If BernieCare Should Hold Sway

If healthcare is made universal and the healthcare industry in the U.S. is given the amount they now bring in, it would eventually require a budget far bigger than that of the military. With a population of 330 million and at a cost per enrollee of $12,000 (2011 number) the yearly costs come to 4 Trillion dollars.  From that you could probably only deduct 1/2 Trillion dollars if everyone in the country paid a $1,000 premium. To offset the costs of Medicare for all, the premium would have to be closer to $8,000.

The only fair solution is to require a progressive healthcare surcharge on every source of income in the country. Nothing wrong with that, we do similar taxation with S.S. and medicare.

There is no doubt that the program would be costly--and it would double by 2040 (CBO). For me, the imperative would be to find every which way of lowering costs and not leave it up to market forces because, to date, they have failed to contain medical costs. My UniCare program would increase efficiency and make things affordable and sustainable but it is too radical and not something a candidate would embrace for it requires thinking outside the box that the medical lobbyists have put us in. However, there are actions that we can take no matter the healthcare plan.

1. If the medication that was prescribed did not work, the patient/UniCare is refunded the money. Too many refunds would tell us that the medication lacks efficacy or the physician is unable to select the right medication for the patient and may be incompetent or engaged in fraudulent practices.
2. When a medication is prescribed for a chronic condition, the patient should have automatic refills instead of having to see the doctor every 3 months. When there is the possibility that a medication could cause adverse reactions, automatic testing should be done such that the patient goes and gets the testing done on his own initiative w/o first visiting a doctor. (controls for this are easily implemented)
3. Laboratory and imaging companies should provide the results directly to the patient so the patient can review the results and write down any questions for the eventual visit. The main objective of this is to ensure that the doctor is on his toes and addressing every medical concern that comes up. Strict guidelines should be implemented with regard to retesting. The days of medicine being an "art," are long gone--we're way beyond hocus pocus. Perhaps the surgeon can lay claim to an artform but no one else.
4. Pharmacists and nurses should be given a license to prescribe common medications. You just don't need 12 years of higher education to prescribe a kid antibiotic drops for an ear infection or a middle-aged person blood pressure medications. With the latter, not even a doctor looks for uncommon causes of high blood pressure and for good reason b/c it needs to be controlled regardless of etiology. How idiotic is it for insurers to allow a psychiatrist to say to his patient, "how are you doing with your anti-depression and sleep meds? Want to continue using them? OK, he's the script, see you next quarter for more." You do the math on a decade of this.
5. Patient records should be on the cloud. It is inexcusable for government not to demand this of healthcare professionals. The AMA would fight us on this because it would mean that that data can be mined for signs of malpractice or incompetence or fraud.
6. No treatment should be undertaken by a doctor unless an A.I. program has given its seal of approval. Naturally, particularly b/c A.I. is in its infancy, a doctor would be allowed to override the program but not without justifying his position. You would think that doctors would welcome an A.I. program that would absolve them of any medical malpractice--this alone would be a great savings which he/she could keep or pass down to his/her patients.
7. No communications should be allowed between your present doctor and previous doctors. With records on the cloud, there is simply no information about the patient that needs to be provided surreptitiously between doctors. This--I admit to it being a suspicion on my part--would be an ideal mechanism to blacklist the "problem" patient to his severe detriment.
8. Every person who dies while under a doctor's care should have his cloud records inspected.
9. Government should establish surgical centers for common and sometimes repeated surgeries like kidney stone removal. I don't think a patient on BernieCare or other plan would object to traveling a bit to be operated on by a doctor who's done thousands of them and has been mandated to use the latest equipment and techniques.