The Medicare/Medicaid Bluebook

Continuous Readers here know the Author wants a major revamp of the Medicare/Medicaid program. He desires a yearly Maximum coverage couple with an immediate Co-Payment of $10 or $25 to the Health Care Provider. This goes far to limit the liability endured by Government and Taxpayer, but it impacts only Demand for Health Care. The problem of American Health Care will not be resolved with only Draconian measures to suppress Patient use of medical Procedures.

The Author proposes Congress mandate a Commission (appointed by themselves, or organized from the current Medicare administration. He suggests a fifty-fifty mix of Doctors and medical Economists)The Commission will be chartered to set the Price schedules for all Medical procedures and Products paid by both Medicare and Medicaid. The Congressional Charter will stipulate Medicare/Medicaid payments must cover the minimum cost of medical treatment by use of whatever Equipment, Drug, or Procedure possible to treat the ailment in question; but can be limited or exceed this minimal level at their discretion. Almost every medical complaint today has at least a dozen differing methods of Treatment--most variation of Drug type or Equipment utilized.

The Commission's responsibility will be to ascertain the cheapest effective potential course of treatment, which will be the amount which Medicare/Medicaid will pay. More expensive Drugs, Equipment, Procedures, and Health Care Providers will be used only if they are willing to accept the reduced rate of Payment. They will be told simply: Accept a more equitable rate of Pay, or lose your market. Congress, in the initial Charter, will have prohibited Health Care Providers from additional billing or Charges to the Insured Patients. Health Care Providers can either conform to the Pay rates, or serve the non-Insured market.

The Commission will yearly publish a Medicare/Medicaid Bluebook containing the complete list of medical treatment Pay schedules to Health Care Providers. Health Care Providers will have opportunity to appeal any Pay schedule to Congress or Commission, but all adjustments to the Pay schedules must be listed in future Bluebooks with the basic rationale for the said alteration. All Bluebooks will be available to the Public in Paperback form for $10, and must be offered for Sale in all Bookstores. lgl