I would like to present for discussion some thoughts on increasing the economic supply of medical services in this country. Any discussion of national health care invariably involves some new type of insurance program. Insurance is an issue of distribution, a question of who gets what. My focus rather is on increasing the supply of health care services in this country to deal with the bulge in demand created by the aging of the Baby Boomers.
To increase the supply of medical services in this country, I would propose the following initiatives which will primarily address the needs of the Medicare population.
1) Most generally, I would propose that we create a clinical trials insurance program administered by a new, and very small organization I call the Medical Services Guaranty program. The basic concept is that clinical trials are a high sunk cost in drug development that means only the largest companies can engage in drug development. Only they can absorb the loss that would occur if a drug gets all the way to the end of the process of human trials and fails. Clinical trial insurance would make it possible for smaller companies to participate in the process, increasing the level of competition in pharmaceuticals. We should require as a part of the insurance programs that the participant set their prices at some percentage of the market price for similar products on the market. We should also require a percentage of the revenue streams generated by successful products as a means of building up the reserve fund.
2) I believe we need to promote what is called now "medical tourism" for procedures qualified for reimbursement under Medicare by allowing a travel benefit that could be brought into play as long as the savings to Medicare is at least 20% off the schedule of usual and customary charges.
3) Similarly, I believe that we should allow medical practitioners to establish medical offices in Canada under the authority of a Medical Branching Act. Such medical providers would operate totally on the Canadian economy and serve Medicare recipients provided that service providers were reimbursed in Canadian dollars. This extension of medical services would specifically not be in competition with the national Canadian medical service and local rules on medical malpractice would apply.
4) I think we can increase service capacity in this country by allowing underutilized Veteran health care facilities to open their doors to non-Veterans up to a certain percentage limit. By way of background, there is much discussion of closing down Veterans facilities that are underutilized and hence high cost. I say we should improve the operating level of the facilities and better serve the public.
5) Although it may be a more contentious proposal than Unity would prefer, I believe we should engage in a campaign to recruit English speaking immigrant women from Eastern Europe to staff up nursing homes to deal with the upcoming labor shortfall as retirements reduce the supply of labor in that industry.
7) I believe we should fast track the approval of a new medical process called HIFU, recently featured in the magazine Science. The acronym stands for High Intensity Focuessed Ultrasound and it is used as a treatment option for some early stage cancers.
8) I think we should begin a discussion of licensing medical doctors for the treatment of the geriatric population. The requirements for this medical license would be graduation from an accredited medical school and a term of residence. It is contemplated that more doctors could apply for this license than could be graduated from the American medical collegiate training system.
9) I would also propose for discussion an idea to improve health in our aging population by increasing the level of exercise in the over fifty cohort of the population. I think we should establish a fund of about $10,000,000 to use as awards in a senior sports league. The idea being that the possibility of monetary rewards would spur more "couch potatoes" to start exercising than a host of grim, televised
warnings about the consequences of a lack of exercise.
10) I would also like to propose for discussion a tax credit benefit for those over 50 for pain management services such as chiropractic servcices. This proposal is primarily directed at people suffering from severe arthritis and is aimed at postponing retirement for those so situated that they could continue to work if they could just manage the pain.
Thank you for your comments.
Mike Moody