Necessary policy changes include addressing the pre-existing conditions coverage that is really no coverage at all and the coverage of care after involuntary separation from employment needs to be addressed as well. Quality issues with health care are certainly a policy issue when speaking about Medicare and Medicaid reimbursement and subsequent outcomes from procedures supported with federal dollars. Additionally, institutions such as nursing homes and skilled nursing facilities are often heavily supported with federal dollars and often have horrible results when speaking of outcomes measurement in areas such as pain management, and susceptibility for a DU type I-IV, which is a skin ulcer of increasing severity.

Therefore, the options must be comprehensive to address these aforementioned issues in a cost-effective manner. What the policy must not do however is add additional bureaucracy to the system or produce excessive waste onto the system. Such options should increase the availability of the types of coverage an individual with or without coverage can choose. The cost of these options should also remain affordable, such that it may not go over a certain percentage of an individual's monthly income.

Solution

The proposed solution is to facilitate a comprehensive framework to provide structure to the public health care market. The private health care market is essentially a separate matter as individuals that want to receive care at what would normally be considered to be out-of-network medical facilities, can afford to pay the difference between the insurance coverage and the hospital charge. Surprisingly, the private health care system is not broken, as these institutions are generally supported by medical research grants and additional money that comes in, such as from foreign patients that can pay out of pocket for services.

Certainly, the public health care system does not have such clientele rendering their services. Actually, it's quite different, as many resident aliens receive care with no documentation for the billing department to charge for services. Gang members whom are often shot in major metropolitan areas where public hospitals exist also represent a large statistic of Emergency Room...

Many times, these services go without reimbursement from insurance and are not paid for in full by the patient. Hospitals have a fund for these types of cases however, they often still operate at the margin.
The solution is to provide full coverage to all individuals as a function of the property, or address on file. A card is mailed to each residence, and actuaries estimate the risk pool cost for a given number of population within a radius of each public hospital. A property tax is apportioned to each property as a function of the cost in the perceived risk pool. With insurance provided to these populations, public hospitals will accrue less debt and enable greater care by increasing the velocity of patient services as the staff now knows that the patient is able to pay and can provide billing information in a timely fashion.

Samuelson, R.J. (2007, Feeling thick as a BRIC? we can help.: [U.S. edition]. Newsweek, 150, 55. Retrieved from ?

http://search.proquest.com/docview/214264580?accountid=13044

Hartman, M., Martin, a., Nuccio, O., & Catlin, a. (2010). Health spending growth at a historic low in 2008.Health Affairs, 29(1), 147. Retrieved from ?

http://search.proquest.com/docview/204517225?accountid=13044

Scott, J.S. (2003). The doctor takes charge: Healthcare prospects brighten under new senate leader.Healthcare Financial Management, 57(2), 32. Retrieved from?

http://search.proquest.com/docview/196370861?accountid=13044

http://politifact.com/virginia/statements/2011/jan/15/eric-cantor/cantor-says-health-care-reform-collects-1o-years-t/

http://www.ftc.gov/reports/healthcare/healthcarerptexecsum.pdf

Samuelson, R.J. (2007, Feeling thick as a BRIC? we can help.: [U.S. edition]. Newsweek, 150, 55. Retrieved from ?

http://search.proquest.com/docview/214264580?accountid=13044

Hartman, M., Martin, a., Nuccio, O., & Catlin, a. (2010). Health spending growth at a historic low in 2008.Health Affairs, 29(1), 147. Retrieved

Scott, J.S. (2003). The doctor takes charge: Healthcare prospects brighten under new senate leader.Healthcare Financial Management, 57(2), 32. Retrieved