A nurse’s ideas for health care reform

By Doreen Suran • November 10, 2009 7:19 pm

There was a time when health care was affordable; doctors in private practice and hospitals were public, non-profit. As a nurse I know how fragmented, expensive and broken our system has become. We fix health care by first fixing the primary care system.

Everyone wants affordable, available and effective health care.I see three major problems in our current health care system. They are the increasing cost of private health insurance, the loss of family practice doctors and the flooding of our ERs by the uninsured and the underinsured.

Medicare, Part B, for all citizens is needed.It would provide basic care, treatments, labs and x-rays at a physician’s office, an HMO, a clinic (private or public).Increasing the current Medicare Tax on gross income will pay for this program.This program will not add to the National Debt and will save most families money.

Annually every person would chose their primary provider, who would be paid a monthly retainer, out of the tax.No billing costs, no paperwork, no insurance adjusters denying claims.It is up to the physicians to manage their patient’s care and their clinics.Every new medical graduate, who establishes a primary care practice in an underserved area, will be offered medical school loan assistance.

Medicare Part B based on a Medical Home Model will centralize care and records.This will reduce Medic 1 calls, ER visits, hospitalizations, and repetitive and unnecessary tests. The Medical Home Office will have to authorize all Medicare expenditures, decreasing fraud. Preventative care will be promoted by having no co-payment or fees for clinic visits.

Lastly, Standards of Care, that have been proven to be effective, must be implemented.This will guarantee that needed treatments are done.But it will also reduce the incentives that fee for service payments promote.To protect the physicians who follow the guidelines, malpractice suits will not be permitted.

This plan gives choice, reduces costs for providers and users, reduces Medic 1 calls, ER visits, hospitalizations and fraud, is paid for, is affordable for families, has tort reform and gives preventative care.

Since everyone pays, it ends cost shifting from the uninsured to taxpayers and the insured. And it supports family doctors.

Doreen Suran is a nurse. She lives in Bellevue.