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Free Market Healthcare Proposal
The Bulletin ^ | 09/07/2007 | Michael P. Tremoglie

Posted on 09/07/2007 5:03:44 AM PDT by Miami Vice

The American people, through the mechanism of the free market, are best able to reform the health- care system. A consumer-oriented system, which is user-friendly for both the apprentice electrician and the aspiring entrepreneur, is the best way to control costs, maintain or improve quality and increase accessibility.

A system that will permit the average person, not their employer; that will allow the individual, not some corporate administrator; that will empower the American citizen, not some government bureaucrat, to make the common-sense choices as to what their needs and wants are and how much they are willing to pay to satisfy them is the best health care system for Americans.

It is not necessary for the intelligentsia or the government to decree what kind of health care citizens should have or how to finance it. This can be done by the rational choices of the American public. Unlike those who worship at the altar of planwirschaft, we believe the American people, as a whole, are entirely capable of acting in their own best interests.

It is with this philosophy that we have developed what we feel is a very unique, free-market oriented solution to at least some of the issues associated with the health care Gordian knot. This proposal contains four components. Each will address areas of the current health care system that need improvement.

Section I is a unique solution for the dilemma of those with little or no health insurance. It harnesses the forces of capitalism.

Section II addresses the issue of using the free market to make health insurance affordable for all Americans.

Section III provides a remedy for the lack of primary care physicians.

Section IV is devoted to the dire need for medical malpractice reform.

I - Establishment of Private Sector Operated Health Care Centers (PSOHC) A. These clinics would be primarily, albeit not exclusively, located in poor and working class, urban and rural areas. B. Investors would be given federal tax incentives to invest in PSOHCs. 1. PSOHCs would be permitted to issue federal tax exempt bonds to finance these clinics. a. Private Activity Bonds are a model for this. 2. PSOHCs would also issue a class of stock exempt from capital gains tax. 3. These tax shelters will stimulate investment of private capital. 4. Any decrease in federal tax revenues as a result of these tax shelters would be offset by increased income, payroll, and sales taxes generated from the creation and operation of PSOHCs.

C. PSOHC Revenues 1. PSOHCs would obtain revenues from treating patients. a) Types of patients 1) The uninsured, whose income does not permit them access to government operated county clinics, and those with only catastrophic insurance a- Payment arrangements would be made between the PSOHC and the patients. b- This is a retro model. There was a time when people paid physicians directly or by installments. c- Health Savings Accounts are also effective for this. 2) Medicaid members a- Some may prefer using PSOHC physicians than those who participate with Medicaid or those with government clinics. 3) Medicare members - same as 2)a 4) Commercially insured patients - same as 2)a D. PSOHC Provider Staff 1. Tuition forgiveness a) Physicians, nurses, and others would be encouraged to work for PSOHCs by permitting tuition forgiveness for those practicing at the PSOHCs located in impoverished areas. b) Without the burden of tuition loan repayments, many doctors would work for less salary. 2. Malpractice liability a) Malpractice awards against providers working at PSOHCs located in impoverished areas would be limited to specified legislated amounts of settlements, thereby reducing malpractice insurance premiums. 1) Malpractice limitations make sense, since these are economically depressed areas. 2) A model is the California Medical Injury Compensation Act of 1975. E. Benefits of PSOHC's 1. Increase accessibility to primary care physicians a) Poor and uninsured will have more access to primary care. 1) This will reduce the amount of unnecessary emergency room visits. 2) More doctors means more market driven fees. 3) A recent study published in JAMA stated that owning health insurance does not necessarily mean access to health care. 2. The uninsured will have an alternative to not seeking medical care. a) The result would be a healthier population, fewer Medicaid expenditures and fewer uncompensated medical services. 3. More hospitals can continue to function. a) They will not be bankrupted by uncompensated care.

II - Buying Health Insurance A- Associations need to be formed for small groups (i.e., fewer than 5 employees, sole proprietors, unemployed and self-employed individuals) to buy health insurance. 1. Many states prohibit the organizing of groups for purposes of buying health insurance. 2. Insurers do not like to contract with such groups. 3. Legislation needs to be enacted to establish these groups along the lines of ERISA. 4. Individuals and small business owners would have the purchasing power of large groups. 5. Groups can be national, statewide or local.

B. The public should be permitted to buy health insurance across state lines. 1. Costs for similar insurance policies vary from state to state. 2. Politically motivated state mandates increase costs. a) Without mandated procedures, premiums for insurance in one state will be cheaper than another. b) One state may mandate fertility procedures be included, yet a 59-year-old self-employed carpenter does not want such a benefit. Buying insurance from another state that does not mandate this decreases costs.

III Incentives for Primary Care Physicians A. There is a shortage of primary care physicians. 1. Family practice, internists, obstetrics-gynecologists, and pediatricians are not compensated as well as specialists, yet they are the gatekeepers and first line of medicine. 2. These practices are essential to easing the emergency department crisis that exists even in affluent areas. B. Increase public health service commissioned officers corps 1. More physicians would be available to practice in poor urban and rural clinics. a. Similar to military academies, participants can receive tuition-free education and stipend and owe five years service after completion. 2. Funding for this initiative will be from a windfall profits tax or excessive profits tax for malpractice awards and attorney's profits.

