Liberal Democracy

Liberal Democracy
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Thursday, February 21, 2013

AEI: Fiscal Policy: Alex Brill: Bowles-Simpson Doesn't Address Unsustainable Healthcare Spending: How to Reform Healthcare and Control The Debt and Deficit

Bowles-Simpson doesn't address unsustainable health care spending - Economics - AEI 

I love talking and writing about healthcare when it comes to deficit reduction because we'll never get the national debt and deficit under control. Without getting our healthcare costs under control and is one of the things that the Obama Administration understood and got right when healthcare reform was debated. Back in 2009-10 that unless we get our healthcare costs under control, we'll never get the debt and deficit under control and we won't have a strong economy in the future. As long as healthcare represents such a huge chunk of our economy and since Medicare and Medicaid both represent such a huge chunk. Of our economy these two critical programs in our healthcare system are great places to start.

Florida Governor Rick Scott a Republican last time I checked anyway has agreed to take the Medicaid money. Thats part of the 2010 Affordable Care Act in return for expanding the Florida Medicaid system. I think thats a good step on his part as much as Republicans and Libertarians may hate that. Because it means more low income Floridians which I'm sure Florida has at least its share of will have access to. Health insurance in Florida and will mean that doctors and hospitals in Florida will have to deliver less uncompensated healthcare. But I would take it a couple steps further, I would turn over the entire Florida Medicaid system over to Florida even with a Republican Governor and Legislature. And allow for them to run their own Medicaid system with the money to run it under the condition that Medicaid money is. Only used for Medicaid and the patients, doctors and hospitals that it covers and that Medicaid remains a non profit health insurer thats fully financed.

I would turn Medicaid over to all of the states at least that would like to run their own Medicaid system. And no longer have to deal with the red tape coming from the Federal Government. Again as long as its fully financed, Medicaid money is only used for Medicaid and the services that it provides. And that each Medicaid system remains non profit but more importantly to save the Feds and states money I. Would make Medicaid fully financed and financially self sufficient and sustainable and create its own revenue stream like with Medicare to fund it. And like I laid out yesterday I would do the same thing with Medicare as well so both of these huge healthcare programs in the country. One of them completely run by the Federal Government and the other partly run by the Federal Government would be run by the. States instead creating one hundred new non profit health insurers in this country. Giving the private health insurance market a lot more competition. And saving the Federal Government hundreds of billions of dollars every year.

The other thing I would do with both Medicare and Medicaid is make them both public options. So they aren't just both left for lack of a better word with elderly and sick but younger healthier wealthier people. As well that would bring down not only their healthcare costs but the healthcare costs of the rest of the country as well. But we also need to change how Medicare and Medicaid compensates doctors and hospitals and stop the practice. Of compensating them based on how much healthcare they deliver but by how healthy their patients are. And allowing people on Medicaid to opt out of Medicaid their choice and using the money they would get from that to purchase their share of what it would cost to buy private. Health insurance and I would do the same thing with Medicare to bring down the costs of both programs. But then we need to look at preventive care as well and get bast sick care and start rewarding healthy living. And charge people who decide to live unhealthy instead.

We should at least to begin to imagine a healthcare system where we all have access to affordable healthcare and health insurance in this country. The Affordable Care Act is just a first step to that and we need to go much further to create this healthcare system. Where healthy people who are healthy because they've chosen to live healthy are rewarded for making those decisions. And people who've chosen to live unhealthy have to deal with the consequences of those decisions. And with a healthcare system like that it would be affordable and we could cut our healthcare costs in half. Because we would have a much healthier population.