have (We the people) Medicare, Medicaid (Government run health care programs already in place.)

I propose we build our own Medicare, Medicaid, Hospitals for our Medicare, Medicaid recipients in each and every County, Parrish, and District. All medical records networked from one Medicare, Medicaid Hospital to the next.
There are about 3114 Counties Parishes, Districts ect….. in the United States.
If we could build a 55,000 square foot hospital ( Medicare, Medicaid Hospital) at a cost of 13 million dollars ( See attached) within each and every County. Parish, District ect in the United States. Now taking that number and doubling it, for property, parking, equipment, and furnishings, it would cost us 26 million dollars (tops) to complete. Multiplying 26,000,000 by 3114 Counties, Parishes, and Districts totals 80,964,000,000. We now have (We the people) a Medicare, Medicaid Hospital in each and every County, Parish, and District in the entire United States. We could set it all up with some of that stimulus money. Jobs now if not but for a few and a short period of time.

We could have our own diagnostic equipment, ambulance and pharmacy right there in our own Medicare, Medicaid Hospital. All computers networked from one Medicare, Medicaid hospital to the next. A patient could go from one end of the United States to the other and there medical records and prescriptions would follow. Any outsourcing that may need to be done such as maybe heart surgery could upload and update medical records to the local Medicare, Medicaid, Hospital along with the bill to be reviewed and passed on for payment. Any local Medicare, Medicaid Hospital employee responsible for review of payment caught in the act of fraud should face severe criminal penalty.

Now let’s build our own Medicare, Medicaid manufacturing plant in say Michigan? We build our own Hospital Beds, Wheel Chairs, Walkers, ect. We now ship them to our Medicare, Medicaid Hospital for furnishings and to distribute among those that need them at home, only to be returned when no longer needed. We just did away with rental costs and who knows how much fraud.

If ninety beds per hospital, per patient, per day saved us 400.00 dollars. We would save 40,917,960,000 per year. Paying for itself in two years. Common sense says the savings will be much more than this. Probably save that much in Rental Equipment alone.

Counties, Parishes, and Districts population will vary. Keeping that in mind a 55,000 Square Foot Hospital is a fair size hospital. It will take some research as to properly distribute what’s needed where. Some will require less Sq/ft, some will require more. Some cities may require more than one Hospital. The savings will still follow.
Now about staffing the thing. How many I wonder have the gifted IQ to become a physician and not the funds. My idea would be to give free education along with room and board. Same goes for the nurses. We put them on contract stating upon graduation you come to work at the Medicare, Medicaid Hospital. We give them the option to leave us for the private sector after a stated period of time. Provided you pay us in full for the educational costs we have invested in you. Those that borrow the money to pay us back or save it them selves to pay us back will only enter the private sector creating competition and greater access to health care for everyone else.. For now we staff it best we can.

All in all Medicare, Medicaid Reform can be had here. No telling how much money could be saved. Records kept on all patients at all Medicare, Medicaid Hospitals. Now think dialysis and nursing homes.

Dale Stoltz
Jacksonville Texas.
American.

Quick Construction Cost Estimate for a Hospital (2-3 Story) with Face Brick with Structural Facing Tile / Steel Frame US National Average as of 1/1/2008
RSMeans Quick Square Foot Cost Estimates

The following analysis estimates the cost to build a hospital (2-3 story) with face brick with structural facing tile / steel frame using US National Average costs from 2008 RSMeans cost data. Costs are derived from a building model that assumes basic components, using union labor for a 55000 square foot building. NOTE: Scope differences and market conditions can cause costs to vary significantly.

Hospital (2-3 Story) with Face Brick with Structural Facing Tile / Steel Frame
Location: US National Average
Stories: 3
Story Height (L.F.): 12.00
Floor Area (S.F.): 55000
Labor Type: Union
Basement Included: No
Data Release: Year 2008
Cost Per Sq Ft: $239.03
Building Cost: $13,146,505

Square Foot Cost Estimate % of Total Cost Per SF Cost
Total $182.46 $10,035,500
Contractor Fees (GC,Overhead,Profit) 25% $45.62 $2,508,875
Architectural Fees 6% $10.95 $602,130
User Fees 0% $0 $0
Total Building Cost $239.03 $,505

 

[Oddball]

"Big savings" brought to us by the same people who gave us $1,000 toilet seats, $500 hammers and a Medicare/Medicaid boondoggle that costs in excess of five times what was projected??

 

[xotoxi]

Sounds great.

What about New York County, Los Angeles County, Cook County, etc.?

