Dr. William J. Rand, a Florida ophthalmologist who was asked to review the health care plan for the Bush administration, says the first step to turn the health care crisis around is to stop the corporate takeover of the medical care delivery system.
Getting Rid of For-profit Managed Health Care Enterprises
Dr. Rand claims HMOs now receive 30 to 40 cents of every health care dollar for matching patients with doctors and hospitals. Here are steps he would take to get rid of them:
- Apply anti-trust, monopoly and cartel laws to medical enterprises
- Make it illegal to enter a capitation (per head) based health care relationship
- Make it illegal to restrict a patient’s access to specified providers
- Allow patients to assign insurance benefits as partial payment to more expensive providers
- Regulate insurance and health care companies as a utility so there will be affordable universal coverage.
Suggestions for Insurance Companies
Dr. Rand’s suggestions, as he well knows, include unpopular options. That is why they haven’t been adopted, and may never be, even if they stand in the way of a workable health care system. He asks that insurance companies eliminate unfair selection practices and issue all clients a choice of defined benefit packages at uniform rates, regardless of age, health status and size of group. Here are more of Dr. Rand’s suggestions for insurance companies:
- Standardize simplified claims forms and computer interfaces
- Issue a national health card
- Require every American to obtain health care insurance the way auto owners must have motor vehicle insurance
Health Insurance Payment Guidelines
He believes those who can should pay for their own health insurance. People with reduced incomes should receive federal assistance with insurance acquisition on a sliding scale, commensurate with ability to pay. That looks like this:
- Full income = no federal support
- Half income = ½ federal support
- Quarter Income = ¾ federal support
- No income = full federal support
Encouraging Health Care Excellence
Dr. Rand has long been a proponent for excellence in health care. The Rand Eye Institute he founded in Pompano Beach, FL, is among the largest eye surgical centers in the nation and attracts customers from around the world. Here are only some of his suggestions for pursuing excellence:
- Change balance billing guidelines, utilizing an income sliding scale
- Use computerized insurance cards to identify status
- Do not entitle persons to free anything if they don’t have need of it
- Enlist doctors in a patriotic effort to hold down unnecessary health cost expenditures
- Empower specialty medical societies to develop guidelines for efficient care
Dr. Rand, who has served as a medical advisor to numerous Democratic and Republican leaders, would also have the government give more support to medical research, noting that as costly diseases are eliminated the overall care for American health care should not keep escalating.
The crux of the choice facing Americans is whether this president can bite the bullet and make unpopular choices. An obstacle is that some of the health field profiteers - including insurance companies - do excellent lobbying and contribute heavily to political campaigns. If he doesn’t, Americans may never have excellent health care for every person, no matter what their age, disease or income.
(A companion article gives more detail on the part of Dr. Rand’s Senate testimony that concerns HMOs.)
Source: A copy of the Senate testimony of Dr. William J. Rand. Medicare Solution Involves Unpopular Provisions
Rosemary E. Bachelor - Rosemary Bachelor, a prize-winning journalist, has had a career as an editor, feature writer, magazine publisher and author. Her latest ...
