My Turn: Here's how to pay for national health carePublished: 2010-02-26 18:23:19Author: John Burke | Salisbury Post | February 8, 2010There's been a lot of talk about the 15 percent of Americans and
undocumented immigrants who don't have health insurance. The truth is,
they get health care, but at a high cost, paid for by those with health
insurance!
Federal law requires hospitals to treat anyone who comes into their
emergency rooms whether they can pay or not. This cost does not
disappear, it shows up in our insurance premiums, hidden away where we
can't see them. But the costs are there, and they add up to over $37
billion last year, and growing.
The sad thing is that if those same people had some form of insurance,
that cost would go down dramatically as they went to family doctors
when the problems start, not when they are seriously ill and require
hospitalization. Another facet of the problem is that the poor (and
undocumented) use the Emergency Room as their primary care doctor, at a
much higher cost, again, to the ratepayer's expense.
Conservatives complain loudly about the cost of a national health care
plan, so let me offer a few suggestions on paying for a national plan
of some sort.
First, take that $37 billion and assume those folks went to a doctor's
office instead. That might save $10-20 billion just by eliminating all
of those Emergency Room visits for routine treatment.
Next, let's have serious tort reform, which Stanford economists
estimate cost as much as $178 billion per year, according to the Post.
Between lowering the astronomical cost of malpractice insurance and
reducing the number of "defensive" tests doctors order, we should be
able to save 20-25%% of that $178 billion, or around $35 billion a year.
Finally, let's make Medicare and Medicaid fraud a serious crime.
Current estimates put the cost of Medicaid fraud at $60 billion and few
participants even get investigated. For those few the small fines are a
cost of doing business and no one goes to jail. Currently there are
seven to ten teams concentrating on these frauds, in the entire
country! Under staffed and under resources, they are barely able to
scratch the surface. Your chances of getting stopped for speeding are
probably greater that fraudsters run in getting caught. Increasing the
size and number of the investigation teams and giving them adequate
resources is a start. Then make Medicare and Medicaid fraud a felony,
with mandatory jail time and big fines would serve to make this a high
risk crime, unlike today. Figure that would cut fraud in half, or
another $30 billion.
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