Do you think that 55,000 sf and 90 beds would cut it?

 

[AllieBaba]

Didn't we already do this once?

 

[Big Black Dog]

We have (We the people) Medicare, Medicaid (Government run health care programs already in place.)

The government has already proven to America that they can't manage these two programs. What on earth makes you think they can manage all the rest of it? I think you better take a good look at all of this before you so willingly jump into the pool. If the government takes control of health care in this country they will then control every aspect of your life. Is that what you want? If so, you need a brain transplant.

 

[Dalestoltz]

The goverment is already running these two programs poorly. Medicare is to go into the red in eight years. I addressed the big citys.

 

[Oddball]

City gubmints aren't any more capable or less screwed up that the state or feds.

 

[Dalestoltz]

So what do we do?

 

[Oddball]

Get them all out and quit pretending that people who could screw up a one-car parade can manage anything for anyone.

 

[Dalestoltz]

It's all become very complicated for anyone. I'm trying to think simple for them. And by the way I don't want goverment run health control. This idea is for a program already run by the goverment and has been for years.

 

[Oddball]

Right.

Has it become too complicated because of too much interference in the marketplace or too little??

 

[Dalestoltz]

Man I don't know how it got to this point.

 

[Oddball]

Wage controls back in the FDR administration, which exempted fringe benefits (like medical insurance) lit the fire, and Medicare/Medicaid stoked it.

 

[PoliticalChic]

So what do we do?

Here are two changes that would move us in the right direction:
1. Scrap all city, state, federal mandates for healthcare insurance policies. When a statute says policies must “cover mammograms of everyone 35 and over,’ how is this fair for a construction company with all male employees? What about ‘Podiatry,’ or ‘sexual reorientation surgery'? Allow insurance companies to write policies covering exactly what the consumer asks for:
Take two very different states: Wisconsin and New York. In Wisconsin, a family can buy a health-insurance plan for as little as $3,000 a year. The price for a basic family plan in the Empire State: $12,000. The stark difference has nothing to do with each state’s health sector as a share of its economy (14.8 percent in Wisconsin as of 2004, the most recent year for which data are available, and 13.9 percent in New York). Rather, the difference has to do with how each state’s insurance pools are regulated. In New York State, politicians have tried to run the health-insurance system from Albany, forcing insurers to deliver complex Cadillac plans to every subscriber for political reasons, driving up costs. Wisconsin’s insurers are far freer to sell plans at prices consumers want.
The gulf in insurance-premium prices among American states is a sign that too much government intervention—not too little—is what’s distorting prices from one market to the next. The key to reducing health-care costs for patients, then, is to promote competition, not to dictate insurance requirements from on high. Unfortunately, a government-run insurance plan is the core of ObamaCare.
Bigger Is Healthier by David Gratzer, City Journal 22 July 2009

2. Tort reform:
The number of U.S. malpractice payments in 2008 was the lowest since creation of the federal National Practitioner Data Bank, which has tracked payments since 1990. And the average payment — about $326,000 — was the smallest in a decade.

While malpractice litigation accounts for only about 0.6 percent of U.S. health care costs, the fear of being sued causes U.S. doctors to order more tests than their Canadian counterparts. So-called defensive medicine increases health care costs by up to 9 percent, Medicare's administrator told Congress in 2005. "
Canada keeps malpractice cost in check - St. Petersburg Times

Now, compare those with these:
"Also, it’s worth noting that while these figures sound like a lot of money — and few would dispute the fact that health insurance company CEOs make healthy salaries — these numbers represent a very small fraction of total health care spending in the U.S. In 2007, national health care expenditures totaled $2.2 trillion. Health insurance profits of nearly $13 billion make up 0.6 percent of that. CEO compensation is a mere 0.005 percent of total spending."
FactCheck.org: Pushing for a Public Plan

The cost of malpractice suits is equal to the profit of the entire industry.

This may be significant of and by itself, but when we look at the costs of defensive medicine, it alone adds to the costs of healthcare by a factor 15!!!

 

[Dalestoltz]

I'm to dumb to understand the first part but I sure understand the need for tort reform.

 

[Oddball]

The first item is about state mandates to insurance companies, which dictate to them what kinds of coverage they may sell (i.e. mandating full first-dollar full coverage rather than cafeteria style policies wih high deductibles), and prohibit people from going out of state to purchase insurance.

 

[Dalestoltz]

Thanks. Sounds to me like that is just prohibiting competion. Not good. Sounds like another mistake adding to how we got to this point.

