ACTUAL MEDICARE REFORMS

It is absolutely essential to reform Medicare.  Reforms should not seek to "ration" care but should "intelligently redesign" the system with at least the following fundamental reforms.

01.  Place "STATUTORY CAPS" on federal health care spending.  Currently the system is "open-ended" and spending is not capped.  Therefore, there is no sensitivity to the issue of "price."  Introduction of consciousness of price in the system is imperative if we are going to stem the rampant inflation.  There must be incentives to control costs which incentives are conspicuously lacking today.

02.  Raise Part B and Part D premiums cutting substantially the projected funding shortages by gathering more funding upfront which will putting more of citizen's skin in the game.  This act alone will get the attention of the citizens who will predictably take steps to further develop health conscious lifestyles to help prevent both chronic health conditions and to prevent further reductions in their discretionary income.  Increased premium in these areas will further encourage judicious use of their access to the health care system.

03.  Raise the eligibility ages for coverage in installments over 10-20 years.  This will require coordination of coverage with the private sector which may need to extend beyond age 65.

04.  Improve coordination of care among providers with a new electronic data base allowing all physicians, pharmacies and other related parties to access the same system with the object of not just coordination of care but a transparency that does not exist now with special emphasis on preservation of privacy and protection of identity etc. etc.

05.  Encourage education, prevention and wellness.  Treat the wound before amputation is necessary and cost will reduce by definition.

06.  Develop Accountability Based on Outcomes by moving away from "Fee for Service" compensation models and encourage reward for the more intelligent practice of medicine by paying doctors as measured against their peers for the aggregated results of their patient bases.  Those who move a greater percentage towards more positive outcomes are compensated more richly for their superior performance than those that do not move their patients as meaningfully forward against the same metrics.