Health Care Give this a thumb up or down

What say you?
This idea (proposal) will restructure, reform, and cut cost, and provide greater care for Medicare and Medicaid recipients. I see this idea benefiting those of us outside Medicare, Medicaid programs by creating competition, maybe stabilizing and possible lowering our tax rate in the future. This idea will flood the market place in time with health care professionals. Creating competition, by educating our own Medical Professionals there by creating greater access to health care for all of us. Limiting liability claims for the health care industry a must.

We have (We the people) Medicare, Medicaid (Government run health care programs already in place.)

I propose we build our own Medicare, Medicaid, Hospitals for our Medicare, Medicaid recipients in each and every County, Parrish, and District. All medical records networked from one Medicare, Medicaid Hospital to the next.
There are about 3114 Counties Parishes, Districts ect…… in the United States.
If we could build a 55,000 square foot hospital ( Medicare, Medicaid Hospital) at a cost of 13 million dollars ( See attached) within each and every County. Parish, District ect in the United States. Now taking that number and doubling it, for property, parking, equipment, and furnishings, it would cost us 26 million dollars (tops) to complete. Multiplying 26,000,000 by 3114 Counties, Parishes, and Districts totals 80,964,000,000. We now have (We the people) a Medicare, Medicaid Hospital in each and every County, Parish, and District in the entire United States. We could set it all up with some of that stimulus money. Jobs now if not but for a few and a short period of time.

We could have our own diagnostic equipment, ambulance and pharmacy right there in our own Medicare, Medicaid Hospital. All computers networked from one Medicare, Medicaid hospital to the next. A patient could go from one end of the United States to the other and there medical records and prescriptions would follow. Any outsourcing that may need to be done such as maybe heart surgery could upload and update medical records to the local Medicare, Medicaid, Hospital along with the bill to be reviewed and passed on for payment. Any local Medicare, Medicaid Hospital employee responsible for review of payment caught in the act of fraud should face severe criminal penalty.

Now let’s build our own Medicare, Medicaid manufacturing plant in say Michigan? We build our own Hospital Beds, Wheel Chairs, Walkers, ect. We now ship them to our Medicare, Medicaid Hospital for furnishings and to distribute among those that need them at home, only to be returned when no longer needed. We just did away with rental costs and who knows how much fraud.

If ninety beds per hospital, per patient, per day saved us 400.00 dollars. We would save 40,917,960,000 per year. Paying for itself in two years. Common sense says the savings will be much more than this. Probably save that much in Rental Equipment alone.

Counties, Parishes, and Districts population will vary. Keeping that in mind a 55,000 Square Foot Hospital is a fair size hospital. It will take some research as to properly distribute what’s needed where. Some will require less Sq/ft, some will require more. Some cities may require more than one Hospital. The savings will still follow.
Now about staffing the thing. How many I wonder have the gifted IQ to become a physician and not the funds. My idea would be to give free education along with room and board. Same goes for the nurses. We put them on contract stating upon graduation you come to work at the Medicare, Medicaid Hospital. We give them the option to leave us for the private sector after a stated period of time. Provided you pay us in full for the educational costs we have invested in you. Those that borrow the money to pay us back or save it them selves to pay us back will only enter the private sector creating competition and greater access to health care for everyone else… For now we staff it best we can.

All in all Medicare, Medicaid Reform can be had here. No telling how much money could be saved. Records kept on all patients at all Medicare, Medicaid Hospitals. Now think dialysis and nursing homes.

Dale Stoltz
Jacksonville Texas.
American.

Quick Construction Cost Estimate for a Hospital (2-3 Story) with Face Brick with Structural Facing Tile / Steel Frame US National Average as of 1/1/2008
RSMeans Quick Square Foot Cost Estimates

The following analysis estimates the cost to build a hospital (2-3 story) with face brick with structural facing tile / steel frame using US National Average costs from 2008 RSMeans cost data. Costs are derived from a building model that assumes basic components, using union labor for a 55000 square foot building. NOTE: Scope differences and market conditions can cause costs to vary significantly.

