Vote on Obama care changes scheduled for today is depressing. The debate is all about coverage,and how the changes will affect coverage. But coverage is the wrong number to look at. Life expectancy is clearly better than coverage as an indicator of healthcare, though still flawed to be sure. And a few years into Obamacare life expectancy just declined for the first time in many years.  Funny considering all the talk about obamacare death panels. Our central planners in Washington don’t know what they don’t know and they’re forcing all their attention to to the wrong things because that’s what creates opportunities for graft for them.

This short essay on US healthcare is good,  but stops short of  naming names of “vested interests who built sweetheart deals for themselves into … the system”  But I will. Vested interests from Obamacare are trial attorneys, liability insurance companies, government employees (but, of course) +. drugs companies  (versus medical Device companies that got taxed) & large corporations (versus free lancers). The list suggests way to reform US healthcare, especially if one filters for ways to reduce cost of healthcare and access to it. Forget about coverage for 5 minutes.  Here is my list:

1.  Allow limited liability services, drugs, and devices. Sophisticated buyers of technical services like Boeing, Exxon, and Intel demand complete transparency with respect to their supplier’s insurance. Some contracts may require $1 million a professional liability service, others might require 10 million.  And these big corporations are very savvy about understanding that lower insurance requirements equal lower prices.  US Healthcare consumers we would benefit from similar leverage and choose.  Healthcare  providers might offers services with different tiers of liability, say $50K, $500k and $5 Million.  Allow  insurers to offer health insurance policies that pay only low liability price.  Have Medicare and Medicaid pay only on the low liability price.

2.  Make drug prices same in USA as elsewhere.  The only thing stopping us is the FDA, and our patent judges.  See more here. Note that anyone who tries to say that healthcare is better in Europe because of single-payer, socialized healthcare, and uses life expectancy to back up the claim, has no real way of knowing if better life expectancy is due to the single-payer, socialized model  rather than the wider assortment of drugs and devices that are available in Europe compared to USA. It may be the case that all we need is the freedom to heal ourselves.

3. Lots of countries to our south get a lot of bang for the buck in healthcare by making many more drugs over the counter.  We need that same right here in USA.  Pretty obvious the vested interests opposing this – doctors, nurses, AMA, Plannned Parenthood.  They change the price of lots of simple drug treatment from $40 to $200.  That’s why it will bi-partisanly opposed with the ferocity of the Japanese at Iwo Jima.

4. Modify Medicare so all healthcare cost for the patient’s last 6 months of life plus half of payments from the previous year (months 6 to 18 before death) come from the patients estate, if there is one.  I expect big savings out of this one.  Medicare spends a big portion of its money on people with a few months to live.  Would be smart to pair this reform with lowering estate tax rates to rates like 5%..

5.Allow policies that do not cover treatment for mental health, IV drug abuse, and sex change procedures.  Inevitably mental healthcare is more prone to fraud and indulgent overuse.  And fraud is a big part of our healthcare costs, more than Drug company profit. IV drug users take more than their share of health care dollars. They need to own that.  Sex change procedures are expensive and if people want to have them it’s fine to do so.  But other consumers should not have to pay for that cost anyone than great implants or other cosmetic surgery is covered with healthcare.  All of these should be private expenditures.

6. Allow polices that discount for documented regular exercise. Set up some good incentives, you know. Fitbit and the other fitness trackers would use a boost.

7. Keep the mandate, but make the penalty for no insurance go into uninsured person’s HSA instead of to government employees. Allow catastrophic policies which may be a better deal for many young people and people with large HSAs.