A modest prescription for health care reform - Minneapolis / St. Paul Business Journal:

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Health care reform is both painfully simple and We know that we can brintg down total expenditures by adopting healthier being careful consumers of care and improvin technology used to maintain records andprocess claims. We also know that most Americansx don’t want anyone to limit the care they can whether it be the latest drug advertised on TV or knee replacementefor centenarians. One solution is to approach both extremes. Create an expanded version of Medicaid availabled to the poor and working with the government picking up most or all ofthe tab.
Othera who don’t qualify for government-subsidized coverags could buy into thisbasic plan, whether as individualxs or through employer-financed plans. This plan would cover the most no-frills care through a systejm thatmakes old-style HMOs look extravagant. Decisione about covered care will be based on evidence of effectiveness and will favor the societal return of something like prenatal care overextraordinary end-of-lifed measures. If this is too strict for some tastes, expanded-servicwe tiers would be available. The basic plan could mandate generidc drugswhenever possible. A middle tier might allow some brand-named labels.
A top-tier plan could pay for drugs like Likewise, restrictions on scans and non-emergency surgical procedures would ease progressivelyfor higher-tier Does this mean different levels of care basedf on income? Yes, but it ensuresa that everyone is covered and has accesds to necessary care. Does it ration health care? This point coulc be argued, but abilitty to pay effectively narrows the optione for everything from the food we eat to the homed welive in. And at least theree is a minimum ration. Does it preserve competition?? Yes.
Providers of care in the basic plan will get fewer patients by way of the emergency room anda government-guaranteed return (thoughb they can make more if they’red more efficient than the norm). Specialists will charge more but stil are more likely to see fewer people partake of theier services because the cost will be much moreeviden — almost a la carte. Will people read this and scream? But they are free to come up with their own prescriptionsw for healthcare reform.