Solving Health Care- Part 2Permalink +
Tue, Dec 30, 2008, 5:29 pm // Craig MayberryOne potential solution for health care that has not been discussed is changing existing laws such that communities can set up a local health care authority (LHCA). A LHCA would serve a local community and be owned by the community in the form of a Co-op or other structure that is independent of government or for-profit business interest. The only way to solve the health care crisis is as a community and the community should own the organization. The LHCA would cover all medical issues in the community, regardless of income, employment status, etc. The LHCA would only be responsible for covering residents of the community. This would eliminate the current health insurance system and replace it with a local solution.
The LHCA would be governed by an executive director that would report to a board of director. The board would consist of the following: 2 elected officials, 2 doctors, 1 hospital administrator, 2 business owners, 1 nurse, 1 medical administration person, 2 community citizens. The board members would be elected by the people they represent. All of the doctors in the community would elect the 2 doctors on the board. All of the nurses in the community would elect the nurse on the board. All of the citizens would elect the 2 board seats for citizens, etc. The structure ensures that the board is represented by all of the key stakeholders and all have a say in the operating decisions of the LHCA. Board meetings would be held regularly and would be open to community members.
There would also be at least two committees, one made up of doctors that would determine medical policy and procedures and make recommendations to the board. The other committee would be made up of an equal number of doctors and citizens to handle any malpractice issues as the first step of avoiding the court system. If a problem arises and a patient has an issue with the actions of a doctor it would go to this committee for resolution, including any monetary award.
The board of directors would be required to have an annual meeting where all members of the community can come and get updated on latest financial information, performance data, and address any issues. The board would also be required to mail periodic statements outlining financial and performance data. The board is ultimately accountable to the members of the community, all of whom will use the health care services.
Revenue to the LHCA would come from a number of sources. First, any money currently being spent by state government, local government, and businesses on providing health insurance would be redirected to the LHCA. This would provide a bulk of the money necessary for operations. Any shortfall between this amount and what is necessary to pay expenses could come from a couple of potential sources. One option would be co-pays from those that use the system (potentially a sliding scale to account for income), another option is a tax (or required monthly insurance payment) from local business or citizens. The board of director would be responsible for figuring out the amount and method of gaining additional revenue when necessary.
The LHCA would then turn around and arrange agreements with local hospitals and private doctors for payment for services. Contracts would be established to set pricing and reimbursement rates. Doctors would have the benefit of not dealing with multiple insurance companies and dealing with only one organization for payment. Doctors would remain private entities and the hospital could be a for-profit or non-profit, but almost all of their business would come through the LHCA. Any medical procedures that require the patient to get treated outside of the local community would be contracted for and paid for by the LHCA. The LHCA would also be responsible for prescription drugs and would make arrangements with local pharmacies for payment, similar as to doctors. Any “profits” made by the LHC over and above what would be necessary for reserves would go back to the organizations or people that paid into the system.
There would be no health insurance companies doing business in the local community as the LHCA would be responsible for collecting the revenue and making payments to doctors. Citizens would only have to deal with the LHCA for all issues, which would be a much smaller and local organization, much different from having to call a 1-800 number to somewhere else to get issues resolved. There would be no real change for the doctors, other than only having to deal with one organization for payment instead of multiple insurance companies. Processing could be streamlined to minimize overhead, which frankly is a big deal. Patients would be able to see any doctor they wish as all doctors in the community would be contracted with the LHCA.
The benefits are many fold, but the main ones are a reduction in overhead and streamlining of the process which would then be used to reduce cost and cover more people. The second benefit is that the system is run by local people for the benefit of local people. I have never understood the assumption by many people that a national system would be more efficient. There is no reason to tie Bellingham’s health care system to Florida or California, with the exception of some services. There is also not any economies of scale so bigger is not necessarily better in the health care system.
I recognize that it is hard to cover every scenario or question in a few hundred words, so questions and issues are appreciated. This is a big change from the current dialogue around solving health care issues, but the changes are not that radical that it could not be done and it does solve all of the fundamental concerns that critics of the other proposals have expressed.
