Comments about ‘How would you fix health care?’

First, just an observation: Medical insurance does not cover auto accidents. Auto insurance does.

The first step to fixing health care is to get the costs under control.

Twenty percent of the nations health care bill is created by malpractice insurance. Another 20% is caused by defensive medicine, doctors ordering tests only so they can say they did if they get sued. Implement tort reform (loser pays) and this all but disappears.

Next insurance is usually intended for things that are both expensive and rare. Offer high deductible ($5,000 or $10,000) basic health insurance that covers non-experimental treatment of illnesses, diseases and injuries.

Let people decide if they want maternity benefits, treatment for STD's, AIDS, Mental Health, Addiction to illegal drugs, Addiction to prescription meds, etc.

Allow people to create Medical Savings Accounts so they can pay the high deductibles.

Require health care providers to charge the same amount for both the insured and uninsured, and post their rates so people can comparison shop.

Allow highly skilled nurses to open clinics for primary care.

Over half of all office visits are unnecessary. Educate the public so this waste can be reduced.

As for as emergency room visits are concerned, the present system is not working.

1. Perform a triage at admitting at all ERs. Send all non-emergency cases to a local clinic. Emergency rooms are the most expensive delivery method for health care. Let's use it for what its intended purpose.

2. You admit emergency cases in the ER but everyone is required to pay. Make medical bills like student loans; filing bankruptcy does not make it go away. Hold people accountable. Just remove the sign that says "Please Rob Me!"

3. Deal with illegal immigration so they are no longer a problem in the ER.

Nobody dies. Everyone is held accountable. Those that can afford insurance will buy it, none will risk not having it.

These provisions (including those in my previous post) will reduce the cost of insurance to about $200 a month for a family of four. That is slightly more that what I would pay for cable TV if I was stupid enough to have cable.

Hi Dr. Cramer. You were our family's pediatrician up until the time that the last DuShane left for a mission, and one of my brothers has pointed out your column to me. I have since been a faithful reader of your column for two reasons: first, your logic is impressively thought provoking, and second, as somebody who has been a figure of trust in my life, I can look at your advice on several issues and know it is sound.

Today in my Constitutional law class, my professor raised the issue of health care. What I learned as it applies to your question is that health care is a complicated issue because people (the primary focus of health care) are complicated. There are no easy answers. Even when discussing the legalities of health care reform where the discussion is less about human nature and more about how to apply law to facts, the answers are not as cut and dry as we would like them to be.

As a society of compassionate, ethical people, we obligate ourselves to provide for those in need. Our collective, societal ingenuity will provide a way for compassion to be reconciled with our dilemma.