Health Care Funding Plan

By Clay Romero

Romero has a plan to reduce health care costs for Mendocino County...

I first took note of how the life-flight carrier, Cal-Star, funded their program. It is an annual membership of modest cost. I wondered if such a program could be applied to funding medical care.

I found that Dr. John Muney in New York City, offered a program in his hospital clinic on a membership basis for $79.00 per month. Dr. Muney's plan worked well and his patients loved the program. However, the State of New York shut down his program because it was too much like health insurance and Dr. John Muney was not licensed for insurance. It nevertheless worked. He reintroduced his plan, at greater cost and against his personal wishes to appease the requirements of the State.

I also found another membership based provider called Christian Healthcare Ministries for $150.00 per month. This is a very good plan, but lacked the streamlined record keeping of the "Carte Vitale" French system and had no provision for justification of costs.

At this point, it became clear. A membership health care model was best for a number of reasons. Insurance companies have significant detrimental qualities. Most notably their allegience to shareholders rather than the patients and doctors they are supposed to serve. Government entities have a serious problem in that they pay so little that it endangers the financial standing of the health care provider.

Health care providers must be fairly paid and patients must be fairly served. My rally cry for health care became: Pay the people who do the work and don't pay the people who don't.

In General: Health care providers universally disapprove of both insurance company policies and government policies, because they are forced to accept a minimal payment that does not cover the actual real costs of the service and they are paid late.

The people universally disapprove of both insurance policies and government policies because they require the people to satisfy ever increasing medical and accounting service costs. This is a very inefficient use of hard earned money.

It's very difficult to start a Health Care funding plan at the national level as large insurance and pharmaceutical lobby interests would be desirous of squashing such a plan quickly in order to keep the status quo. It is preferred to introduce the plan on a local level so it can have significant resistance to usurpation.

Guiding principles:
1. Health care is not free.
2. Everyone must have health care.
3. Health care must be paid directly by the people.
4. No matter if one is rich or poor, when we are sick, we are all sick the same.

Health Care funding in America is fraught with several problems.
1. Health Care costs are brutally expensive.
2. Critical health care decisions are made by entities other than the doctor and the patient.
3. Health care providers are coerced into accepting less payment.
4. Malpractice insurance and legal abuses.
5. Expensive and time consuming accounting to control and monitor insurance fraud.
6. Costs are not well established for health care procedures.
7. Expensive medical record keeping practices.
8. Many people avoid medical care costs unless it is life threatening.
9. Overall costs of medical procedures and pharmaceuticals are unjustified.
10. Pre-existing conditions prohibit health care access.
11. Health insurance companies have incentive to minimize payments to the insured.

I propose to reduce the cost and general hassle of health care funding by:
1. Removing health care decisions from all except the doctor and patient.
2. Pay the people who do the work and don't pay the people who don't.
3. Cap malpractice lawsuits against legitimate health care providers.
4. Medical membership is not insurance. Health care providers paid directly.
5. Medical costs must be justified and guaranteed.
6. Replace medical record keeping with French style "Carte Vitale".
7. Promote preventive medicine for the benefit of the people.
8. Pharmaceuticals costs must be justified and guaranteed.
9. Pre-existing conditions don't matter. Healthy lifestyle determined by doctor.
10. Simplifying accounting, thereby making fraud very difficult to achieve.
11. Reduce the government input to making medical guidelines only.
12. This medical membership plan is voluntary for the people to decide.
13. Pay the health care providers who do the service, in three days.

---------A Unique Health Care Plan-----------

This Health Care funding plan shall be called the Mendocino Medical Membership. Hereinafter, "MMM". MMM is the non-profit clearing house for the collection and dispersal of payments. The MMM staff will be comprised of two paid employees to monitor transactions per 20,000 members. There will also be a three person revue board for assessing abuse, fraud, or other irregularities that would threaten the financial standing of the MMM, the health care providers, or patients.

Patient requirements: Those willing to participate as patients will need to become members of MMM.

This will require:
1. Address and contact information of the new member.
2. Existing medical record of the new member for incorporation into the MMM membership card.
3. A fee of $20.00 to transfer medical information to the MMM membership card.
4. A fee of $83.00 to cover the first month of the medical membership. This is a best guess starting cost.
5. If one can not pay the monthly membership fee, the cost must be covered by government.

I expect there will be a cap on medical malpractice suits to control those insurance costs. To be determined.

Healthcare provider requirements:
1. License identification as a federally recognized health care provider.
2. Address and contact information of the new health care provider.
3. A one time site license fee of $100.00 to cover MMM software required.
4. A personal computer with internet access to run MMM software.

MMM requirements:
1. MMM to provide software for working with MMM membership card.
2. MMM to provide the physical MMM membership card.
3. Promote healthy living to maintain reasonable costs for all.

How it all Works

1. A patient presents his/her MMM Membership card to the health care provider.
2. The health care provider checks to see if member has membership fees paid current.

A. If not, membership must be paid current, up to one years worth membership fees.
B. This may be brought current by the department of Social Services if required.

A. Example: Surgery, blood test, anesthesia, day of hospital recovery, would be $40.00.
B. Example: Pharmaceuticals would be $5.00 each.
C. If money is not immediately available, the charges will be added to next month's membership fee.

About the MMM Card The MMM membership card contains each members medical record in an encrypted form and is only accessible by authorized health care providers. An MMM member may choose to maintain a backup card. Additional backup MMM membership cards can be purchased for $5.00. Found cards may be returned to the MMM by simply depositing it in any US Postal Office with no postage affixed.