What you are saying that we should just pack it in, quit, turn out the lights, it's hopeless.
I don't think it is because we can always come up with something better. But it's so complex that would be a hell of a challenge.
We've been doing it wrong all along. The first step is to lower the cost of healthcare, and then decide how we pay for it. But the costs are what needs to be addressed first, and thus far, nobody has been able to do that, not a President, not a House member, not a Senate member.
Okay, let's take it one piece at a time.
Lower the cost of healthcare. This is complicated. You have
Facility
You can't change the Hospitals but you can add neighborhood clinics that are public supported. The Clinics would charge according to the income of the patient. Yes, the clinic is going to need money from public taxes. But it gets the ball rolling. We aren't far away from that now. Preventive Medicine is the best investment we can have.
Support Equipment
This going to have to a government intervention. Sorry, Capitalists, this is one area where Capitalism has gotten way too greedy. But the Government doesn't actually do it themselves. They appoint civilian over see er groups appointed by the local government to be the watch dog. For the Federal, I am sure that a group of Doctors would volunteer to oversee such a program. Then the Suppliers would have to justify their costs to the panels.
Staff Support
Here we get creative. Doctors already moonlight. But if we use the VA method and don't allow them to then a Doctor can't get bloody assed rich like they can today. For instance, the VA pays between 129K and 139K for their Doctors and doesn't allow moonlighting. But across town at the local hospital they still pay between 129K and 139K annually but they allow moonlighting. That same doctor ends up making more than 500K a year. So the VA has a shortage of Doctors while the Hospital has more than enough. This applies to any Doctor that wants an office or affiliation with any given hospital. This does not affect the independent Specialists. If you can't live on 139K a year you just can't live. That's much more than almost all Business Owners make.
This is just the start. But you will notice that it takes community involvement. Instead of the HMOs and Insurance Companies calling all the shots, the Community and the Doctors start calling the shots.
Now, about "You get to keep your Doctor". You didn't leave your Doctor, he left you. he decided not to accept funds from the ACA and to keep accepting funds from only the Insurance Companies, Drug Companies and the HMOs because he got nice little "Gifts" from them. Under the ACA, there were no nice little "Gifts". I suggest you work towards getting rid of the Corruption that is rampant in our Health Care today.
Medical is like anything else. The better you are, the more wages you are worth. There are good doctors and not so good doctors. There are good hospitals and not so good hospitals. The best doctors make the best money like in any line of work. That's why the VA doesn't have very good physicians.
In your estimate what doctors make, you didn't consider their largest cost--malpractice insurance. Malpractice insurance can rage from 8K a year to over 200K a year, depending on what kind of medicine they practice and what areas they are practicing in. Malpractice is needed because we are a lawsuit happy country. The solution to that problem is what Britain does, and that is have a loser pays all law. Sue anybody you like, but if you lose, you are liable for all the costs associated with the person or company you tried to sue. That would reduce phony lawsuits by the billions in this country, and certainly would help in the healthcare field.
Next is administration costs. If you read any articles from CEO"s of hospitals and insurance companies, you'd discover that administration fees are very costly. A person goes to the doctor for 80 or 100 bucks. That gets billed to your insurance, and they run back and forth with the provider to come to a settlement, and it costs them a small fortune which is paid for by the premiums we pay.
A mandatory medical savings account would reduce those costs for both provider and insurance company. A 1% deduction from your gross pay that goes into an MSA. When you see a doctor or visit an ER, you swipe your MSA card and the bill is paid.
There are just so many ways to reduce medial costs without sacrificing the great quality of medical care we currently have.
Medical savings accounts do not at all work.
That is because the amount you would have to save in order to be able to pay for any possible risk is far too large.
The only way to pay for health care is by pooling risk.
Everyone has to contribute, even though almost no one will ever need any significant pay out.
And the problem then is that whomever runs the pool has to make the payout, not you.
So then there is a problem controlling costs and quality of those medical providers billing the pool.
Private, for profit, insurance companies have proven to be horrible at this because they have no incentive to keep costs down or quality up.
And they do not allow you to control quality or costs either, because you alreadly prepaid.
Prepaying anything is always a horrific idea, and is always essentially a scam.
So the ONLY alternative that has ever worked is public health care.
That is because the large staff of a government run system can ensure both quality and costs.
And while the VA does not pay as much so has worse providers, they still are an example of a system that works.
The VA still does provide much better health care at much lower costs.
That is because you get seen by a number of doctors instead of just one, so any deficiencies in any one doctor can be taken care of by another.
It clearly works, and if everyone would have VA hospital access, clearly health care in the US would be much better and much less expensive.