 

[PoliticalChic]

Thanks. Sounds to me like that is just prohibiting competion. Not good. Sounds like another mistake adding to how we got to this point.

OK, let me try.

If the insurance companies gave you a checklist, and you could determing what you would like to be covered for, you would determine what you could afford.

There would be folks who currently have no healthcare insurance due to cost, who could now budget and buy same.

Make sense?

How about these:

1. Doctors currently have no ability to re-price or re-package their services that way every other professional does. Medicare dictates what it pays for and what it won’t pay for, and the final price. Because of this there are no telephone consultations paid for, and the same for e-mails, normal in every other profession.
Most doctors don’t digitize records, thus they cannot use software that allows electronic prescription, and make it easier to detect drug interactions or dosage mistakes. Again, Medicare doesn’t pay for it.

2. Another free market idea aimed at better quality is have warranties for surgery as we do for cars. 17% of Medicare patients who enter a hospital re-enter within 30 days because of a problem connected to the original surgery. The result is that a hospital makes money on its mistakes!

3. Walk-in clinics are growing around the country, where a registered nurse sits at a computer, the patient describes symptoms, the nurse types it in and follows a computerized protocol, the nurse can prescribe electronically, and the patient sees the price in advance.

4. To reduce healthcare costs, increase the number of doctors. Obama care would do the opposite. Both tax incentives and support of the tuition of medical school.

5. Identify the 8-10 million who need and are unable to get healthcare, including those with pre-existing conditions,and provide debit cards as is done for food stamps:

"Food debit cards help 27 million people buy food, similar to the number who need help buying health coverage. In all fifty states, debit card technology has transformed the federal food stamp program, which used to be notorious for fraud and abuse. (Only 2 percent of card users are found to be ineligible, according to the General Accounting Office.) Cards are loaded with a specific dollar amount monthly, depending on family size and income, and allow cardholders to shop anywhere. The same strategy could be adapted to provide purchasing power to families who need help buying high-deductible health coverage. It's what all Americans used to buy (see chart 5), and it's all that's needed for families with moderate incomes, who can afford a routine doctor visit. "
http://defendyourhealthcare.us/downgradinghealthcare.html

 

[Dalestoltz]

You are more informed than I am. I have been a little more educated now. Please read my idea again to see if it helps resolve any of this. It throws a big blanket over a lot of it. Of course only for the goverment run health programs in place now. But maybe down the road help the rest of us?

 

[Oddball]

Thanks. Sounds to me like that is just prohibiting competion. Not good. Sounds like another mistake adding to how we got to this point.

OK, let me try.

If the insurance companies gave you a checklist, and you could determing what you would like to be covered for, you would determine what you could afford.

There would be folks who currently have no healthcare insurance due to cost, who could now budget and buy same.

Make sense?

How about these:

1. Doctors currently have no ability to re-price or re-package their services that way every other professional does. Medicare dictates what it pays for and what it won’t pay for, and the final price. Because of this there are no telephone consultations paid for, and the same for e-mails, normal in every other profession.
Most doctors don’t digitize records, thus they cannot use software that allows electronic prescription, and make it easier to detect drug interactions or dosage mistakes. Again, Medicare doesn’t pay for it.

2. Another free market idea aimed at better quality is have warranties for surgery as we do for cars. 17% of Medicare patients who enter a hospital re-enter within 30 days because of a problem connected to the original surgery. The result is that a hospital makes money on its mistakes!

3. Walk-in clinics are growing around the country, where a registered nurse sits at a computer, the patient describes symptoms, the nurse types it in and follows a computerized protocol, the nurse can prescribe electronically, and the patient sees the price in advance.

4. To reduce healthcare costs, increase the number of doctors. Obama care would do the opposite. Both tax incentives and support of the tuition of medical school.

5. Identify the 8-10 million who need and are unable to get healthcare, including those with pre-existing conditions,and provide debit cards as is done for food stamps:

"Food debit cards help 27 million people buy food, similar to the number who need help buying health coverage. In all fifty states, debit card technology has transformed the federal food stamp program, which used to be notorious for fraud and abuse. (Only 2 percent of card users are found to be ineligible, according to the General Accounting Office.) Cards are loaded with a specific dollar amount monthly, depending on family size and income, and allow cardholders to shop anywhere. The same strategy could be adapted to provide purchasing power to families who need help buying high-deductible health coverage. It's what all Americans used to buy (see chart 5), and it's all that's needed for families with moderate incomes, who can afford a routine doctor visit. "
Downgrading Health Care

You must spread some Reputation around before giving it to PoliticalChic again.

You're so much better at that wordy stuff than I.