as I see it Healthcare

The Healthcare Cure as of 8-9-9
First of all, as I listen to all the discussions I keep hearing of ONE plan, as if a "One Size Fits All". That may be what the government wants ultimately, a "one payer system", but that's is not the cure.
As I see it, there are various classification of healthcare users:
*Those currently insured.
*Those not insured by choice.
*Those not insured by inability to afford it but employed
*Those not insured an unemployed
*Those on Medicare / Medicaid

*Those currently insured.
There is an old common sense saying " you do not throw the bay out with the bathwater" and this is true of healthcare. 70 % of those who have healthcare are happy with it, why change it ?
If it ain't broke don't fix it.
That does not mean that it can not be improved. That it is not perfect, does not mean it is broken.
After all, this is the healthcare that all wealthy people use...world wide.
Can we improve on that portion of it ? Absolutely...
we do not need to kill it and force everyone into a cookie cutter style plan.
here are some suggestions for THIS category:
1)Set up billing (charges) on a "per job" basis as it were. This would lower the unnecessary charges which hospitals charge and providers pay.
Right now, there is no incentive for the providers to curb expenses.
2) Allow coverage to go across state lines to foster competition and lower prices, thus possibly allowing more companies to afford to provide such.
3) Allow small companies to "group" themselves as a co-op or similar group and increase their buying power. Some of the smaller companies may then be able to provide all or part of insurance for their employees.
4) Allow extra premiums to be charged for self-inflicted conditions such as obesity. We charge someone with multiple wrecks more than we do those who stay accident free don't we ?
5) Allow portability upon departure from a job. "Cobra" is not a good plan, the individual gets raped each time....individuals should be allowed to continue to pay the same premium...which is deceiving because the employer pays part and the employee pays part, so the bill may be actually higher than what the employee pays.
6)Reduce idiotic and excessive lawsuits.

*Those not insured by choice.
1) Add a "tax penalty" to those who are employed, but do not choose to have insurance.
This SHOULD NOT apply to those who can not simply afford it...so INCOME minimums should go in place and this penalty should only apply to those above such income level.
This should add YOUNG people into the mix of buyers and relieve government of some possible risk
This penalty should be large enough to provide an incentive, but should not be so large as to turn it into a MANDATE.

POWER should not be abused ....I do not mean a MANDATE to buy...If a person after knowing that there is a penalty for choosing to not be insured still does not want to be...so be it, but their "penalty" is contributing. I see it as a reverse discount, as it were.
If you get insurance you get a break, if you choose to not do so, it is still your choice.

*Those not insured by inability to afford it but employed.
This is the hardest of classes, so I will offer a couple of options:
a) To Treat healthcare insurance like automobile insurance,
where there is a minimum coverage policy available.
It will not cover all catastrophic situations,
but would allow for some basic coverage and prevention.

Let COMPETITION work.
Have the insurance providers come up with a "minimal" coverage policy across the board that could possibly be implemented in the $ 100 per month / per person rate.....and have them compete.
Yes, catastrophic situations would still have the person at risk...but
the government could then buy a blanked "rider" police ONLY to cover those who exceed their coverage.

If only 20 % ( made up no for example use) reach such level, then we are only paying for such % and not 100 % of the policy...should be much less expensive.

*Those not insured and unemployed
Obviously, these people need help and should be provided, but we MUST do a couple of things:
a) keep these people AWAY FROM EMERGENCY facilities...we can not afford to reimburse these facilities at their current rate.
We do not need to continue to pay $1000's per non-emergency treatment.
It would be less expensive if a "basic policy" similar to those who can not afford it was implemented and then a "rider" also provided for the handful exceeding the "basic coverage".
But,
WE MUST KEEP PEOPLE AWAY FROM EMERGENCY FACILITIES FOR NON-EMERGENCY TREATMENTS....even if we have to turn them away.
If we do this, we must provide an alternate option, which could be a "very basic prevention-maintenance" coverage policy, similar to the one stated above in the previous category.
We must also look at illegal medical care.
We do not ever want to turn people away that need emergency, live threatening care,
but if you are in this country illegally, you need to buy your own "basic coverage"

If you are here illegally, you likely came for the earning opportunity; so, whether you are working full time or part time you should contribute.

If you do not have a job and are here illegally, you are on your own

I do not belief in welfare to those here illegally.....
what would other governments do if we showed up at their city and asked for money because we chose to be there illegally ????
sideline note: I am an immigrant, but came to this country legally and got my citizenship in the same manner. I am not against common sense immigration, I am not even against some concessions for those who are here working and have been for years....but there is not enough money to go around for everyone under all circumstances.
Also, I am talking of the government buying these policies with our money (the government has no money) not talking of the government implementing a NEW healthcare agency.
We know how efficient government is abut spending money and how diligent they are regarding paperwork and the simplification of such...
THERE IS NO NEED TO CREATE A GOVERNMENT agency and for US TO BECOME more dependant on the government..
It would be cheaper for the government to have SPECIAL CARE CLINICS (only available to those unemployed) than to pay the money we are paying for EMERGENCY ROOM CARE....and even this is a reach for me...Government Option should be a last choice and only for those we depend on the government...we do not need to make all Americans dependants.
I really think that government can BUY / PROVIDE the basic care policies without becoming the HEALTHCARE PROVIDERS themselves.
If the government thinks it can do such a great job, then it should compete head on with private enterprises using the same pricing / reimbursement schedules.
If their service is better, people will go to them....but we all know what would happen. Using a different fee and/or reimbursement schedule is a disguise for driving people towards a one-payer system.
That would be a disaster.

*Those on Medicare / Medicaid
We need to reduce the bureaucracy and look at the effects of low compensation to providers, or we will not have providers. Fraud and waste needs to be addressed. Let's get this plan running well first before we try to take over another one.
Maybe "fair compensation" to providers would be better than "low ball" compensation.
Also, if we asked the providers to look a the "compensation per job" concept, we may see a reduction in costs.
====================================================================
THE GOVERNMENT CAN BE THE SUPPLIER-FACILITATOR
BUT DOES NOT NEED TO BE THE ADMINISTRATOR
===============================================
The ONLY government option, if one MUST exist, should be one of a "last resource", for those who are not accepted by regular insurance companies.
Those who can be accepted, MUST NOT BE ALLOWED to buy cheaper ins. from the government, that would kill competition and insurance companies.