Comments on: Doctors at “house party” deplore destructive “reform” ideas http://www.aapsonline.org/newsoftheday/00119 from the Association of American Physicians and Surgeons Thu, 07 Apr 2011 16:47:01 +0000 hourly 1 http://wordpress.org/?v=3.3 By: Lawrence Mallette, MD, PhD http://www.aapsonline.org/newsoftheday/00119#comment-2262 Lawrence Mallette, MD, PhD Wed, 04 Feb 2009 05:54:18 +0000 http://www.aapsonline.org/newsoftheday/?p=119#comment-2262 I have posted the following open letter to Obama on my MySpace Blog at <>. I will copy it here. It expresses the basic principal that must be followed to arrive at a reasonable system> Open Letter to President Obama: Health Care Solution Category: News and Politics Houston, TX April 3, 2009 Dear Mr. President, Here are the basic principals upon which a sound, sustainable and ethical health care system can and should be built:.... 1. It shall be illegal for physicians to contract with anyone other than their patient or patient's legal representative. There shall be no contracts with the government, with any "managed care" entity or insurance company, or with any other third party..... 2. It shall be illegal for physicians to receive payment directly from a third party "payor." Payment must come from the patient directly and shall be made at the time of service..... 3. It shall be illegal for third parties to request discounts from a physician for their clients. The price for various services is to be negotiated between patient and physician, as is the case with all other professions. .... 4. Each American citizen shall have a Health Savings Account established at birth. The HSA will be maintained with an investment firm or bank, the accounts being insured by the Federal government to the amount of $150,000, as are bank deposits. Increases in value on these accounts via interest, dividends or increases in investment value are not taxed, and these assets are protected from creditors, as with the usual IRA. (Regulations will need to be developed regarding the type of investment, allowing a certain low percentage to be invested in more volatile investments.) Funds in the HSA can be spent only for Health Care, but can be passed on to heirs as would an IRA, to be used for the heir's health care needs. .... 5. Each American citizen shall be able to exclude from taxation the amount of $5000 per year (adjusted for inflation) for deposit in his or her Health Savings Account, with catch up contributions allowed if the prior year's expenses exceeded this amount. There is no limit to the total amount of capital the citizen can accumulate in his or her HSA. .... 6. Businesses can no longer subtract from taxable income any payments to "insurance companies" for health insurance plans. They can, however, deposit money yearly into thier employees' HSAs as a salary expense, the yearly maximum contribution per employee to be determined after study by qualified economists. .... 7. Each American citizen shall have a catastrophic health insurance plan in place that covers yearly health care expenses over $20,000 (adjusted yearly for inflation). This plan will be sponsored and financed by the Federal Government. See Comments about administration of this plan..... 8. Citizens with income below the poverty level will be provided yearly with a "tax rebate" from the Federal Government, deposited directly into their HSA..... 9. The government will mandate that the states educate every citizen about this "self-reliant" system. Every citizen must realize the need for preventive health care and a healthy lifestyle. They must realize that prudent use of these funds and maintaining a healthy lifestyle are the surest route to security. They must be made aware that contribution yearly to the HSA must come before purchase of consumer goods, a new car, or a vacation, for example. There will be no free “safety net” other than the catastrophic coverage..... 10. Citizens who become ill before they have accumulated sufficient funds in their HSA to cover the "gap" (whose HSA balance falls below zero in a given year) will be LOANED the needed funds by the Federal government, to be repaid with interest in the future. This loan will show up on their credit report and will influence their ability to borrow for other purposes until it is repaid. .... Comments..... This plan relies on human nature to reduce costs. When payment is coming directly from funds controlled by the patient, the patient will make wiser choices. There will be less desire to obtain expensive tests that are marginally indicated for a minor complaint or to obtain expensive tests when less expensive tests will do. Less expensive, but equally effective, medications will be demanded by the patient..... With this system, the medical profession will be restored to an ethical status, it being unethical to allow outside influences to intrude on the physician-patient relationship (as contracts with third parties invariably do). .... The public will demand transparency and equality in pricing of services and will cease to tolerate overpriced services. .... The nation will then be pooling risks that are in the catastrophic range, rather than simply using the "insurance industry" as a (leaky) conduit of money from employer to physician or hospital for everyday care. .... With prudent living and prudent saving, within five to six years each citizen will have in their HSA sufficient funds to cover the $20,000 "gap" in any one catastrophic year, and within ten or so years should have the funds to cover the gap for several years of catastrophic ill health. With good health and good planning, these funds can be passed from generation to generation, allowing those families with good health to become fully covered with only rare intervention by the government. .... The government can negotiate with the current managed care industry to obtain management of the catastrophic funds with minimal administrative expense, or can set up its own administrative agency (to replace the current CMS, for example) to manage and administer the catastrophic coverage program..... Physicians will now be free to concentrate on what they do best, care for patients and maintain their knowledge base, and will no longer have to waste time dealing with managed care contracts and meaningless requests from managed care companies. .... I urge you not to let the powers that be within the current managed care industry or withn the established government agencies to bring pressure against the adoption of such a rational and beneficial plan..... Respectfully yours, Lawrence E. Mallette, MD, PhD, FACP, FACN I have posted the following open letter to Obama on my MySpace Blog at
<>. I will copy it here. It expresses the basic principal that must be followed to arrive at a reasonable system>

Open Letter to President Obama: Health Care Solution
Category: News and Politics

Houston, TX
April 3, 2009

Dear Mr. President,

Here are the basic principals upon which a sound, sustainable and ethical health care system can and should be built:….

