I would argue that the same way maximums were set in item #B above, a geographically mapped system to avoid over-charges could be applied. What constitutes an overcharge http://truecoverage.com is again decided by committee at Federal RE in much the same way that pharmaceuticals are banned when costs are unreasonable to both the insurers and the government. Because 100% of the American population is insured with Basic (unless they foolishly “opt out”) the CUSTOMER is now the dual processors of Federal RE and the private insurance company involved in each case. If cost controls are unreasonable by today’s standards to any given clinic, the quality of health care will suffer tremendously when the operating units do not get to charge whatever they want, or whatever they used to feel an insurer will pay. But when medical organizations get 100% continuity in payments through a single-payer style system with few errant delays in the simplified processing, they will actually make far more money than they do now in the world of constant claim disputes, and zero consistency. The monitoring committee, as with the prescription committees, are comprised of qualified professionals at Federal RE who understand the true economics of a hospital or clinic. Severe overcharges that are way beyond scale cannot and will not be honored. Plenty of money will still be spent for procedures (especially at the onset when the system is brand new) but the whole key to controlling price is actually not price controls as the system matures…but rather the lower cost of running a hospital and clinic when the payments are made for services with lightening speed. That’s right..there is no reason to hold up funds under the new program once the services are provided. Medical billing will be a snap, and the incredible amounts of money spent on corrective systems can be lessened for each institution. Speed of payment to medical facilities is a major factor for overall success. So is having a fairly large and very intimate accounting system to track abuses. Frequent audits will replace much of the former aggravation of charging insurance companies, and will be a much more regular event at hospitals. A strong governmental role in auditing each facility regularly is actually a pillar of this plan, and will be gone in to more detail in later articles as to who and how this occurs, and how frequently.
The American dream is still a wonderful thing. We do not have to take away the profit motive from professionals who seek their fortune through honorable health industries, medical jobs, and insurance work. We simply need to define the rules of a new system that uses the age old insurance RULE OF LARGE NUMBERS to create a national group. The same talent required to be a preferred doctor, dentist, or insurance provider still exists in a more comprehensive form. State programs and the endless bureaucracy that encompasses them are eliminated and replaced by the new system. Welfare mothers and low-income households are fully sponsored for the coverage they really need, and the investments of Federal RE: over long period of time pay for most of the built-in deficiency. Hospitals, clinics, insurers, and drug companies all have to compete on the basis of quality and product provided instead of what HMO or PPO they belong to, or what “level of care” is minimally chosen. You will find that in practice it is an absolute fact that Federal RE will actually show a small profit when the smoke clears away, and medical care will improve through TRUE COMPETITION, not the bureaucratic version of it most of us suffer with today.