Rethinking Healthcare in America

By 2022, Healthcare and related services would be 20% of the US economy, despite the reductions due to Obamacare reforms. This means 1 in every 5 dollars os economic activity will be in healthcare.

The camel in the tent

fig 1: Healthcare costs, from NPR blog

Costs do not include the veterans administration medical care.

This surely means that American healthcare is the best in the world. Nope, not even close. Despite pockets of isolated brilliance, healthcare based on outcomes is worst among countries in the developed world.

This is because of an incestous mix of free market capitalism with socialist policies and a dose of state rights. Obamacare was a disappointment as it was not far reaching in its scope despite what its detractors say. Still it has bent the cost curve slightly in the right direction.

Since Republicans in Congress are going to be in majority from 2015 onwards, here are some suggestions from a centrist.

  1. Bundled payments for 30 day episode of care
  2. Remove tax breaks on Health Insurance
  3. Bidding on Drugs and Medical Equipment
  4. Payer Consolidation across states
  5. End of life care
  6. Healthcare pricing transparency and simplification
  7. Increase Medicare Eligibility age to 67
  8. Medicaid Simplification
  9. Domestic Medical tourism
  10. Student loan forgiveness