IV Malpractice Reform A. Tort liability should be for medical and compensation only for PSOHCs. B. Frivolous lawsuits should be policed by American Bar Association and Department of Justice. 1. Use Dragonetti lawsuits. C. Establishment of malpractice courts 1. Courts modeled after family and patent courts a. Refer to American Enterprise Institute proposal of 2002. 2. Jurors should come from medical and legal field. a. Since this is not always possible, mandate that jurors are given full pay for service. This will ensure more diverse jury pool.

The enactment of these proposals will increase access to health insurance and health care; make health care more affordable and accessible to all; eliminate unnecessary costs; address the concerns of providers, payers and the public and make the health care system more effective and efficient.

The use of PSOHCs is truly unique. The closest is what Wal-Mart is doing. As referenced, there are models in other industries for the financing of this plan and the tax shelters.

Providing less salary in return for less expense for physicians practicing at PSOHCs is another example of capitalism at work. The forgiveness of a few hundred thousand dollars of debt and less malpractice insurance expense in exchange for less salary is a valid one.

Ultimately, the free market will determine if doctors will work for that price.

The idea of purchasing health care across state lines has already been proposed in Congress. Some presidential candidates have included the idea in their platform.

Forming associations for the purpose of buying insurance is antithetical to the insurance industry, but it is an idea whose time has come. The notion that such groups will be prone to fraud is not valid. Most small business owners need to go to work and will do so regardless of their health.

A windfall tax for excessive malpractice judgments is an idea that will be a litmus test of sorts. There are those in government who favor windfall taxes for certain industries they think are being unjustly enriched. This will permit them to apply this principle to one of their major political constituencies.

It is important to note that this proposal is not a magic potion. It is not intended to provide a utopia - nor should it. After all, utopia means "no place."

The reaction by some health care industry groups - think tanks and professional organizations - to this proposal has been favorable. Indeed, one presidential candidate, Republican Congressman Duncan Hunter of California, is considering adopting these innovations as part of his platform.

The uniqueness of this plan is that it provides solutions to some intractable problems using the truly innovative and creative free market solution of investors investing in areas of medical and social concern. It should be welcomed by anyone who believes in the American economic system.

*Michael P. Tremoglie is an advisor to the presidential campaign of Representative Duncan Hunter who is seeking the nomination of the Republican Party. He was formerly director of managed care at Temple University Health Sciences Center.*


TOPICS: Business/Economy; Culture/Society; Editorial; News/Current Events
KEYWORDS: capitalism; duncanhunter; freemarket; healthcare; tremoglie
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To: Miami Vice
And since you are on the subject, this whole article raises another issue, the republican subsitution of "privatized" services for government services.

All this does is turns government functions over to private corporations, and in many cases raises real civil liberties issues.

In this case, I quote Establishment of Private Sector Operated Health Care Centers (PSOHC) ... federal tax incentives ...federal tax exempt bonds to finance these clinics. ... a class of stock exempt from capital gains tax. ... tax shelters

Real free market at work there.

21 posted on 09/08/2007 7:51:35 AM PDT by AndyJackson
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To: Miami Vice
Unlike those who worship at the altar of planwirschaft...

This isn't another RINO proposing even more "planwirtschaft (to correct the spelling)"

22 posted on 09/08/2007 7:53:05 AM PDT by AndyJackson
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To: Miami Vice
Govt healthcare is an oxymoron

This is a conservative website and somebody had to say it


BUMP

23 posted on 09/08/2007 7:57:18 AM PDT by capitalist229 (ANDS)
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To: Miami Vice

bookmark


24 posted on 09/08/2007 8:41:57 AM PDT by GiovannaNicoletta
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To: Miami Vice

Nope...wrong again. You can pay for your own med (you could certainly use some).


25 posted on 09/08/2007 10:54:28 AM PDT by RasterMaster (Rudy McRomneyson = KENNEDY wing of the Republican Party)
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To: Miami Vice
The purpose of the PSOHC’s is for the private sector to operate healthcare centers for all of those even without insurance who will pay cash - just like people used to do.

Unless you get rid of EMTALA, why wouldn't the poor go to the ER where they can get "free" treatment?
26 posted on 09/08/2007 10:58:46 AM PDT by Kozak
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To: AndyJackson

You are about as plastic as they come you holier-than-thou hypocrite.

Who invests the money that is collected in premiums you stupid dope. You? The policyholder?

No the insurance company.

Who pays the expenses and pays for the healthcare? You? The policyholder?

No the insurance company.

If it’s so easy you knowitall then why don’t you just self-insure?


27 posted on 09/08/2007 6:55:28 PM PDT by Miami Vice
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To: AndyJackson

What proposal was there for a new kind of health insurance?

