My Turn: Here's how to pay for national health care

By John Burke

There's been a lot of talk about the 15 percent of Americans and undocumented immigrants who don't have health insurance. The truth is, they get health care, but at a high cost, paid for by those with health insurance!

Federal law requires hospitals to treat anyone who comes into their emergency rooms whether they can pay or not. This cost does not disappear, it shows up in our insurance premiums, hidden away where we can't see them. But the costs are there, and they add up to over $37 billion last year, and growing.

The sad thing is that if those same people had some form of insurance, that cost would go down dramatically as they went to family doctors when the problems start, not when they are seriously ill and require hospitalization. Another facet of the problem is that the poor (and undocumented) use the Emergency Room as their primary care doctor, at a much higher cost, again, to the ratepayer's expense.

Conservatives complain loudly about the cost of a national health care plan, so let me offer a few suggestions on paying for a national plan of some sort.

First, take that $37 billion and assume those folks went to a doctor's office instead. That might save $10-20 billion just by eliminating all of those Emergency Room visits for routine treatment.

Next, let's have serious tort reform, which Stanford economists estimate cost as much as $178 billion per year, according to the Post. Between lowering the astronomical cost of malpractice insurance and reducing the number of "defensive" tests doctors order, we should be able to save 20-25%% of that $178 billion, or around $35 billion a year.

Finally, let's make Medicare and Medicaid fraud a serious crime. Current estimates put the cost of Medicaid fraud at $60 billion and few participants even get investigated. For those few the small fines are a cost of doing business and no one goes to jail. Currently there are seven to ten teams concentrating on these frauds, in the entire country! Under staffed and under resources, they are barely able to scratch the surface. Your chances of getting stopped for speeding are probably greater that fraudsters run in getting caught. Increasing the size and number of the investigation teams and giving them adequate resources is a start. Then make Medicare and Medicaid fraud a felony, with mandatory jail time and big fines would serve to make this a high risk crime, unlike today. Figure that would cut fraud in half, or another $30 billion.

If you add all that up, it comes to $75 billion a year, or $750 over 10 years, about the expected cost of the Senate plan. This isn't even counting the proposed savings already in the current plans.

In a nutshell, national health care could be made self-supporting by simply legislating tort reform and making fraud an actual crime! Let's tell Congress to get off of their partisan rear ends and do it!

John Burke lives in Salisbury and is a retired CPA and former corporate CFO.

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