Thursday, October 30, 2014

Let's fix Obamacare & properly handle infectious diseases in NY


Today, I expanded on my commitment to fix Obamacare and properly handle infectious diseases in the city.

As it relates to healthcare:

Increase community health centers and hospitals  by boosting incentives and promoting Public-Private Partnerships (PPP) that will increase access to high quality healthcare in NY7: 

PPPs improve service delivery by allowing the government to concentrate on setting policy and serving the public while the private sector takes responsibility for all other costly functions such as operating and maintaining the buildings. They are more Cost-effective by being able to manage costs more effectively than the public sector, PPPs will result in lots of savings that can be used to fund other needed services.   They increase investment in public infrastructure.  With PPPs the private sector would be investing their own funds in hospitals to serve our community. This reduces the initial capital cost taken-on by the city and controls its overall debt.  They reduce public sector risk:  This transfers the financial risk of the construction to the private sector, which is very willing, because they are more capable of managing buildings at a more cost-effective way to get a better return of their investment. This will result in a faster delivery of projects and higher levels of service for the people.

Reform Medicare: Give Seniors Better Choices.     

Older Americans should have access to coverage similar to the insurance plan Congress has and Medicare should also receive all the funds needed to reach solvency.

Without major reforms to the program, there is simply no way for the US to address the federal deficit, contain the national debt, or save Medicare itself from collapse.

By 2030, when the last of the Baby Boomers retires, there will be 77 million people on Medicare, up from 47 million today, and there will also be 30% fewer working people funding the program benefits of this much larger retiree population.

The primary cause for Medicare’s troubles is its enormous increase in costs.
Healthcare inflation has risen 48% last decade alone compared to the only 26% of the economy.
Providing a more expensive service to a rapidly growing population and at the same time drawing on a fast-declining group of taxpayers is a recipe for disaster. Therefore, it is impossible to fix this problem only by increasing the taxes that fund Medicare.


Solutions:

a.     Adjust the eligibility age for Medicare. Inducing more middle-aged people to remain in the work force will decrease the ratio of number of retirees per worker.

b.     Restore the tax subsidies (eliminated by Obamacare) that encourage employers to maintain private health coverage for retirees. This would take some of the burden off of Medicare.

c.     Engage private insurers in a competitive bidding war for equal health coverage of the elderly. Retirees who choose plans that cost less than the average bid will retain three-fourths of the savings by having it applied to any deductible.

d.     Address the problem of Medicare fraud. It is estimated that 8% and 13% ($60 to $100 billion) of the total spending of Medicare is fraudulent. Medicare processes over one billion claims per year, and is required by law to reimburse claims within 15 to 30 days. This makes it almost impossible to prevent criminal activity.


Increase tax credits to small businesses:  

Obamacare has dramatically increased the costs of health insurance forcing small businesses to reduce the amount of hours of their employees. Tax incentives will help them mitigate this cost.  The Small Business Health Care Tax Credit helps small employers afford the cost of providing health care coverage for their employees. Employers that have fewer than 25 full-time employees, pay average annual wages below $50,000, and contribute 50% or more of insurance premiums qualify for a credit of up to 50% to help offset the cost.

I believe that this incentive is still too low to motivate a small business to increase its operating costs by adding health insurance as a benefit to their employees.  This credit should reach 75% during the first three years and gradually decrease to 50% throughout the next five.


EBOLA:  Create a specialized First Response Unit for Highly Infectious Diseases

We are lucky to live in a city that has 8 hospitals that have been designated as Ebola ready, none of which are in District 7.  However the most crucial part of intervening with a possible Ebola case is right at the beginning, during the first response.  As soon as a there is an indication of a possible exposure to this disease the first team deployed should be a highly specialized one.

Even though our First Responders in NYC are all very well trained to handle this situation and have all the equipment necessary to keep them safe, a highly specialized group of responders with new and more specialized equipment could immediately eliminate any risk of any further cross-contamination.  This team should be equipped with a portable isolation pod that can be quickly transported to the site where the patient can be immediately enclosed in the pod to avoid any other human contact and any further contamination of the premises. The patient will remain in the pod during the transfer to the nearest Ebola safe facility. The more isolated we keep the patient the higher the probabilities of success in eliminating any threat.

We know that Ebola may not be the only highly infectious disease which we will have to deal with in the future, so creating a highly specialized team to immediately isolate and transfer these patients will virtually eliminate any possible threat to our community.


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