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Better health care is the key to solving the ‘repeal and replace’ problem PDF Print E-mail
Written by JOHN TORINUS   
Wednesday, 19 July 2017 18:49

   The Republican Party has driven its “repeal and replace” legislation into a box canyon. It isn’t selling with the American people. But there is a way out.
    I have talked with many of the great innovators in the delivery of health care over the last decade, and they have come up with a far better business model.
    Based on those insights, I am offering this speech to House Speaker Paul Ryan free of charge:
    My fellow Americans:
    The debate over U.S. health care has carried us way off track. We have spent far too much time on insurance reform and not enough time on real reform of the delivery and cost of care.
    I look to my own state of Wisconsin for innovations. The following breakthroughs have been tested and proven to work in my state and elsewhere.
    n Provide primary care for every family or individual. Some call it a medical home. Many company plans already offer this huge benefit. They do it because it’s the right thing to do, and because it saves big money by helping them avoid the hospital. QuadGraphics created its first medical home here in 1990 and has saved more than 20% in health insurance costs. Every health plan, whether funded by a company, by the government or through an insurance policy, should provide proactive primary care.
    n Set single price for most procedures. Car repair shops give you an estimate, and they must call back if the price is going beyond what they quoted. Clinics and hospitals must do the same. I know they can do it, because companies in my back yard are contracting for “bundled prices.” They are saving as much as 50% on elective of care.
    n Do you cringe when you enter a hospital, fearful of either an infection, a medical accident or an astronomical bill? I know my family does. There is a fix. It’s called lean health care, the same kind of disciplines that car companies have applied to sharply improve the quality of their vehicles. Several Wisconsin hospitals have led the charge to lean practices, and they have driven out waste, sharply lowered costs and eliminated defects, such as infections that can prove lethal.
    Premiums will come down if people stay healthy through proactive primary care. It’s the underlying costs that matter.
    We will need to create insurance pools for people with catastrophic issues. A tax on each insurance policy, whether the insured is on an employer plan or individual policy, will fund the high-risk pools.
    We will ask employers to continue to offer coverage. By and large, they have done a great job with their plans.
    And we should scrap Medicaid for people who can’t afford care in favor of a model based on Medicare Advantage, a far better managed program.
    Both parties should see a lot to like in these proven best practices. Let’s hammer out a bipartisan plan that works for all. Only bipartisan legislation will stand the test of time.
    Torinus, of West Bend, writes about health care and political issues on his blog at

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