Idea to Fix Health Care: Medical Management Aid Societies (MMAS)
Reverend K
market option outside the government that can cover the fundamental
needs of citizens. I propose we take a given population size say for
arguement 20,000 people in a MMAS and five of those to pool resources
for the second part of my plan.
Each person should be able to afford one days income a month for
health care at a minimum that would be say $50 (as a base) or $600 per
year. With the base group that is $12 million. Take that and split it
60/40 for $7.2 million. Use that to set up a primary care clinic with
doctors on salary and some nurses, a few general lab techs and primary
care to the 20,000 people. The rest pool for a community hospital
serving the 100,000 people in five of these MMAS that is $24 million
for a general basic hospital capable of doing 95% of general medical
services. All this overseen by MMAS commities of citizens in the
program to control costs they would hire the medical staff, fire them,
apporve hiring end expenditures and negotiate drug prices perhaps with
other groups.
For expensive care that the system cannot handle either the people
should be sent abroad to first rate for profit hospitals in India,
Singapore and Thailand with an escort OR the government could run such
a program for extremely expensive care OR both.
To control costs I propose having each member agree in a legal
contract not to sue the MMAS or any provider, the people would give up
most if not all choice of medical providers in the system and there
would be no government money. As for providers we should look at
loosening the laws so doctors from internationally respected medical
schools could enter the country and practice general medicine easily
without extra training or concerns. As I see it a Cuban doctor should
be perfectly capable of providing general practice care as well as an
American trained doctor and would likely not demand ahigh salary. And
hospitals would likely ahve to focus on wards with several patients in
a room unless there was a medical reason for a private room or the
patient pays for one. But wards were common and are used in other
nations with say twelve people to a room you would need fewer nurses
to care for them saving money.
So what do you think?
Rod Speed
> I was thinking about this a great deal and what we need is a
> free market option outside the government that can cover the
> fundamental needs of citizens. I propose we take a given
> population size say for arguement 20,000 people in a MMAS
> and five of those to pool resources for the second part of my plan.
There's plenty of places which have a decent modern universal health
care funding system where 100K isnt anything like enough for all facilitys.
> Each person should be able to afford one days income a month for health
> care at a minimum that would be say $50 (as a base) or $600 per year.
Thats more than some modern first world universal health care funding systems
charge. If you are going to charge that, it makes a lot more sense to just have
a decent modern universal health care funding system instead, what very single
modern first world country except the US has had enough of a clue to have gone for.
> With the base group that is $12 million. Take that and split it 60/40
> for $7.2 million. Use that to set up a primary care clinic with doctors
> on salary and some nurses, a few general lab techs and primary
> care to the 20,000 people. The rest pool for a community hospital
> serving the 100,000 people in five of these MMAS that is $24 million
> for a general basic hospital capable of doing 95% of general medical
> services.
Thats nothing like the split in costs that we see in modern first world countrys.
> All this overseen by MMAS commities of citizens in the program to
> control costs they would hire the medical staff, fire them, apporve hiring
> end expenditures and negotiate drug prices perhaps with other groups.
> For expensive care that the system cannot handle either
> the people should be sent abroad to first rate for profit
> hospitals in India, Singapore and Thailand with an escort
Cant see that being viable for what is a major
modern need, heart attacks, stents etc.
Or for the accident and emergency either.
Or even for the long term treatment of diabetes either. I've been
amazed at what diabetes can cost with a couple of individuals I
know who have eventually been killed by their diabetes.
> OR the government could run such a program
> for extremely expensive care
Thats what a decent modern universal health care funding system does.
The US is the last modern first world country that hasnt gone that route
and if it does go that route, there isnt any need for your MMAS.
> OR both.
You only see much of that when the modern universal health care
funding system doesnt cover some stuff like cosmetic surgery etc.
> To control costs I propose having each member agree in a legal
> contract not to sue the MMAS or any provider, the people would give up
> most if not all choice of medical providers in the system and there
> would be no government money. As for providers we should look at
> loosening the laws so doctors from internationally respected medical
> schools could enter the country and practice general medicine easily
> without extra training or concerns. As I see it a Cuban doctor should
> be perfectly capable of providing general practice care as well as an
> American trained doctor
Thats less than clear, particularly whether they are qualified to use the
range of diagnostic services that are available in the US for the more
serious problems like angioplasty and stents etc, let alone bypasses.
Its less than clear what Cuba does about those, whether Cubans
end up with the same level of care that those in modern first world
countrys get or whether its more like what modern first world countrys
used to end up with in the 60s etc. Modern first world countrys have
moved on a long way past what was common in those days.
> and would likely not demand a high salary.
Thats not clear either, particularly when they have been allowed to practice in the US.
