The Challis Bipartisan List of 21 Things Government Should Do to Reform Health Care

I don't want my mostly Democrat family to assume they know Danny's and my opinions about health care and health care reform, so I will explain what we think on my blog.

Danny and I have done a lot of talking about health care. It's interesting to us, because most of the past year and a half I have been pregnant. We were forced to learn how to maneuver through a corrupt and miserable system. This complex issue is one we entirely agree on.

Instead of listing our complaints with the current system, I will share what we think can be done to make a better one, and from that you will have some idea whether or not what we think is Republican, Democratic, Libertarian, or just intelligent. Regardless, we've come to these conclusions because WE think they are intelligent, not because they are one or another party's platform. Whether or not you agree is your own affair, but at least you will not assume that my politics are based on goodness knows what. Be aware, we are willing to discuss these issues, which sometimes causes us to change our minds! Imagine that.

In no particular order...

1. Government should have a limited role in mandating health procedures.
My Aunt Yvonne made a good point with the PKU testing: some mandated tests are great. My mom brought up gestational diabetes. Again, we don't object; those are both random conditions that could happen to anyone. We object to being forced into tests for diseases which are NOT random, which we know we do not have. However, some health procedures really are for the good of the country. Some vaccines are absolutely necessary, and should be sanctioned by the government (and in some states, they are; vaccines are a state-to-state issue). We think that some tests can make our country and states safer.
Libertarians support some of this, Democrats support some of this, Republicans support some of this, but we support it because we think it's intelligent.

2. Government should reevaluate laws as technology changes.
The law must be allowed to change, though. Some time in the next 10 to 15 years, Danny says that everybody will have a copy of their genome attached to their medical records. A genome is a map of a person's genetic code. It can tell you a plethora of information about that person's health care situation and needs. Currently, accuracy of a genome is between 97.5-99.95%, and accuracy only increases. We predict that in the next 10-15 years, a genome's accuracy will be so close to 100%, it will be a highly reliable and valuable tool. Many genetic diseases can be ruled out by analyzing this data. Therefore, the laws must be allowed to change with the technology. If, at some point, a look at a person's genome can determine whether or not they have a disease, we had better change the laws regarding government mandated testing! Currently, laws have not caught up with technology, and there are thousands of bioethics suits waiting in the courts, which will decide the future of health care.

So far, we have not heard any party talk about this. We have no idea who would or would not support this. We support it because we think it's intelligent.

3. Government should enforce laws requiring a minimum standard of care, but private entities can impose higher standards on themselves.
Government requires children to be educated in grades 1-10. They do not require all students to get masters' degrees. We believe it should be the same with health care. States should agree what is a minimum standard for their state, and enforce these laws. Whether or not a hospital or physician's office has higher standards should not be decided by the government. This would allow people more opportunity to "shop" for providers and hospitals.
Mostly Republicans support this, but we support it because we think it's intelligent.

4. Government should sanction Medical School Reform
Doctors are over-educated. They spend 7+ years developing their overconfidence and pride. This means that holistic health ideas are overlooked as too simplistic, or not scientific enough. Often those same holistic methods would be cheaper, less invasive, and more beneficial to the patients. For example, maternity care costs could be significantly lowered if midwives were legitimized and accepted as being worthy of administering care to low-risk pregnancy patients. Also, we need to attract people to the medical profession by changing medical school requirements, lowering the cost of a doctor's education, and making it easier to become a general practitioner.
We have not heard any party talk about this, but we think Democrats would more likely support it because they are more progressive in their ideas about education, and they are more willing to make new laws. We support it because we think it's intelligent.

5. Government should sanction ongoing Doctor Education
In order to have a license to practice medicine, a doctor should continually take classes on new scientific developments, methods, and discoveries.
We have not heard any party talk about this, but again Democrats would be more likely to support it; they are in favor of more regulation of businesses. We support it because we think it's intelligent.

6. Government should require doctors and hospitals to have a Schedule of Costs of Procedures
What a procedure should cost should be transparent to a patient as they go into the hospital or doctor's office. This can fluctuate with the market by day, week, month, or year. We understand that currently, this is impossible because of the mere existence of health insurance companies. However, we don't see why the hospital can't say, "Having a vaginal birth will be $2,500 for all of our patients, and if you have one of our preferred providers, it will be $2,000." Transparency is good. Transparency lowers costs and allows families to budget.
We have not heard any party talk about this, but we believe it is something Democrats would be more likely to support. They value transparency, and regulation of business. Though Republicans want less regulation of private businesses, like Hospitals, we think Republicans also value transparency, and could support this. We support it because we think it's intelligent, and because it's absurd that we can't plan the cost of a pregnancy before the pregnancy. Or even almost a year later!

