First, end Congress public employee taxpayer-funded entitlements of superior benefits that last through retirement. The old-time idea that better benefits were provided to public employees in exchange for the fact that their wages are lower than those in the private sector has been dead and gone for decades.
Voter pressure should be applied to make sure that public employee salaries and benefits are brought more in line with the rest of the population. It is outrageous that as of 2018, federal civilian workers' rise in public employee wages and the entitlements has now reached the absurd level that with salary and benefits "In 2018 total federal compensation averaged $135,971 or 80 percent more than the private-sector average of $75,381," See "Downsizing the Federal Government," 8/2/2019, https://www.downsizinggovernment.org/federal-worker-pay. That's for "federal civilian workers," public employees, including Congress.
This is the most vital way for the public employees of government, including Congress to stay on-board with making sure Medicare and Medicaid are available AND solvent, make their benefits under Medicare the only retirement benefits they get paid for by taxpayers instead of the cushy plans they give to themselves.
Second, reinstate the medical expense deduction threshold to 7.5 percent, which it was before President Obama from the 10 percent threshold we have now, or better yet, make it even lower based on the damage done during the Obama years that widened the gap between rich and poor in the US. (See 9/1/2013, HUFFINGTON POST, "Income Inequality Grew Faster Under Obama, According To One Measure," Jillian Berman.
In 2013, Berman explained, "Those at the bottom of the income scale are making fewer gains compared to those at the top. This data point is one of many that illustrates that in Obama’s America the rich are gaining while the rest of us are struggling to get by."
Third, incentivize insurer and government payers to go after fraud instead of discouraging it by excusing the expense and allowing consumers to be charged more for their administrative failures. If an insurer or payer is raising costs to consumers because of FRAUD, then that's their fault, they're not doing a good job. Immediately, such insurers and payers should be responsible for their failures in controlling the costs of fraud instead of passing it onto consumers. There should be a ban, an automatic rejection of cutting coverage and-or increasing costs of insurance to consumers either directly through premiums or indirectly through taxes on the basis of covering the costs of fraud.
For private insurers, a program of imposing fines could be effective. For government payers, an automatic salary freeze, probationary status for a year for all employees involved in a cost center with fraud expenses would be an easy way to at least incentivize public employees to do something besides reduce coverage for beneficiaries to cover their sloppy and substandard job performance.
This would be easy, after all, Obama, in an effort to reduce readmissions to hospitals instituted the Hospital Readmissions Reduction Program under Obamacare instituted fines on hospitals for high readmission rates for heart attacks, heart failure or pneumonia. It should be noted this remains in place even though there's evidence that in an effort to avoid fines, people are dying.
(See "Obamacare Readmission Penalties Associated With More Patient Deaths: Study, New research finds that certain patients discharged from hospitals that face financial readmission penalties are at higher risk of death," Alexa Lardieri, US News, 12/21/2018, https://www.usnews.com/news/health-news/articles/2018-12-21/obamacare-readmission-penalties-associated-with-more-patient-deaths-study.)
Fourth, federally ban the practice of balance billing and allow states the opportunity to legislate more protections than the federal law, as they currently can for other federal legislation, but remove the possibility of no laws, or piecemeal and inadequate bans on balance billing.
Fifth, institute a medical debt forgiveness program in place of a college debt forgiveness program. People have a CHOICE about college expenses, not so with needed medical care costs. Medical debt forgiveness should be absolute after 10 years of income based repayment, using the Social Security current law about when social security income becomes taxable to permit full forgiveness for individuals falling below a certain income threshold.
Sixth, repeal the Medicaid recovery provisions of 1993 that put individuals' estates up on the block for states to claw back Medicaid payments and make it more difficult for middle income families to leave their property to their heirs, creating and-or perpetuating a cycle of poverty for families. This is increasingly necessary as expanded Medicaid which enlarged the scope of the availability of Medicaid for people with assets, under Obamacare, has also meant that more people will be subject to this claw back.
These things are easily accomplished and would show some evidence of good-faith effort on the part of the federal government towards health care consumers.