Tue, Dec 30, 2008, 5:29 pm
2 comments; last on Jan 02, 2009
Mon, Dec 29, 2008, 5:12 pm
At the risk of displeasing friend and foe alike, may I ask what has been accomplished this past year to fix Lake Whatcom and protect Bellingham's water supply?…
Mon, Dec 29, 2008, 1:13 pm
12 comments; last on Jan 03, 2009
Editor note. Barney died Thursday, Dec 25. He strongly deserves tribute for his public service. Bob Aegerter provides a brief look at his life. Bob was the architect…
Sat, Dec 27, 2008, 3:05 pm
1 comments; last on Dec 29, 2008
Fri, Dec 26, 2008, 3:13 pm
9 comments; last on Jan 04, 2009
Happy Holidays and the best to you and your loved ones.
This is the one day of the year when we all share renewed hope for peace…
Thu, Dec 25, 2008, 9:12 am
Today, McClatchy stock is trading at 74 cents a share - down 99% in value from their high of $74.50 in 2005. McClatchy was a $5 billion company…
Tue, Dec 23, 2008, 1:15 pm
3 comments; last on Dec 27, 2008
Fri, Dec 19, 2008, 1:22 pm
2 comments; last on Dec 22, 2008
The book on Northwest weather has just been published. I mean _the_ book. "The Weather of the Pacific Northwest by Cliff Mass. For any person who is not…
Thu, Dec 18, 2008, 3:39 am
Forty years ago, during the convention in Chicago, someone explained to me, success in politics often requires rising above your principles. In the face of the Daley machine,…
Sun, Dec 14, 2008, 3:45 pm
5 comments; last on Dec 16, 2008
Fri, Dec 12, 2008, 12:46 am
7 comments; last on Dec 14, 2008
Sheri Ward has contributed this guest article. Sheri was the editor of the Whatcom Independent weekly newspaper. She wrote a first article on this Roeder Home issue on…
Wed, Dec 10, 2008, 2:50 am
For a guy who promised change, pledged a definite end to the mess in Iraq , and lambasted his opponents for not stating a timetable to withdraw our…
Sun, Dec 07, 2008, 7:54 pm
9 comments; last on Dec 10, 2008
Thu, Dec 04, 2008, 4:32 pm
2 comments; last on Dec 07, 2008
Tue, Dec 02, 2008, 1:56 pm
3 comments; last on Dec 03, 2008
We Thank Our SponsorsClick to See All Sponsors
About NWCitizenDonations maintain site
Thru the years
Election LinksJeff Strung / WA Auditor
Mike LaPointe / US Congress
League of Women VotersCalendar of Events
Videos of Districting Committee
Local Online NewsBellingham Herald
Bham Business Journal
Bham Politics & Econ
KPLU fm radio
Western Front - WWU
Local CausesChuckanut C. Forest
City Club of Bellingham
Community Wise Bham
Futurewise - Whatcom
Lummi Island Quarry
N. Cascades Audubon
NW Holocaust Center
Powder River Basin R. C.
Salish Sea Org.
Save the Granary
WA Conservation Voters
Whatcom Peace & Justice
Our Governments- Whatcom County
Port of Bellingham
US Supreme Court
US The White House
NWCitizen 1995-2007Early Northwest Citizen
Weather & ClimateCliff Mass Weather Blog
EPIC World Photos
Nat Hurricane Center
Two day forecast
Watts Up With That?
Local LeisureAdventures NW
Good Web SitesAl-Jazeera online
Change The Mascot
Edge of Sports
Foreign Policy in Focus
Julia Ioffe/New Republic
Middle East Times
New American Century
Personal bio info
Portland Indy Media
Project Vote Smart
Stand for the Troops
Talking Points Memo
The Crisis Papers
War and Piece
Quiet, Offline or DeadBellingham Register
Bhm Herald Politics Blog
Citizens of Bellingham
Cordata & Meridian
Facebook Port Reform
Friends of Whatcom
Get Whatcom Planning
Intrnational Herald Tribune
N. Sound Conservancy
No Leaky Buckets
Protect Bellingham Parks
The American Telegraph