7. Government should enforce laws about Hospital Billing Procedures
Currently, we know that you can wait up to 8 months to get a hospital bill because we haven't gotten Jane's yet! This is absurd and should be illegal. Patients should know what they owe when they leave the hospital or doctor's office.
Democrats would more likely support this idea because they like regulation. We support it because we think it's intelligent.

8. Government should enforce laws that prevent Pharmaceutical Companies from courting Doctors
Currently, Pharmaceutical Companies give doctors huge gifts of cash, vacations, and parties if they agree to prescribe x amount of their product per year. There is a huge conflict of interest in this situation and it is unethical.
This truly is a case where we don't see how any party could possibly argue that the current situation is acceptable. Probably Democrats would more likely support this, again, because they like regulation; we support it because we think it's intelligent.

9. Government should enforce laws that regulate Pharmaceutical Companies' CEO's profits
Danny says he wouldn't mind this, because it is such a tiny drop in the bucket that it ultimately doesn't matter very much. I think it would do a lot to help eliminate corruption. 
Definitely this would be mainly supported by Democrats, we support it because we think it's intelligent.

10. Government should offer low interest loans to new Health Insurance Co-Op programs
Currently, there is no free market for Health Insurance. The employer's provider trumps all. But what if there were Co-Ops, not for profit organizations like Credit Unions, where all the profit goes back to the members? These Co-Ops could be great models of efficiency, especially because members would get to join one which has members with similar health needs. Student Health Insurance at BYU was great for us at the time because we didn't have to pay high premiums for things we didn't need, like prescription drugs, but it had great maternity coverage (as many BYU students have babies before leaving the plan). Danny doesn't have much in common health-wise with his co-workers; why should he be forced to pay for their prescription drugs or smoking habits or whatever else in his premium? A free market for health care can spring out of nowhere if the government is willing to front the expense.

Republicans first had this idea, and continue to fully support it. We support it because we think it's intelligent. We have had a great experience with our Credit Union and co-op-esque Student Health Insurance. We think this would work very well.

11. Government should expand medicaid and WIC type programs
Medicaid is a good program. The standards should be reevaluated and the program vastly expanded, possibly to help cover some of those 30 million uninsured.
From what we understand, Republicans support this idea. We support it because we think it's intelligent.

12. Government should get rid of medicare
Just because you are old does not mean that you should get free health insurance.
Again, from what we understand, only Republicans support this idea. We support it because we think it's intelligent and more fair.

13. Government should establish what "the Right to Health Care" means.
If Americans decide that health care should be a right, we need to have precise language about what that even means. Right now, politicians from either camp just assume that it is a right or isn't, but all of them disagree on what "health care" means. We need language to clarify this matter.
Republicans are begging for this discussion. We don't see how we can get anywhere without establishing this, no matter in which camp you lie. We support it because we think it's intelligent.

14. Government should enforce laws that require online medical records for patients
Americans are too mobile to truly have a permanent, life-time primary care physician. When they move, their records should be easily accessible by their next physician. And when they go into an ER, the records should be accessible to the strangers who will need to diagnose them without knowing them.
Democrats came up with this idea. They claim that this will reduce costs drastically. We don't think it will be a huge decrease in costs, but it will greatly improve efficiency and safety of patients. We support it because we think it's intelligent, and we love technology.

15. Government should offer incentives to Health Insurance Companies who offer incentives for becoming and staying healthy
Like car insurance, where you can get "safe driver" discounts, your health insurance company should give you a discount for going to a yearly physical, and improving your health in ways over which you have control, such as choosing to smoke, drink, exercise, etc.
Again, government meddling in private business is a Democrat thing. Republicans would prefer incentives to laws, and we could see them supporting this. We support it because we think it's intelligent.

