We the People, can solve the Health Care issue....
How to solve the Health Care issues in the United States of America.
To solve the problem of “health care” in the USA we must first define the problem. The conditioned problem has been access and costs.
To address these two primary concerns you must first address the three elements that control them, namely: Pharmaceuticals, Litigation, Tax-funded option.
In this white paper we will discuss, in brief but thoroughly, how to address the health care issue as defined above.
Tax-funded Option
Much like with the public school system, public library, trash and recycling services the public in mass has agreed that some social needs are attainable under a Capitalist society. In keeping with this tradition that some help to the masses from the masses is sustainable in a Capitalist environment we suggest the following:
Tiered- Health Care Service.
Tier I:
Tier I applies to children under the age of 18. This service would be entirely taxpayer paid for children that cannot be covered under other tiers. This service would allow for all necessary medical services that are deemed life threatening or permanently altering and in need of medical attention by a review board. A review board, setup at the state level, would dictate what health care codes fall into this tier per that specific state. This coverage would be medical, dental and vision/hearing. This is done to ensure that children have rudimentary access to medical attention when they cannot be accepted into another tier of the system.
Tier II:
Tier II is for low-income families. Low income is defined as under the national poverty level. In this tier the taxpayers pay 80% of the costs. The individual covers the additional 20%. If the individual cannot afford the 20% the 20% will be levied at tax time annually. Certain conditions are applied to this tier such as mandatory child guidelines. Any individual on this plan that has 4 or more additional dependants cannot be accepted in this tier and must elevate himself or herself to Tier III or be removed from the health care options provided. Additional clauses include emergency room visits. If a person had claimed more than 3 emergency room visits annually, the visits will be reviewed. If not deemed critical by a state review board, the individual will be charged the full service amount. If they cannot pay, this amount will follow Tier I protocol and be applied at tax time. A state review board will assign benefits under this tier, as done in Tier I. This plan will also include access to necessary dental/vision/hearing needs.
Tier III:
Tier III operates under the traditional format of paid health care. This tier allows individuals and companies to purchase health care packages from providers of their choice with benefits of their choice. There is no applied structure to what is available at this level. No public funds are used in assistance with this tier.
Under this tier the individual assumes all costs and all agreements/plans are under the individuals control.
Clauses to Tiered Policy:
• The Federal Government will establish an official government document for health care reimbursement from a health insurance provider. This document will not exceed 5 pages in length and be mandatory and principal to all reimbursement. The insurer from the health care provider may request no additional reimbursement documentation. This documentation will be handled electronically.
• State Review Boards: SRBs will be established by each state that wishes to provide a tiered federal approach. The state review board will be a conglomerate of specialized doctors in key fields. This group will be responsible for working with individuals, communities and associations in establishing the base regulations for the state for mandatory-tiered assistance. The SRB will also negotiate costs with insurers to provide the best possible costs for their packages, per the state.
• No new tax dollars will be raised to pay for this tier approach. The state and federal government will utilize new policies and improved reductions to obtain the necessary funds.
Pharmaceuticals
The primary costs of health care are driven by the costs of the industry. One of the primary forces in this is the unique research and development necessary for the Pharmaceuticals industry to produce product with necessary government approval. This cost is not without substance. The Federal government, who imposes the regulation on this industry, will be responsible for revamping the regulation and funding of the industry to reduce costs.
Litigation
A key-cost driver in health care is malpractice suits and litigation against doctors, hospitals, agencies and corporations. To avoid the irrational suits the SRB established by the tier-approach will be responsible for reviewing all proposed litigation. The review board will give a “go” or “no-go” ruling on the litigation effort. There is NO appeal process. If litigation is given a “go” vote it will move forward. “Go” votes will be determined by a 2/3 approval vote by the panel.
If a malpractice suit or litigation involves a member of states SRB, the litigation will be moved to another states SRB chosen via a lottery.
All rulings are final and without review. The SRB cannot operate under an umbrella of additional review. Members of the SRB are chosen by election via the state citizens. Elections will be held every 5 years.
