Every once in a while I come across a blog where I waste a whole afternoon reading all the back-posts.I don’t know whether to thank you…or curse you.

That was well said. Always appreciate your indepth views. Keep up the great work!

John

Gordon Horwitz
ghorwitz1@mac.com

The simplest solution to HC financing is to allow providers to deduct the cost of uncompensated charity care they provide from their income. This would make it clear to everyone that it’s the providers (not politicians) who provide care. Many providers who currently severely restrict Medicaid and Medicare access would step up and provide more, not less, of such care.

Long term financing options for those with limited resources and no insurance could be made available by providers with a sliding income scale that makes sense to them and the marketplace (not necessarily politicians). Patients who pay for their care after the fact ought to be able to do so with tax free dollars, just as (pre-care) insurance premiums are tax deductible. One might consider closing the ‘free care tax loop hole’ by allowing providers who provide uncompensated charity care to file some sort of a 941 for those they provide uncompensated care for to let the government identify those who feign poverty but really have the resources to pay for their care.

Making uncompensated charity care tax deductible would also clear out the red tape associated with Medicare and Medicaid. Also, with such a simple change in HC financing, providers (and clinics and hospitals) could better develop sustainable plans for providing preventive and walk in care. Best of all, this could be done without any changes to Medicare or Medicaid programs… These programs could still be there, but just ignored if it makes more sense to the providers and patients to seek alternative ways to provide care.

Bottomline — As it currently stands, the compensation provided by Medicare and Medicaid programs is about 50% or less than the ‘normal’ cost of care, in many cases it’s 30% or less, plus there’s a huge bureaucracy associated with running these programs. This puts the overall economic cost of providing Medicare and Medicaid care on par with the cost of making uncompensated charity care fully tax deductible to health care providers.

The primary reason this sort of simple market based solution is unlikely to ever happen is under such a system, health care providers, not politicians, would be getting the credit for providing care. Politicians won’t put up with being out of the loop… Which really points out what lurks at the core of most contemporary health care problems — politicians trying to buy votes through other peoples efforts and misery. Any true solution to fix this problem should empower providers, people and the marketplace while leaving politicians out of the mix as much as possible.

Does that sound like a fair billing practice?