16. Government should offer low interest loans to hospitals or private companies who build an  Urgent Care Facility within sight of an Emergency Room
ERs are a huge problem right now. They raise the cost of health care for everyone, mainly because so many Americans use them as their "Primary Care Physician." Urgent Care centers are more affordable because they only treat certain problems, they are open only during certain hours, and they don't have as much expensive equipment. Certainly not all, but MANY patients' problems would be more properly addressed in an Urgent Care Facility. If there were UCF's in direct proximity to ER's, intelligent patients would choose to go to the UCF, if it were open. This would significantly lower the cost of unpaid ER bills.
We think this is originally a Republican idea, but surely Democrats would support it! We support it because we think it's intelligent.

17. Government should enforce laws that dictate hospital employees informing ER patients about the Urgent Care Facility
Unintelligent, illiterate, or uneducated people should be given a choice about going to the UCF. They should be informed about what it is, why it may be better suited to their problem, and what the exact cost difference would be.

We think that the main supporters of these laws would be Democrats. We support it because we think it's intelligent.

18. Government should offer more incentives to families for having children
The ratio of young to old right now is a huge reason why our country is having such problems with health care. The rising generation is smaller than the younger generation, the baby boomers, who are entering the years where they have greater health care needs. If the ratio of young: old is larger: smaller, we would have fewer problems because there would be more people available to pay premiums and taxes.
This is a Republican ideal. Libertarians think any kind of government interference in one's private life is a bunch of baloney. We think most Democrats are more worried about population increase than population decrease, even though typically they are more prone to complicate the tax code. We support it because we think it's intelligent and because we want a lot of children!

19. Government should make elective abortions illegal. Government should protect the unborn as it does the living children in its jurisdiction.
     Well, for one, this would fix our population predicament. To us, the argument of medically necessary abortions to save the mother's life, or abortions due to a horrible forced rape are so comparatively rare that they don't warrant much discussion here; they are a separate issue. Maybe there should be laws that allow abortions in some cases, yes, but maybe making all of them illegal would be better in the end. In our opinion, focusing on these cases too much avoids the main issue, which is that the vast majority of abortions are, sadly, elective. This should be illegal. We believe abortion is or could be murder. The point is, nobody knows for sure. We cannot gamble when it comes to something as important as a life.
     We strongly believe that the millions of children who would be saved each year if elective abortions were illegal would find loving, caring families to raise them, if their parents could not. If there were a need, we would be willing to adopt children into our family, and we know that millions of other families feel the same way. The current situation is that the demand for infants for adoption in this country is far greater than the supply. The ratio decreases dramatically with the increase of the child's age (the older a child gets, the fewer parents want to adopt them), but our understanding of this is that the demand for adoptable children STILL is greater than the supply of adoptive parents! We have done much research on this, and while we recognize that we could still be wrong, we believe we are not.
     We believe that making abortion illegal would stop people from using it as their first form of birth control. People would find other methods for preventing pregnancy, and so fewer children would actually be born (who would have potentially been aborted) than are currently aborted.
     We believe that it is the government's duty to protect its citizens and potential citizens, and this includes the unborn. They are the most helpless, and the most in need of protection. Abortion is an attack against the defenseless.
For some reason, the only people we hear supporting this idea are Republicans. Perhaps a blue dog Democrat or two? We support it because we think it's intelligent, and probably the worst thing that our country is currently doing. This one issue could completely change our votes for a particular candidate, it is that important to us.

20. Government should enforce laws that protect doctors from most medical malpractice suits
There is a place for suing a doctor who willfully neglects a patient, or willfully harms a patient. It should be in a criminal court. Currently, suing doctors for malpractice doesn't do anything to punish the doctor; it just raises everybody's premiums, including the sue-er. The doctor has already been "punished" for all the past doctors' mistakes, by having to pay over half of his income to malpractice insurance. This is ridiculous. Doctors are humans, and should be allowed to make mistakes, even if it means sometimes those mistakes lead to patient deaths. Those mistakes in themselves should not ruin the doctor.
This is a Republican idea. We support it because we think it's intelligent.

21. Government should increase incentives to charitable donations for Community Health Programs
We're sure all kinds of free or low cost health care could be provided by creative people in communities or churches if their members had enough incentive to give charitable donations. Right now, that incentive is too low.
This is a Republican idea. We support it because we think it's intelligent and would increase services to the needy.

Where Danny and I stand
Republican Ideals: 10
Democratic Ideals: 8
Bipartisan Ideals: 3

Libertarian Ideals: 1

Our Own Ideals that don't follow a party line: 1

But like my brother says, "Republicans and Democrats agree with each other on every meaningful issue."