To solve the problem of “health care” in the USA we must first define the problem. The conditioned problem has been access and costs.
To address these two primary concerns you must first address the three elements that control them, namely: Pharmaceuticals, Litigation, Tax-funded option.
In this white paper we will discuss, in brief but thoroughly, how to address the health care issue as defined above.
Tax-funded Option
Much like with the public school system, public library, trash and recycling services the public in mass has agreed that some social needs are attainable under a Capitalist society. In keeping with this tradition that some help to the masses from the masses is sustainable in a Capitalist environment we suggest the following:
Tiered- Health Care Service.
Tier I:
Tier I applies to children under the age of 18. This service would be entirely taxpayer paid for children that cannot be covered under other tiers. This service would allow for all necessary medical services that are deemed life threatening or permanently altering and in need of medical attention by a review board. A review board, setup at the state level, would dictate what health care codes fall into this tier per that specific state. This coverage would be medical, dental and vision/hearing. This is done to ensure that children have rudimentary access to medical attention when they cannot be accepted into another tier of the system.
Tier II:
Tier II is for low-income families. Low income is defined as under the national poverty level. In this tier the taxpayers pay 80% of the costs. The individual covers the additional 20%. If the individual cannot afford the 20% the 20% will be levied at tax time annually. Certain conditions are applied to this tier such as mandatory child guidelines. Any individual on this plan that has 4 or more additional dependants cannot be accepted in this tier and must elevate himself or herself to Tier III or be removed from the health care options provided. Additional clauses include emergency room visits. If a person had claimed more than 3 emergency room visits annually, the visits will be reviewed. If not deemed critical by a state review board, the individual will be charged the full service amount. If they cannot pay, this amount will follow Tier I protocol and be applied at tax time. A state review board will assign benefits under this tier, as done in Tier I. This plan will also include access to necessary dental/vision/hearing needs.
Tier III:
Tier III operates under the traditional format of paid health care. This tier allows individuals and companies to purchase health care packages from providers of their choice with benefits of their choice. There is no applied structure to what is available at this level. No public funds are used in assistance with this tier.
Under this tier the individual assumes all costs and all agreements/plans are under the individuals control.
Clauses to Tiered Policy:
• The Federal Government will establish an official government document for health care reimbursement from a health insurance provider. This document will not exceed 5 pages in length and be mandatory and principal to all reimbursement. The insurer from the health care provider may request no additional reimbursement documentation. This documentation will be handled electronically.
• State Review Boards: SRBs will be established by each state that wishes to provide a tiered federal approach. The state review board will be a conglomerate of specialized doctors in key fields. This group will be responsible for working with individuals, communities and associations in establishing the base regulations for the state for mandatory-tiered assistance. The SRB will also negotiate costs with insurers to provide the best possible costs for their packages, per the state.
• No new tax dollars will be raised to pay for this tier approach. The state and federal government will utilize new policies and improved reductions to obtain the necessary funds.
Pharmaceuticals
The primary costs of health care are driven by the costs of the industry. One of the primary forces in this is the unique research and development necessary for the Pharmaceuticals industry to produce product with necessary government approval. This cost is not without substance. The Federal government, who imposes the regulation on this industry, will be responsible for revamping the regulation and funding of the industry to reduce costs.
Litigation
A key-cost driver in health care is malpractice suits and litigation against doctors, hospitals, agencies and corporations. To avoid the irrational suits the SRB established by the tier-approach will be responsible for reviewing all proposed litigation. The review board will give a “go” or “no-go” ruling on the litigation effort. There is NO appeal process. If litigation is given a “go” vote it will move forward. “Go” votes will be determined by a 2/3 approval vote by the panel.
If a malpractice suit or litigation involves a member of states SRB, the litigation will be moved to another states SRB chosen via a lottery.
All rulings are final and without review. The SRB cannot operate under an umbrella of additional review. Members of the SRB are chosen by election via the state citizens. Elections will be held every 5 years.
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