#PeoplesPlanHealth

David Haddad
Aug 8, 2017 · 3 min read

My response to Scott Adam’s request for a people’s health plan. The goal is to (1) increase access to care, at (2) an affordable cost with (3) the highest possible quality.

If you believe that insurance is important in protecting you against future risk, then Obamacare was a great step in the right direction to make sure that health insurance be mandatory and eliminating the right of insurance companies to refuse care for pre-existing conditions.

Here’s what I might do to satisfy the triple aim from above. These are just ideas. I’ll add more as I think of them:

  1. Roll the country into ONE health insurance plan for almost everyone (aka Medicare). This is a catastrophic coverage plan which is low-cost and covers basic care and in the event of serious injury or illness. Both employers and citizens will contribute to mandated health savings accounts based on your income. This account can be used to pay for a whole slew of health services. Like Singapore, the government will top-up accounts for the poor and elderly and those with special needs. The upper echelons of society will pay into the system (based on income) but will be forced to purchase private insurance–they don’t want to be there and we don’t want them : ) Health insurers don’t go away, they just contract with Medicare (like they do now) to make payments to providers easier. Boom! Everyone in the country is now covered over night! All this nonsense around “market competition” doesn’t work. If markets could have solved healthcare they already would have.
  2. Outsource primary-care. A whole lot of primary care can be done virtually. 80% of the costs in healthcare are from treating chronic diseases (which are in part the role of primary care). Patients can use their mandatory health saving accounts to purchase a cost-effective, virtual care solution to manage their day-to-day primary care. Patients will be encouraged to go online first; then get care in person.
  3. Make citizens in control of their healthcare information. My data about my body should not be locked-down by a hospital or insurer. By moving data ownership to the patient, we start to chip away at the barriers which help to inflate healthcare costs. Lack of data ownership leads to poor outcomes, delayed care, and does not allow me to truly move my information to the best provider that I see fit.
  4. Make healthcare pricing transparent; not go above Medicare rates and set out-of-pocket expenditures to a max limit. Price transparency in healthcare is a joke. The only way to make it feasible is to get rid of hospital chargemaster (which is a huge racket) and make all prices at or less than what Medicare is willing to reimburse for services. This works when you have one insurer.
  5. Make doctors salaried; not paid fee for service. Salaried doctors and nurses don’t stress about trying to over diagnose and test so they can get compensated for their services. Not to mention doctor groups can contract with the one insurer making it a huge relief for doctors to not to have to do contracting with a bunch of insurance companies.
  6. Force doctors to take more classes in nutrition and food. A lot of my friends are doctors and they tell me that they got anywhere from 4–16 hours of instruction in medical school on nutrition and food. This is absurd. Food is the reason why so many chronic diseases exist.
  7. Buy drugs in volume. The USA is one of the only countries in the world that does not buy drugs in volume. We should be leading the

Originally published at davidhhaddad.com.

David Haddad

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