One payer wont work. We've been through that argument for fifteen years. What will work is transferring Medicaid back to state policies and implementing supplemental policies for working people and those who can afford them. Medicare Aetna/ Humana as examples. The supplemental policies will help to cut costs to Medicaid providers with respect to overall cost to states for the policies. States can handle the Medicaid administration with more cost effectiveness than the federal government. More money savings. Having non profit clinics and minor medical care centers for all users will also drastically reduce costs of Medicaid and reduce the costs overall, in the system. The federal government should assume over site regulatory controls based on criteria models in patient diagnosis and scheduled treatment. That includes legal definitions of adequate and equal care per patient.
The largest expenditures in Medicaid come with minor medical expenses. Real costs per patient verses payments for services per patient is drastic in the differences. In some cases a normal visit to a minor medical center would cost an estimated 250 dollars in actual costs to see a patient. This number can go as high as 2500 dollars to see the same patient in a specialist center or major medical care facility. That is ten times the amount of money that it should cost to treat the patient. The profits made on this practice is usually none. In most cases the actual expenses are transferred to other areas to cover the costs of a minor medical treatment. This is called cost transference and should be against the law. Cost transference allows the patient to be treated for minor medical issues at a major medical facility and have the bill be nearly the same that it would be in a lower cost setting. This seems to be a service provided mostly for convenience to patients who have policy coverage. They receive minor care at a nominal fee but the real cost is ten times the bill. The bill is 250 but the actual expense to the facility is 2500. It adds up fast. But the savings can add up fast too if more facilities are incorporated to treat people for minor care conditions at non profit based facilities. Facilities that are located outside of low income neighborhoods and slum or high crime areas. The government has always had a policy of putting facilities in those areas knowing that the impact of using the facilities would be trivial. But facilities that are outside of those demographics can be a money saver. A huge money saver if you compare 2500 to 250 in actual costs to treat the patients. Eliminating Medicaid from private sector care facilities is equal to segregation enforcement. Which would be unconstitutional.
Supplemental policies will work. Minor care centers that are non profit will work. Transferring Medicaid administration to the states will work. And in this way a guarantee of care for all Americans can be worked out. This is the way to do it.
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