I find it hard to believe that most of them wouldnt eventually feel that
they were entitled to the same level of salary that american doctors
are entitled to and I cant see that it would be viable to get them to
sign up to stay on the initial low levels of income for life etc.
> And hospitals would likely ahve to focus on wards with several
> patients in a room unless there was a medical reason for a
> private room or the patient pays for one. But wards were
> common and are used in other nations with say twelve people to
> a room you would need fewer nurses to care for them saving money.
No real evidence that it has much effect on the number of nurses required.
> So what do you think?
I've given up on that thinking stuff, it just makes my head hurt.
Reverend K
There is one glaring problem with a government run system, fraud. And
the political cronies that will shove in more than the system can
afford. In the case of the funding with the costs and monies involved
even at just $600 a year one should be able to cover most procedures
in community hospitals. In those rare or very expensive cases one
could alot a small amount to specialty service hospitals and trauma
centers. Doctors will just have to take what pay they can make in the
system.
And with consistant long term care available with primary care in the
long run the need for expensive care should be reduced.
As for sending people abroad I never meant emergency procedures but
elective ones that can include cancer treatment and things such as hip
resurfacing or procedures that are not needed immediately like
stenting that is not in an emergency setting.
Rod Speed
>>> OR both.
Turns out they are badly short of stuff as basic as bandages, so its just
a tad unlikely they they have much experience with modern diagnostic
tools like angioplasty, CAT scans etc, let alone stents and full bypasses.
>>> and would likely not demand a high salary.
>> Thats not clear either, particularly when they have been allowed to practice in the US.
>> I find it hard to believe that most of them wouldnt eventually feel that
>> they were entitled to the same level of salary that american doctors
>> are entitled to and I cant see that it would be viable to get them to
>> sign up to stay on the initial low levels of income for life etc.
>>> And hospitals would likely ahve to focus on wards with several
>>> patients in a room unless there was a medical reason for a
>>> private room or the patient pays for one. But wards were
>>> common and are used in other nations with say twelve people to
>>> a room you would need fewer nurses to care for them saving money.
>> No real evidence that it has much effect on the number of nurses required.
>>> So what do you think?
>> I've given up on that thinking stuff, it just makes my head hurt.
> There is one glaring problem with a government run system, fraud.
Nope, its completely trivial to handle that, and the current insurance
system is even more vulnerable to fraud anyway, because there
are number of insurance companys that pay out on claims.
And the US system costs basically double what the Canadian system does,
and delivers the same result on health care outcomes, and the US medicare
system is a national health care system anyway. The main problem with it
is that it only applys to those over 65, not everyone.
> And the political cronies that will shove in more than the system can afford.
Have fun explaining why every other modern first world country has a
universal health care funding system that works. Even the US does
with medicare, the only problem is that it isnt universal so you can
be bankrupted by a serious medical problem if you arent over 65.
> In the case of the funding with the costs and monies involved even at just $600
> a year one should be able to cover most procedures in community hospitals.
Nope, not with the most expensive medical problems like
heart bypasses, hip replacements, diabetes etc etc etc that
are the major cost in modern first world countrys today.
Community hospitals cant even do stuff as common
as angioplasty and stents at that funding level.
> In those rare or very expensive cases
They arent anything like rare. Angioplasty, stents, bypasses, diabetes, cancer
completely dominate the services provided in modern first world hospitals today
and you wont be paying for that with $600 per year and community hospitals.
> one could alot a small amount to specialty service hospitals and trauma centers.
You'd need a hell of a lot more than a small amount to cover all those
angioplastys, stents, bypasses, diabetes, cancers and road trauma.
> Doctors will just have to take what pay they can make in the system.
Thats the way any modern universal health care funding system
works in every other first world country except the US.
> And with consistant long term care available with primary care
> in the long run the need for expensive care should be reduced.
Pure fantasy. Have fun explaining why no other
modern first world country has managed to do that.
> As for sending people abroad I never meant emergency
> procedures but elective ones that can include cancer treatment
Completely impractical given the time it takes to do the chemotherapy.
> and things such as hip resurfacing or procedures that are not
> needed immediately like stenting that is not in an emergency setting.
Stenting is just that. If it doesnt done immediately, the patient will die
and thats what used to happen before stenting became the common
treatment for heart attacks.
Yes, you could certainly use foreign hospitals for hip replacements
etc, but thats only a very minor part of total hospital costs.
It isnt even feasible for childbirth, let alone the repeated treatment of diabetics.
Your scheme is extremely poorly thought thru and wont work.
It wont even work with the non hospital side.
What does work is a decent modern universal health care funding system
that every other modern first world country has had enough sense to use.
Even the US has that, its just not universal.