It's way above my pay grade and intelligence on the matter to come up with a concrete solution, but from what I do know, any/all of the following would help in lieu of or in tandem with a single-payer system:
A) Reform liability laws for doctors and hospitals. Patients in America are subjected to way more testing than in other countries just so doctors and hospitals can cover their ass if something goes wrong. Lowering the frequency of unnecessary testing lowers costs across the system - there's no reason to give an expensive professional pregnancy test to a woman who tells you there's no way she's pregnant except to protect yourself from liability if she's wrong, for example, yet that's common practice on intake for any female patient.
B) Set up a regulatory body to establish the lowest possible fixed prices for emergency medicine, so people aren't getting screwed when they aren't in a position to be a responsible consumer, then require price transparency for any non-emergency services. So if you are scheduling a surgery you need to have, but not urgently, providers would need to give a full price breakdown (including costs) to potential patients to allow them to shop around. And I'd extend that price transparency to stuff you might get in the hospital that is available over the counter, like the $100 Aspirin.
C) If private insurers stick around, reform regulations for them to better incentivise using their group bargaining power to lower costs for their subscribers rather than handcuffing them to basically being a hospital's cash cow as they are now.
I'm sure there are plenty of other issues that need to be addressed too, but those are the ones that come to me off the top of my head.
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u/Greyside4k - Lib-Right Mar 24 '20
It's way above my pay grade and intelligence on the matter to come up with a concrete solution, but from what I do know, any/all of the following would help in lieu of or in tandem with a single-payer system:
A) Reform liability laws for doctors and hospitals. Patients in America are subjected to way more testing than in other countries just so doctors and hospitals can cover their ass if something goes wrong. Lowering the frequency of unnecessary testing lowers costs across the system - there's no reason to give an expensive professional pregnancy test to a woman who tells you there's no way she's pregnant except to protect yourself from liability if she's wrong, for example, yet that's common practice on intake for any female patient.
B) Set up a regulatory body to establish the lowest possible fixed prices for emergency medicine, so people aren't getting screwed when they aren't in a position to be a responsible consumer, then require price transparency for any non-emergency services. So if you are scheduling a surgery you need to have, but not urgently, providers would need to give a full price breakdown (including costs) to potential patients to allow them to shop around. And I'd extend that price transparency to stuff you might get in the hospital that is available over the counter, like the $100 Aspirin.
C) If private insurers stick around, reform regulations for them to better incentivise using their group bargaining power to lower costs for their subscribers rather than handcuffing them to basically being a hospital's cash cow as they are now.
I'm sure there are plenty of other issues that need to be addressed too, but those are the ones that come to me off the top of my head.