Part II: Nationalized Healthcare Service at the Clinic Level

There are two tiers to healthcare in the U.S.

The first is the clinic/G.P. doctors. This is the first line of defense against illness and first assessments of the need for hospitalization and long term care. One of the complaints is that people are seeing their doctors for minor health concerns, like colds and common flu, take up time and cost more than just using over the counter solutions. Reimbursements for vaccinations are such that nurses are the ones that usually administrate the shot and perform most of the work, freeing the G.P. for the final review and assess the more complex situations.

The second is the hospital and long term care needs. This is the arena of specialists and the area that per-patient costs are highest. This is where bones are set and life threatening treatments are performed.

The government (Fed or State) have an interest to keep costs under control. I believe that a regulated medical system is needed; however, direct involvement should be kept to a minimum at the hospital & specialist level.

The second approach I believe could work is one were more “free clinic” are available to those without health insurance. Staffing them is always an issue, but I have some ideas on that too. If a person without health insurance comes to a clinic for a non-emergency reason (flu/minor injury) they would have to be means tested. By this I mean that they have to fill out a financial record. Yes, it might be a bit time consuming and I don’t suggest this instead of treatment, but if the “Uninsured” is poor enough then they can sign up for Medicaid. If they have means but their employer doesn’t offer insurance, then a national ins. Policy linked to Medicaid type benefits would be offered but with premiums based on income.

This would be only offered to those currently without insurance.

• Doctors & nurses who perform a certain amount of service for free in these clinics will have their student loans reduced and if they full fill a five year contract will have gone to school for free.
• Limits on awards for malpractice suits.
• No companies forced to offer it, except to make their employees aware of the policy.
• Tax credits for small companies who offer health insurance (public or private)
• This health insurance is just an addition to the Medicaid system and not an addition.
• Tax credits for individuals who take the plan if not offered through their employer.
• Allow insurance to cross state boarders just like auto insurance.
• Government oversight on reimbursement rates, much like utility companies.