Improving Our Healthcare System:

1)  Control the Cost of Employer-Based Plans

Physicians for Reform seeks to strengthen employer-based healthcare plans. The primary force destabilizing our employer-based system is the skyrocketing cost of healthcare.

The reforms outlined by Physicians for Reform control cost not by restricting access to care, but by encouraging both patients and physicians to ask two important questions:

1)  Is this test necessary?
2)  How much will this cost?

In this time of economic uncertainty America must make every effort to control unnecessary spending so American businesses can compete in the global economy.

2)  Allow Portability

Allowing Americans to purchase individual policies across state lines with pre-tax dollars (see Tax Reform) will let people maintain coverage when they change jobs. More elaborate, employer-based policies will still be available. But for Americans who simply want basic, portable healthcare coverage, this provides an alternative.

3)  Encourage Transparency

As more Americans use lower cost / higher deductible plans with personal Health Savings Accounts, patients will increasingly ask “how much will this cost?” and “do I need to have this done?” When the public begins to consistently asks about cost, free market forces will encourage physicians and hospitals to make this information readily available.

For example: A man wants to have an MRI because of persisting headaches. Suppose there are two hospitals in his town that perform MRI’s. Hospital #1 readily tells him they will charge $800. Hospital #2 will not disclose the cost. More often than not he will choose Hospital #1.

Driven by free market forces, Hospital #2 will soon begin to disclose its pricing to compete for business.  Simply giving patients a reason to ask “how much will this cost?” can effect this change without a government mandate.

4)  Encourage Direct Pay for Primary Care

According a 2009 Medical Group Management Association report, the average physician office requires 4.43 support staff for every provider. That number rises to 5.24 staff per physician for “better performers.”*The billing and administrative burdens of Medicare, Medicaid, and traditional insurance drive much of this need for excessive staffing.

By dropping all third party payers, a North Carolina physician (Brian Forrest, MD) reduced this ratio to 1.0 support staff per working physician. Running a direct pay / low overhead practice enables Dr. Forrest to spend more time with patients and achieve better outcomes at a fraction of the cost of a traditional practice. If a physician office can nearly triple its efficiency by ridding itself of the billing, collections, and administrative overhead of third-party payers, this massive inefficiency provides a target ripe for reform.**

5)  Provide a Ladder to Help People on Medicaid Return to Work

For millions of Americans, keeping their healthcare coverage through Medicaid is a powerful reason to not reenter the workforce. Many part-time, hourly wage jobs do not include healthcare as a benefit. However, these jobs generate enough income to disqualify the individual from Medicaid.

Assisting lower income workers with sliding scale healthcare benefits would make it possible for millions of people on Medicaid to go back to work, even if only part-time to begin with. As they gain experience and skill these individuals would increase their earning potential. As their incomes increased the amount of assistance they need would decrease. I call this the “Elevator Effect.”

Over time this policy would help keep the number of Americans on Medicaid to a minimum and encourage able-bodied Americans to reenter the workforce.