Please cite the part of the article that said there would be a new kind of health insurance?

Go ahead I dare you! You can’t! You know why? Because there was none.

You are a fool or you’re lying can’t tell which.


28 posted on 09/08/2007 6:57:23 PM PDT by Miami Vice
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To: AndyJackson

Are you seriously saying there should be no health insurance?

You are insane. You must be one of those Ron Paul guys.

He is full bs and so are you.


29 posted on 09/08/2007 6:59:50 PM PDT by Miami Vice
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To: AndyJackson

SO tell me where is the government central planning here ( that’s is what planwirtschaft means AndyJackson)?

Come on show me the part that says the government controls the system?

It doesn’t. It is a private repeat private secotr operated health center.

Are you really that blind?


30 posted on 09/08/2007 7:01:52 PM PDT by Miami Vice
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To: RasterMaster

Tellme genius how are you going to pay for a heart transplant ( or in your case a brain transplant that you desperately need)


31 posted on 09/08/2007 7:03:08 PM PDT by Miami Vice
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To: AndyJackson

So tax incentives to invest are a violation of civil liberties?

You wouldn’t know a civil liberty if you tripped over it.

Yo why don’t you post to a Ron Paul blog. That’s where you belong in RonnieWorld.


32 posted on 09/08/2007 7:05:19 PM PDT by Miami Vice
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To: Miami Vice

I certainly wouldn’t ask YOU to pay for it....that’s what Hillary, Romney and other LIEberals are pushing.


33 posted on 09/08/2007 7:23:31 PM PDT by RasterMaster (Rudy McRomneyson = KENNEDY wing of the Republican Party)
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To: RasterMaster

Your nonanswer is an answer.

Bye Go post to a Ron Paul blog with that other genius Andyjackson


34 posted on 09/08/2007 9:30:27 PM PDT by Miami Vice
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To: Miami Vice

You can stop pimping for Ru Paul....I don’t support crazies from the BLAME AMERICA FIRST crowd.


35 posted on 09/08/2007 10:02:51 PM PDT by RasterMaster (Rudy McRomneyson = KENNEDY wing of the Republican Party)
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To: RasterMaster

You’re the Ron Paul pimp. Hell you and Andyjackson are the stable.


36 posted on 09/09/2007 12:01:13 AM PDT by Miami Vice
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To: Miami Vice
SO tell me where is the government central planning here ...the part that says the government controls the system? ... It is a private repeat private secotr operated health center....Are you really that blind?

Pull your head out and you might be able to see what a clueless self-aggrandizing croney capitalist twit you really are.

With all that government subsidy, favors NOBODY else gets, such as a tax free class of stocks, this thing lives in the pocket of the taxpayers.

No you are not forcing a deal down our throats like this under the guise that this is private enterprise anything.

37 posted on 09/09/2007 6:59:17 AM PDT by AndyJackson
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To: William Tell 2
They finance healthcare. They take our premium dollars

Is your ability to use logic that poor. They take our premium dollars and therefore, they do not finance healthcare. The folks whose pockets the dollars are taken out of finance health care, which is largely the customers of the companies who purchase that healthcare on behalf of their employees.

In other words, the cost is socialized, spread across so many payers that you don't know who is really paying for it. The one thing we do know, is who is not paying for it, which is the person you and MAIMIVICE keep trying to claim is paying for it.

Stop acting, along with MIAMIVICE, as though healthcare organizations are philanthropic foundations they are not. They pay for nothing out of their own pocket.

38 posted on 09/09/2007 7:04:08 AM PDT by AndyJackson
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To: Miami Vice

Obviously you didn’t even look at the links you went off on in post #14...none of which have anything to do with your fetish, Ron Paul....

Here’s a couple of videos regarding the subject:

Duncan Hunter on “Universal” Healthcare
http://www.youtube.com/watch?v=2EyYa0Jc730&NR=1

Duncan Hunter “Kennedy Wing”
http://www.youtube.com/watch?v=cUz-AgMGLQA

Hunter - Healthcare (purchase plans across state lines)
http://video.msn.com/v/us/v.htm?g=7f04aa1d-7c48-486a-b8af-9858007c082b&f=34&fg=rss

And in case you think the idea of “free healthcare” is something new...the commies have been pushing it since the 1920’s....

Ronald Reagan on “Universal” Healthcare (1961)
http://www.dirtyworldnews.com/files/ronald-reagan-socialized-medicine.mp3

I can only assume you are mistaking me with someone else, didn’t look at the links at all and just looking to pick a fight, or are completely mental.


39 posted on 09/09/2007 7:26:57 PM PDT by RasterMaster (Rudy McRomneyson = KENNEDY wing of the Republican Party)
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To: All

Ronald Reagan on “Universal” Healthcare (1961)

http://www.dirtyworldnews.com/files/ronald-reagan-socialized-medicine.mp3


40 posted on 09/09/2007 8:23:19 PM PDT by RasterMaster (Rudy McRomneyson = KENNEDY wing of the Republican Party)
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