5 Winners! Physicians' Best Ideas to Replace the ACA

Disclosures

May 15, 2017

In This Article

Raji Srinivasan, MD, Family Physician
Hamburg, Pennsylvania

Raji Srinivasan, MD

Sundar Vedantham, PhD, Senior Technical Manager, Intel
Allentown, Pennsylvania

Highlights of Dr Srinivasan's and Dr Vedantham's plan include:

  • 2% of income goes into a healthcare savings-type account to use until it's drained

  • Once empty, healthcare system pays 98% of remainder; individual responsible for 2%

  • All providers list the price of their services

  • Eliminate Medicare, Medicaid, other government-run healthcare services

Dr Srinivasan's and Dr Vedantham's Plan:

Sundar Vedantham, PhD

Everyone agrees that US medical expenses are exorbitantly high for the quality of care that we get. We need to implement a solution that resembles other businesses that are extremely successful in driving costs down consistently while making their products and services available to everyone as years go by.

To arrive at the solution we propose, we start with these assumptions:

1. If we get rid of insurance systems, market forces will help contain the rising cost of healthcare. But in respectable/civilized societies, letting people die because they can't afford healthcare is inhumane. So, some form of efficient healthcare support is needed.

2. A single-payer system run by the government might be good from control and cost perspective, but this doesn't address the potential for fraud and inefficiency.

Keeping these points in mind, we propose the following framework:

1. Two percent of all income gets deducted and put in a personal account (similar to Health Savings Account currently in use). Because US median income is about $55,000, this will mean roughly $1100 per earning member.

2. No specific insurance company-negotiated rates for any medical procedure/medicine/consultancy will be allowed. All providers must list the price for their products and services openly.

3. When you need medical care/products/services, you can get it from whomever/wherever you like anywhere in the country. Expenses will be paid from the 2% account mentioned above until it is fully drained. At the end of the year, if it still has funds left, it is given back to the individuals. This will make sure people use coverage carefully and the providers who provide good quality services at low cost thrive.

4. Once that account is drained, the healthcare system will kick in and pay for all additional coverage at 98% rate. The remaining 2% will still be paid by the individual user of the service. This will ensure that all needed coverage is available without bankrupting individuals while the 2% cost share by users will ensure that there is still a small cost (like co-pay) to restrict and discourage abuse.

5. Because one huge federal program administering healthcare may lead to fraud or abuse, we can either set up a separate nonprofit entity (like US post office) that handles healthcare or let the states manage it at the state level with block grants based on the size of the population so that smaller offices/budgets/geographic proximity can limit fraud/abuse. But the care/products/services are standardized nationwide so that states don't get to limit/deny coverage.

6. Allow anyone to buy pharmaceutical drugs from anywhere in the world. The simple act of opening up the market will make sure the prices remain real and not inflated due to regulation and middlemen.

7. Eliminate Medicare, Medicaid, and other individual government-run healthcare systems to save cost and improve efficiency, as this one model can serve everyone in the country.

8. Some details could be tweaked. For example, instead of 2%, it could be 1% or 3%. But establishing these principles in a simple, easy-to-understand system should be adequate to get things under control.

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