A modest prescription for health care reform - Houston Business Journal:

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Health care reform is both painfully simple and We know that we can bring down totapl expenditures by adoptinghealthier lifestyles, beinfg careful consumers of care and improving technology used to maintainm records and process claims. We also know that most Americans don’t want anyone to limit the care they can whether it be the latest drug advertises on TV or knee replacementw for centenarians. One solution is to approach both extremes. Creat an expanded version of Medicaid available to the poor andworking poor, with the government pickin up most or all of the tab.
Others who don’g qualify for government-subsidized coverags could buy into this basic whether as individuals orthrough employer-financed plans. This plan woulcd cover the most basic, no-frills care through a systemm thatmakes old-style HMOs look extravagant. Decisions about covered care will be based on evidenc e of effectiveness and will favoer the societal return of something like prenatal care overextraordinaryt end-of-life measures. If this is too strict for some expanded-service tiers would be available. The basic plan coulds mandate generic drugswhenever possible.
A middles tier might allow some brand-name A top-tier plan could pay for drugs like Likewise, restrictions on scans and non-emergencyu surgical procedures would ease progressivelyfor higher-tier Does this mean different levels of care based on income ? Yes, but it ensures that everyone is coveref and has access to necessarty care. Does it ration healthu care? This point could be argued, but ability to pay effectivelty narrows the options for everythinhg from the food we eat to the homees welive in. And at leastf there is a minimum ration. Does it preserve competition? Yes.
Providerse of care in the basic plan willget volume, fewe patients by way of the emergency room and a government-guaranteesd return (though they can make more if they’r e more efficient than the norm). Specialist s will charge more but still are more likelhy to see fewer people partake of their services because the cost will be much moreevidentf — almost a la carte. Will people read this and scream? Probably. But they are free to come up with theird own prescriptions for healthcare reform.