Hospital (2-3 Story) with Face Brick with Structural Facing Tile / Steel Frame
Location: US National Average
Stories: 3
Story Height (L.F.): 12.00
Floor Area (S.F.): 55000
Labor Type: Union
Basement Included: No
Data Release: Year 2008
Cost Per Sq Ft: $239.03
Building Cost: $13,146,505

Square Foot Cost Estimate % of Total Cost Per SF Cost
Total $182.46 $10,035,500
Contractor Fees (GC,Overhead,Profit) 25% $45.62 $2,508,875
Architectural Fees 6% $10.95 $602,130
User Fees 0% $0 $0
Total Building Cost 239.03 ,505

I will confine myself to two points -
[ul][li]Just off the top of my head, I rather doubt you can fill a hospital with equipment, duplicating whatever other hospitals are already in the county, for $26 million. [/li][li]One of the major hurdles with the electronic medical record is the cost of conversion of the old, paper formatted records. Estimates of an electronic system range between $30,000 - 40,000 per physician per year to purchase and implement. This does not include the cost of converting, which is estimated at $75 - 100 billion. (cite).[/li][/ul]
I notice you did not include the cost of setting up a bunch more medical schools and nursing schools in your plan. How much will those cost? I assume you know that they require a lot of infrastructure as well. And the AMA is a little tetchy about standards for doctors, and I imagine they will have something to say about your ideas.

Regards,
Shodan

Start with one networked software program for all hospitals. Start from scratch loading each patients file as they come in per there prospective county,parish, district.

Surly the facilities to ecucate is out there somewhere for sale on the open market We remodel to suit our needs. Cost is about 250,000 to educate a phisician. Proper group training and I believe we could cut way back on that number.

I looked around on line at various medical equipment. I was suprised to find C.T. Machines for 300,000 Ambulances for the same. E.K.G.s and such suprisingly cheap in the big scheam of things. I could not find any numbers for Dialysis machines.

I like your thinking.

What makes you think any of it is economically viable? What makes you think if the gov’t runs something it will be cheaper (offer competition, etc.). Who is going to run such facilities?

The VA already runs hospitals. Are they cheaper than the competition? Is the care “better”? What makes you say that? The profit motive is gone so the care must be better? Is that really the way things work in the private sector? Greedy people give poor care? Why wouldn’t they get run out of business?

You could make the same arguement for any industry. Why not build a car plant in each and every state, run by “we the people” to provide “competition” and “high paying jobs” for “we the people”. “We the people” will buy, build, and drive our own cars made by “we the people”. It’s gibberish.

The gov’t doesn’t have a good track record on cost estimates or cost containment.

There already are hospitals in existence, where is the value added from building new ones?

That’s the kind of thing I was talking about, and it will run you something like $30K per physician per year. And converting all the Medicare/Medicaid patient records over is where it starts getting spendy.

I worked for a number of years for a hospital system. You need multiple systems - one for ADT (Admissions/Discharge/Transfer), a payroll/HR system. plus a whole other set to do DRG/CPT/HCPCS coding. Plus the lab system, clinic scheduling (I wrote much of the software for this, and it is much more than simply adding a Calendar function to a website).

I’m sure it could be done. The question is, could it be done for less than it is already? My guess is No.

I’m not sure you realize all the myriad supplies that are used in a modern hospital (cite). And I would be surprised if you could get your pharmaceutical supplies much cheaper than the hospitals do today, and it ain’t cheap.

The basic problem of Medicare is that the baby boomers are getting old. Most of the health care costs for the average person are incurred during the first year of life, and the last five. Setting another, separate system of hospitals and medical schools doesn’t address this.

Regards,
Shodan

Hang on. I’m not an elected official making any decisions.
First of all, this is only for Medicare, Medicaid patients. These are programs already run by the government. I am not for goverment run health care. I believe for the rest us, capitalism and tort reform.

I know I was care giver for my mother for five years. I watched her die slow. We paid, you and I, over ten thousand dollars in rental fees for just her bed and wheel chair at home. I witnessed cat scans run unneccessarily over again due to lack of medical record keeping. Did you hear about the big bust regarding medicare fraud to the tune of millions just the other day.