  1. This is awesome. I'm linking to you guys from my blog-- these are awesome. I think I have similar sentiments almost all of these-- with the possible exception of abortion, just for reason that it's a complex issue and I'm not sure exactly where I stand yet. I had not heard about the Health Insurance Co-op idea, but dang I'd love to see that happen. I feel that major parts of our health care problem are the lack of a free market, and the lack of pricing transparency. I love having intelligent in-laws/relatives.
    You guys rock.

  2. You have some good ideas, but the overall tone of this comes off as being terribly elitist.

    "Unintelligent, illiterate, or uneducated people should be given a choice about going to the UCF."

    Really? Why can't we just say "people?" Punctuating that and all other sections with "We support this because we think it's intelligent," does not increase the appeal or writer/reader friendliness. We get it. You think you're intelligent--much more so than those poor imbeciles who need to be told about UCFs.

    Also, I totally disagree with your idea of capping the amount of learning that can happen at a med school. Doctors' jobs are to heal and save lives using methods based firmly on scientific inquiry. Learning how to do that takes a lot of time and money. Plus, I have a soft spot for Dr. House.

    The other really big thing that I completely disagree with is the abolishment of Medicare. I DO think that the elderly have a right to highly supplemented health care "Just because you're old." I do not think that institutionalized neglect of the aged is "intelligent" or moral. I have several near and far eastern religious leaders backing me up on this. If we don't help the people who need health care the most, and for whom it is most expensive, why even bother with any kind of health care legislation?

    All that said, I really do think you have several well-argued and valid and genuinely helpful points--most of which I had never considered before.

    But jeez, Kate.

    Intelligence is over-rated, anyway.

  3. Michael (not Mykle), the reason I kept stating "we like this because we think it's intelligent" was to drive home the point to my family that we don't think a certain thing because it's of one or another party line. I guess my intent was unclear. Sorry. I'm just a bit tired of my liberal family members thinking my politics are conservative because I married into a conservative family, and my conservative family members thinking my politics are liberal because I am from a liberal family (great, with that sentence, I have single-handedly managed to offend every single one of my relations who bothers to read the comments on my blog! I apologize in advance!). Our politics have to do with what makes intellectual sense to us. Sorry to come across as cocky.

    I think you also totally misconstrued my point about med school reform. There shouldn't be a limit on what doctors can learn, at all (did you read the part about mandatory continuing education for doctors so they can stay abreast of new discoveries, technologies, etc? I'm pretty sure that it already exists, actually. That isn't about limiting education?). If a doctor elects to go to extra school, go for it.

    The fact is that currently, all med students are required to ace organic chemistry and physics. Being a good doctor has nothing to do with acing organic chemistry/physics/etc., it's just a tradition that has been in our system since the early 1900's. We think the requirements should be reevaluated to reflect the realities of being a physician. We think that right now, to be an MD requires too many pointless years of school. School in itself does not increase one's intelligence.

    People always have and probably will always have the choice to go to either an ER or a UCF. I guess the way I see it is that the choice exists, but how much of a choice can you really qualify it as if people don't know about it? Free Agency requires multiple choices, and I guess I would qualify that as multiple choices that the chooser knows about. The reason I specified "unintelligent" and "ignorant" was not very nice, I'll admit. I do apologize for my snooty tone.

    Back to medicare: Maybe I don't quite understand the system completely. This is what I understand: medicaid is for the poor who don't have medicare, and medicare is for the elderly. Why can't we expand medicaid requirements to include more old people? As I understand it now, you are not eligible for medicaid if you are over a certain age. That makes no sense to me. Economic status and age don't have a corresponding relationship. Probably there will have to be somebody way smarter than me to figure out medicaid requirements, because yes, they probably SHOULD be more lenient for people who live from their retirement money and no longer work. But the current system, as I understand it, allows all kinds of people to be eligible for medicare even if they are wealthy enough to buy an insurance policy. But perhaps I do not understand the system?

    I think a co-op system would be GREAT for the elderly wealthy sector. The problem is that people who don't work can't get good insurance because they have to buy it on their own. But if a bunch of people with similar health problems went together, they could get coverage that would maximize their personal cost. Or it could be indemnity insurance, like Aflac.

    I don't begrudge people for being old! They are a vital generation in our society. I just don't see how age IN ITSELF should be a factor in providing Government aid. Explain to me why it should. I'm open to other opinions.


Add a comment!