Article 105. Explaining How We can Afford Health Care

Explaining How We can Afford Health Care

While Congress and the media are wringing their hands on where the money is going to come from for Health Care.  There is no reason why we can not have affordable healthcare. The following is a simple explanation of how we can pay for Health Care.

The Problem begins with Congress
Congress focuses on one problem at a time: Health Care, Tax reform, balancing the budget etc.  The reason is these are very complicated issues but when they do this they miss the big picture and all of these issues are related because you have to have a way of paying for them. These issues are seen as being mutually exclusive, you cannot have Health Care and tax cuts and balance the budget. The false thinking is that there is only so much money that the government has without raising taxes. This is a nearsighted false concept.

Congress focuses on passing legislation and not on managing legislation. That is left up to the “Spenders” the Government Departments that get the budget to run their organizations.  This is supposedly monitored by the Office of Inspector General within Each Department.  But since the OIG reports directly to the head of the Department nothing is done until a whistle blower goes public then the OIG is asked to look into the Matter.  The result is that waste is built right into the system. US Government Waste is in the $Billions. Ref: LawrenceRosierConsulting blog article 88.

Congress’s Problem
Passing Legislation is only one half of Congress’s Job the other half is insuring that the legislation actually works and does the job efficiently. In this half Congress has been a complete failure.  The fact is that almost nothing is done to prevent waste and Congressmen don’t seam to care and are seemingly unaware that waste and mismanagement exits.  This is because they see it as someone else’s problem and not their own.

The Solution
Once legislation has been passed by Congress the Congressional Budget Office reviews the bill to see if the funding is close to what they think will be required. But instead of sending the budgeted funding directly to the Department for which it was intended it is sent to the new Government Management organization (OIG Analysts) to determine how it will be efficiently used.  If too much funding has been approved by Congress the excess funding will be returned to the US Treasury and if not enough funding has been provided the Government Management organization will determine how much extra funding is required and how it will be used.

The New Government Management organization will be within the Office of Inspector General organization which I recommend be separated from the Government Departments and reports directly to the Office of Management and Budget.

The Office of Inspector General's main job is to investigate misuse of Federal Funds this an after the fact investigative organization of waste and mismanagement meaning the investigation occurs after the funds have already been wasted.  With the new Government Management organization the investigative function of the OIG will be greatly reduced allowing OIG Analysts to become available to manage the governments business.

Where the Money for Health Care Comes From
By now you should be realizing that the money for Health Care is found in the elimination of waste both in our Healthcare system and in the Federal Government.   But even more savings becomes available with the implementation of efficient Health Care and Government Management Systems.  While Congress and the media are wringing its hands on the question of where the money is going to come from for Health Care.  The answer is simply stop the waste in government and make the Government and Health Care operate efficiently and no new taxes are needed.

Changes needed to Make US Health Care Work
The Major changes that are needed to make the US health care system efficient and affordable.
But first mistakes were made by Democratic lawmakers in the design and passage of Obamacare.
1. They brought in all the major players to get their input: Private Health Care Providers, Health Insurance Companies etc.  Sounds good but tells us that the lawmakers did not understand why our Health Care costs so much.  Our Private Healthcare System is based largely on defrauding the government to pay for the high cost of health care. Our Fraud based Health Care costs double that of government based European Health Care.  It even costs twice as much as our government based Veterans healthcare system. Ref: LawrenceRosierConsulting Blog Articles: 101.

2. Health Insurance Companies did not explain why the insurance of catastrophic Health Care would drive up the cost of premiums.  This was the major failure of Obamacare Catastrophic health insurance can become costly due to the unpredictably of the need for long term high cost medical services. When Catastrophic Health Care is combined with regular Health Care premiums are driven up due to the high cost of the Catastrophic Health Care making Health Insurance unaffordable.  This became an insurmountable problem when citizens were forced to buy health insurance.

3. They were not focused on bringing down the high cost of healthcare only in passing health care for all.  Once Obamacare was passed we are left without a way of paying for it.

Trump Administration
The Trump Administration did not realize the way that Congress normally operates, focusing narrowly on passing legislation in individual areas.  This GOP Congress has seen few risk takers, they have focused on proposing quick fixes to Obamacare and failed to see that it could be funded by eliminating waste and implementing management reforms to get efficiency.  This puts the responsibility for solving major government problems and introducing innovations in government with the President and his staff. 

If the GOP Congressmen had focused on eliminating waste and had implemented efficient government Management reforms first then a more accurate accounting of saving that could be gotten from this approach would have shown that Health Care may be affordable after all.  This opportunity was missed because Congress has never admitted that it is responsible for the waste and inefficiency of the US government.  The President can correct this problem by implementing recommended reforms in the Veterans Administration as a pilot reform for further implementation throughout the Federal government.  Ref: LawrenceRosierConsulting blog articles 104, 101, 96 and 88.

Congress can enact legislation for separating the Departmental Offices of Inspector General in a single watchdog organization with management responsibility for the recommended new Government Management system. Ref:  LawrenceRosierConsulting blog articles 104, 96 and 88.

Repeal and Replace Obamacare with this Recommended System
The recommended near term approach is to let the people pay what they can afford for their Health Care. Above that the government will provide catastrophic Heath Care to all Americans in a new Catastrophic Health Care System.  Health Care recipients should pay each year for their own health care from private providers up to a specified amount determined by income at several levels.  No one is required to buy health insurance.  Paying all the health care costs for everything that people want is not possible and should not be provided by the Government. As an option private Health Insurance Companies can compete in providing the minimum coverage up to the catastrophic level if wanted by individuals and companies (as was done in the past). Health Insurance is not provided in the governments Catastrophic system.  The Federal Government should not provide healthcare to non-citizens, however State Governments may chose to provide this service.

The key to this system is the elimination of Private Health Insurance and Private Hospitals from the Catastrophic Health Care System. Health Insurance for catastrophic health does not work because profits necessarily drive up insurance rates and co-pays.  Private Hospitals have resorted to massive fraud to survive. Congress has not been able to prevent the waste and corruption found in our health care system. Americans simply can not afford or be expected to pay for a health care system that is the most wasteful and expensive in the world.  The current health care waste from fraud and abuse has been passed on to the public and not enough has been done to make the day to day health care processes themselves efficient.  But now we have the Reforms to be implemented in the VA which makes health care efficient and effective.
This makes possible the Government catastrophic affordable alternative to the current private health care system. LawrenceRosierConsulting Blog Articles: 103,101,97,98

Transition Alternatives
The VA Healthcare system must have reforms fully implemented in all of its facilities and be treated as a separate system providing Vets the health care they need.  The VA system changes according to needs of the Vets with age and with injury types.  Therefore there is a need to go outside the system for healthcare it cannot provide.  This alternative will be the Catastrophic Health Care System that mostly serves those receiving Medicaid.  The cost of the Catastrophic Health Care System may be shared with the State Government.

In the future the US Government may pursue the development of a complete government Health Care system for Medicare as an alternative to the current private health care delivery system that is mainly driven by fraud.  US Health Care reforms can move to a government run system over the next 10 years similar to Europe but with better management controls.  More than $1trillion can be saved by eliminating waste paying for Medicaid, Medicare. LawrenceRosierConsulting Blog Articles: 103, 100, 96.

Catastrophic Health Care should easily Pass both sides of the aisle in Congress. Who is to argue with Health Care paid for by the elimination of waste and a new Government Management system for efficiency.

Contact Lawrence Rosier
Lawrence Rosier Consulting
12143 Cedar Grove Rd.
Rolla, Missouri 65401
573 578 4716
lawrencerosier4@Gmail.com