1. It shall be illegal for physicians to contract with anyone other than their patient or patient’s legal representative. There shall be no contracts with the government, with any “managed care” entity or insurance company, or with any other third party…..

2. It shall be illegal for physicians to receive payment directly from a third party “payor.” Payment must come from the patient directly and shall be made at the time of service…..

3. It shall be illegal for third parties to request discounts from a physician for their clients. The price for various services is to be negotiated between patient and physician, as is the case with all other professions. ….

4. Each American citizen shall have a Health Savings Account established at birth. The HSA will be maintained with an investment firm or bank, the accounts being insured by the Federal government to the amount of $150,000, as are bank deposits. Increases in value on these accounts via interest, dividends or increases in investment value are not taxed, and these assets are protected from creditors, as with the usual IRA. (Regulations will need to be developed regarding the type of investment, allowing a certain low percentage to be invested in more volatile investments.) Funds in the HSA can be spent only for Health Care, but can be passed on to heirs as would an IRA, to be used for the heir’s health care needs. ….

5. Each American citizen shall be able to exclude from taxation the amount of $5000 per year (adjusted for inflation) for deposit in his or her Health Savings Account, with catch up contributions allowed if the prior year’s expenses exceeded this amount. There is no limit to the total amount of capital the citizen can accumulate in his or her HSA. ….

6. Businesses can no longer subtract from taxable income any payments to “insurance companies” for health insurance plans. They can, however, deposit money yearly into thier employees’ HSAs as a salary expense, the yearly maximum contribution per employee to be determined after study by qualified economists. ….

7. Each American citizen shall have a catastrophic health insurance plan in place that covers yearly health care expenses over $20,000 (adjusted yearly for inflation). This plan will be sponsored and financed by the Federal Government. See Comments about administration of this plan…..

8. Citizens with income below the poverty level will be provided yearly with a “tax rebate” from the Federal Government, deposited directly into their HSA…..

9. The government will mandate that the states educate every citizen about this “self-reliant” system. Every citizen must realize the need for preventive health care and a healthy lifestyle. They must realize that prudent use of these funds and maintaining a healthy lifestyle are the surest route to security. They must be made aware that contribution yearly to the HSA must come before purchase of consumer goods, a new car, or a vacation, for example. There will be no free “safety net” other than the catastrophic coverage…..

10. Citizens who become ill before they have accumulated sufficient funds in their HSA to cover the “gap” (whose HSA balance falls below zero in a given year) will be LOANED the needed funds by the Federal government, to be repaid with interest in the future. This loan will show up on their credit report and will influence their ability to borrow for other purposes until it is repaid. ….

Comments…..

This plan relies on human nature to reduce costs. When payment is coming directly from funds controlled by the patient, the patient will make wiser choices. There will be less desire to obtain expensive tests that are marginally indicated for a minor complaint or to obtain expensive tests when less expensive tests will do. Less expensive, but equally effective, medications will be demanded by the patient…..

With this system, the medical profession will be restored to an ethical status, it being unethical to allow outside influences to intrude on the physician-patient relationship (as contracts with third parties invariably do). ….

The public will demand transparency and equality in pricing of services and will cease to tolerate overpriced services. ….

The nation will then be pooling risks that are in the catastrophic range, rather than simply using the “insurance industry” as a (leaky) conduit of money from employer to physician or hospital for everyday care. ….

With prudent living and prudent saving, within five to six years each citizen will have in their HSA sufficient funds to cover the $20,000 “gap” in any one catastrophic year, and within ten or so years should have the funds to cover the gap for several years of catastrophic ill health. With good health and good planning, these funds can be passed from generation to generation, allowing those families with good health to become fully covered with only rare intervention by the government. ….

The government can negotiate with the current managed care industry to obtain management of the catastrophic funds with minimal administrative expense, or can set up its own administrative agency (to replace the current CMS, for example) to manage and administer the catastrophic coverage program…..

Physicians will now be free to concentrate on what they do best, care for patients and maintain their knowledge base, and will no longer have to waste time dealing with managed care contracts and meaningless requests from managed care companies. ….

I urge you not to let the powers that be within the current managed care industry or withn the established government agencies to bring pressure against the adoption of such a rational and beneficial plan…..

Respectfully yours,

Lawrence E. Mallette, MD, PhD, FACP, FACN

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