Consumer Driven Healthcare Reform
Arguments revolving around “who pays” for healthcare have left government in an unending gridlock.—Larry Sharpe
One important neglected assertion is that healthcare reform and health insurance reform are two separate matters. Due to that fact, our repair process revolves around reforming healthcare into a more consumer driven industry.
To reflect a transition into a healthcare marketplace that depends upon consumers, as governor, Sharpe would take these necessary actions:
1) Require all providers to have transparent pricing that is simple and easy to understand.
2) Provide a website resource to help New Yorkers find the best and cheapest solutions for their healthcare, including price comparisons between providers.
3) Repeal Certificates of Need (CON)- CONs are essentially permission slips that healthcare professional, who are already properly licensed, must obtain to provide healthcare to consumers. In theory, this piece of paper “proves” there is a need for their practice. In reality, this is a pointless barrier to entering the healthcare field that has zero positive trade offs such as increased quality or reduced cost.
Medicaid and State-funded Health Plans
Conversion of Medicaid into an HCDA (Healthcare Debit Account)would give greater flexibility to patients as it will allow them to use it to see virtually any doctor. If the recipient’s’ personal savings account runs out, then they would be able to use traditional Medicaid as a backup option. The HCDA will roll over to an individual or company HSA (Healthcare Savings Account) when the individual no longer requires Medicaid. This will also save money because recipients will be more encouraged to care about the cost associated with medical care choices.
Patients would be more likely to use preventative care with a visit to a regular doctor, clinic or urgent care in lieu of expensive, last resort ER trips. A health market like this would also facilitate the development of low-cost, cash-only clinics and practices which would grant even greater freedom in patients’ provider choices as well as help alleviate the incredibly high patient load ERs are currently struggling with. Two necessary measures to achieving these goals include:
1) A minor, but necessary increase in copays which must be paid before using the HCDAfunds, however, we will maintain $0 copays for things like vaccines and birth control since these are measures that help keep the overall cost of healthcare down.
2) Waived copays for destitute people or those who are otherwise incapable of paying
3) State healthcare plans be converted to HCDAs or traditional HSAs with an insurance backend so they still have the same coverage as now
We must address the overwhelming shortage of medical personal which is driving up costs, wait times, and simultaneously degrading care. In order to do so, as Governor, Mr. Sharpe would do the following:
1) Allow all medical school graduates to be licensed as physician’s assistants until the remaining requirements , such as residency, have been met to become a doctor.
2) End college course requirements for medical school which will enable doctors to finish school with less debt and have an easier time starting their own practice or clinic.
3) The same should be done for nurses and class capacity should be increased to accommodate rising demand to pursue the opportunity.
4) Residency requirements should be capped at 1 year regardless of who accredits them. End the exclusion of professionally competent healthcare providers and workers and expand acceptance of residency training to graduates of all officially recognized medical programs.
5) New York will recognize all doctors who graduate from any IMED recognized school like most states do. Licensure will be expanded by endorsement and New York will opt into the Interstate Medical Licensure Compact. (IMLCC)
6) Empower nurse practitioners to do more.
Expanded access and use of telehealth will lower costs and provide care in underserved areas. Some important fundamentals of implementing greater reliance on telemedicine include:
1) All telemedicine providers be allowed to operate in New York as long as they meet requirements to practice. We must also stop requiring them to be on a list of pre-approved sites.
2) Elimination of on-site assessment requirements for telehealth.
3) Reduced restrictions on housecalls- Similar to reduced restrictions on telemedicine, house calls should be added as an another option to receive healthcare. Permissions will be given to physicians in all Article 28-licensed health systems, as well as non-Article 28 clinics, to have the ability to make house calls and be compensated for them
In conclusion, please understand that Consumer-Driven Healthcare Reform means returning choices and power to people while driving prices down because providers must once again compete for business. Instead of being primarily concerned with who pays, this policy is more concerned with reforming the primary healthcare markets and state-level management of the care industry itself.