When you think about it, I think everyone would agree that reform is called for.  But what reform?  Follow models which have been shown not to work?  Well that doesn’t sound too bright to me.

One of the problems lies in the definition of “healthcare reform”.  There is no specific definition – everyone defines it to mean the reform they want.  Consequently there will never be agreement or satisfaction.  So lets just take a few specific measures to make some specific changes, see how that works and come back to it again if we can improve it even more.

Here are my thoughts on some areas of healthcare which could use some reform.

Tort reform. Lets put an end to ridiculous awards.  The fact is, every time there is an enormous “punitive damages” award it moves money out of your pocket (through increased medical malpractice insurance premiums passed on to you in the form of increased cost of service) and into the pockets of trial lawyers and “victims”.  That does nothing to keep medical costs down.  Mistakes happen in life.  From time to time a surgeon will leave a sponge in you after closing you up.  So what.  Your life probably wasn’t in danger.  But through TV ads you think you can hit the lottery.  That’s not right.  Lower the cost of treatment by lowering the cost of medical malpractice insurance by limitation of ridiculous awards to something representative of actual damage.

Emergency care. Stop treating anything except genuine emergencies in emergency rooms.  A runny nose is not an emergency and using the most expensive facility along with the most highly trained emergency healthcare personnel to treat non-emergencies is wasteful.  Stupid too.  People with genuine emergencies are writhing around on the floor waiting for a room which is occupied by someone with a hangnail to vacate it. Provide vouchers to those who qualify for care at a local physician or doc-in-the-box – there are plenty of them around.  Provide “non-emergency care vouchers” to anyone who qualifies for indigent care.  The details could easily be worked out to include showing a food stamp card or an unemployment check stub or some other government-issued item to prove indigence.

Illegal Immigration reform. Put a stop to illegal aliens coming here and running up the cost of medicine for the legal residents who have to pay for it.  When an illegal alien shows up for treatment, treat them, arrest them, ship them back on the next flight, sell whatever they have to pay for the treatment, deduct taxes from whats left and send them the balance.  Require that anyone wiring  money out of the country be required to prove they are here legally.

Care without payment. If someone states they cannot afford treatment, check to see that they really can’t.  Check property records, car registration, employment, etc. and make a determination as to whether they can’t pay or just don’t want to pay. Whether we like it or not, we should recognize that we have enabled a segment of society that is defined by moochiness.  If they can’t pay, as a caring society we should pay for them.  On the other hand, if its some mooch who doesn’t want to sell their Cadillac to pay for their own healthcare that’s another story.

The exorbitant price of prescription drugs. This is usually justified by the drug companies claiming that research drives up the price.  That could be true.  I’ve got two suggestions.

• Establish a national drug research laboratory and begin developing patent-free drugs for production by any qualified manufacturer – in or out of the United States.  Put our brain power to work for us.  Make a deal with qualified science graduates to pay off their student loans after a period of time with the national lab.  Look at how well NASA and the CDC work for us.  it can be done.  The long-term benefits and spin-offs from the research at NASA are astounding and undeniable.  If it worked like NASA has, we’d probably end up curing cancer and every other ailment thanks to the research and testing done by the national lab.
• Establish an “export tax” on drugs exported from the US to other countries.  If drug manufacturers want to sell drugs which cost $100 in the US for $10 to Canada tax them $90 and bring parity.  Of course we could have exceptions for those countries who can’t afford drugs needed for national epidemics.   Why should we be burdened with the cost of research so other countries can benefit?  Let them pay their share of the research costs.  Of course this would result in drug companies charging them the same as they do us which would lead to more competition among the drug companies and result in fair pricing.  Overall, it would bring the cost of drugs down in the US and raise the price of drugs in other countries.  Maybe their socialized healthcare systems wouldn’t look so good to those in the US who think socialized medicine is the way to go  if Americans weren’t subsidizing the cost of their medications…

From Chris Strohm writing for the  National Journal

A coalition of business groups continued to wage a legal battle today as a government mandate took effect requiring federal contractors to verify the immigration status of employees working on government projects.

Of course the ACLU has a problem with this.  The Washington Independent quotes an ACLU statement:

In the middle of the toughest job market in decades, the administration has chosen to erect another roadblock to gainful employment for U.S. workers. Mandating all federal contractors to use E-Verify could encourage contractors to fire workers based on erroneous database discrepancies and to avoid hiring workers who are perceived to be foreign born. This flawed Bush-era policy, now adopted by the current administration, will only hurt the American workforce without improving our nation’s immigration enforcement practices.

“U.S. workers” is obfuscation of the facts.  What they are talking about here are illegal aliens, not legal aliens and US Citizens.

This program is a good thing for our country, our unemployed workers and our economy.  If workers are here illegally they should not be employed.  Period.  The stats for the success of the re-configured e-verify are acceptable.  From the NPR site:

Years Of Refining The Program

The rule does give companies 30 days after a contract is awarded to enroll employees.

Spokesman Bill Wright of U.S. Citizenship and Immigration Services, the agency that administers E-Verify, says the Web site is quicker and more precise than older methods.

Earlier versions were not so accurate: At one point 20 percent of all workers were flagged as illegal. But after years of refining the program, Wright says, the rate is down to 3 percent. And less than one-tenth of those are mistakes, such as wrong numbers or wrong names, rather than illegal workers.

“That basically means 2.8 percent — just under the 3 — were found to be not authorized to work in the United States,” Wright says. “Translation: E-Verify system works. That’s exactly what it’s supposed to do.”

Predictably, some people are unhappy about it.  Unhappy because it will either cost them money to check the legality of their existing workforce or cost them money to hire legal American workers to replace the illegal aliens who are currently working for them on government projects.  Very patiriotic don’t you think?  Maybe if they didn’t hire illegal aliens in the first place they wouldn’t have this problem – because WE wouldn’t have this problem.  Quit whining and play by the rules.  It is especially egregious to me that illegal aliens are working for government contractors.

This system should be required by every employer in the United States. And severe penalties should come into play if illegals are hired.  If the didn’t have jobs, they’d go back where they came from and maybe our healthcare system wouldn’t be overtaxed and ridiculously priced to cover the cost of illegal alien who use it and don’t pay.  If the illegaliens are removed the picture, there are enough jobs available bring unemployment down to normal levels.  They would voluntarily remove themselves if they couldn’t work here.  We wouldn’t have to round them up.  At the borders we could concentrate on terrorists, drugs and gang members instead of being overwhelmed with trying to hold back the tsunami of illegaliens coming here to take jobs from Americans and suck dry the healthcare system.