Immediate Steps to Improve Care and Prep the System
Our current system prioritizes profits, not care, so removing profit incentives both lowers costs and improves care. Certain structural improvements must be made to implement Single-Payer and it will take time to implement and realize their cost savings. Many of these quality-improvement reforms will have bipartisan appeal, and I will fight for them even if I serve in the minority in 2019. Reforming 1/6th of the economy will take time, so we cannot wait for control of both Houses and the Presidency to start. Fortunately, most reforms are both the financially responsible, and humane thing to do.
Expand Medicare to 55 & over and CHIP to all children 18 & under and pregnant women. Lowering the age will also increase job availability for younger workers.
All medical plans must include comprehensive Dental Care as part of the plan.
Alternative pain treatments with evidence-based results (ex. acupuncture) covered by insurance and Medicare/Medicaid/VA/CHIP.
Birth control and hearing aids (personal sound amplification devices) should be over-the-counter.
Eliminate the ‘family-glitch’, so the cost of the whole family’s health coverage is considered when calculating ACA subsidy eligibility.
Structural Improvements in Care Delivery and Payment
Lower drug prices: Medicare negotiates drug prices and consumers can buy from Canada; ban prescription drug advertising to consumers and provider bonuses for using prescription drugs.
Universalize Electronic Medical Records (EMRs): Your records from one doctor will be available at another. Create open-source, quality focused, EMRs developed by practitioners/providers.
Hospitals publish common procedure price lists: Patients will have more agency in markets with multiple providers and insurance can predict out of network costs for better coverage.
Implement ‘best practice’ software: Hospitals rein in unnecessary diagnostics and treatments.
Increase non-physician providers (ex. NP, PA): Expand programs in University partnerships to save costs and incentivize them going to underserved areas with loan repayment.
Replace medical device tax with percent profitability cap: make-up revenue with taxing capital gains as work income (4x more revenue).
Structural Improvements in Care Development
Patent Reform: Ensure taxpayer funded discoveries benefit the public! Give patent ownership back to funding body and researchers, but still give exclusive licences. Crack down on limited-utility tweaks renewing patents, which keep generics from use.
Do research in real-world populations: Many drugs and diagnostics do not work well in women and non-studied populations because they were not tested in clinically-relevant populations or models. Expanding better model use through researcher training and improved standards, will results in more effective treatments, improving quality and lowering costs.