I saw bills for over 600.00 for many ambulance rides. With our own ambulance it would cost us half that I’m sure.

How much would we save on a C.T.scan. We pay near full price now. I bet we could save at least 500.00 to a 1000.00 a pop there.

How about having our own pharmacy The recipient could pick up their meds anywhere in the U.S.and pay close to cost for the med. rather than such big mark ups.

How much would we save on the room instead of paying full price.

These are just a few examples of how we could save.

With this idea I believe we can narrow down accountability.

We are in a bind staffing it for now. We are short on professional care. That’s why if we spent the money to educate even the poorest with the proper I.Q in time that will correct itself.

Moved from General Questions to In My Humble Opinion.

Gfactor
General Questions Moderator

Ah. May I ask why those patients are put in separate facilities? Why duplicate hospitals? If there’s already one hospital in any given area, why duplicate it with anothe one just b/c those patients have different letterhead on their bills?

Why? How would the ambulance magically become cheaper? Does all the expensive equipment inside the ambulance suddenly become available for free? The scanners, too? Do the EMTs now work pro bono? And the scanner techs? What would be bringing the cost of an ambulance or scan machine down?

Explain, please.

How would we get meds at “close to cost?” Do the pharmaceutical companies … not care about <snort> their own profi<giggle> excuse me, profits anymore? (Almost got that one out.:D)

I’m all for having networks of pharmacies, and for setting up a network of connected medical records. That’s fine. But what does being able to pick up my Rx anywhere in the country have to do with the cost of the meds themselves?

(Say I own Purple’s Pharmacies. I call up Pfizer and say, “Hey, you know those boner pills you charge $50 a piece for? Well, I set up my pharmacy so that Purple’s customers can pick up their boner pills anywhere in the country! Isn’t that great!”

And they’ll say, “Oh, it sure is. How wonderful for you! But those boner pills? Yeah, they’re still fifty bucks a pop.”)

Also, this money you want spent on education. Where will the money come from? I’m not against spending $ on education - I just want to know how you’re going to get the money in this scenario that you’ve set up.

My post above might come across as snarky, but I’m genuinely trying to get more information. I can’t give this a thumbs-up or -down as is.

When you own the store the goods come at cost.

But if you sell them for it you aren’t in business for long.

Regards,
Shodan

I like that. We must come up with number that will keep it afloat and provide the best care anywhere yet save us being taxed so heavily.

Any body out there? I’m still looking for my thumbs up or down. I value what you think.
Did you know if we charged ourselves full price we would develop a surplus.

:confused::confused::confused:

So … is Pfizer setting up the pharmacies? And Bayer? Cuz they’re the ones who own the goods.

You’re implying that the various pills etc. out there don’t cost all that much, and that the “store” i.e. the pharmacies are running up the charges.

Walgreen’s isn’t doing *that *well, dude.

The “big mark ups” you’re talking about? It’s the pharmaceutical companies that are making the multi-bazillion-dollar profits. Not Walgreen’s.

Did you know the hospital will charge you five, six, seven dollars for an asprin?

They don’t actually. They have huge fixed costs and that is their way of spreading it onto patients. If everyone brought their own aspirin from home the hospital would have to get the missing revenue by charging more for other services.

Instead of looking at a hospital’s incredible profit on ONE aspirin, look at the profit of the ENTIRE HOSPITAL. Surely, charging $6 for 2 cent aspirins must mean that hospitals are a hugely profitable business. But they aren’t. Where does the money go?

You’re trying to replicate what the free market is doing because you can do it “cheaper” and “better”. There’s no evidence that the gov’t can do any of that. The idea of one hospital per county or parrish is just pulled out of a hat. There already are hospitals, plenty of them. Why not build more auto plants while you’re at it? Existing auto plants are idle and closing so why would it make sense to build more?

I agree with you on the asprin thing. I know you are right about that. It was a quick retort to what sounded like someone who has never even run a lemonade stand. You might want to read it again and think it through. I wish you would anyhow.