We need consumer-driven healthcare reform. This means returning choices and power to people while driving prices down because providers must once again compete for business. Instead of being primarily concerned with who funds, this policy is more concerned with reforming the primary healthcare markets and state-level management of the health care industry itself. Regardless of who funds (individuals, employers or taxpayers), we must have lower healthcare costs. To accomplish this, Assemblyman McIntyre would take the following necessary actions:
1) Require all providers to have transparent pricing that is simple and easy to understand.
2) Provide a website resource to help New Yorkers find the best and cheapest solutions for their healthcare, including price comparisons between providers.
3) Any healthcare plan that has a hybrid of high deductible with a built-in HSA (Healthcare Savings Account) that ignores provider networks and will be exempt from healthcare taxes. The same will be done for out-of-pocket expenditures. These accounts should be paid into by the employer and/or insurance company to keep the financial experience for consumers the same. The remaining healthcare taxes collected should be used to encourage firms to move their employees to this system, up until it becomes the norm and prices have fallen. The effect will be individuals shopping for healthcare providers instead of insurance companies.
4) Individuals will always have custodial control over their HSAs. This means that if they change insurance companies or go to another employer, it stays with them.
5) All state employees should be moved to the previously mentioned system.
6) Any prices for payments made out-of-pocket or by an HSA may not exceed the lowest price paid by insurance companies of whom they are in a provider network of.
7) Anything paid for out-of-pocket healthcare or by an HSA where there is a monopoly, shall be put under price controls comparable to Canada’s. The moment a competitor or competitors begin selling the product or service en mass, the price control shall be automatically lifted.
END ANTI-COMPETITIVE INSTITUTIONS
1) Repeal Certificates of Need (CON)- CONs are essentially permission slips that healthcare professionals, who are already properly licensed, must obtain to provide healthcare to consumers. In theory, this piece of paper “proves” there is a need for their practice. In reality, this is a pointless barrier to entering the healthcare field that has zero positive trade-offs such as increased quality or reduced cost.
2) End dependence on legally mandated cartel boards that govern how different types of medical institutions must operate and what services they must offer.
We must address the overwhelming shortage of medical personnel which is driving up costs, wait times and simultaneously degrading care. To do so, as Assemblyman, Mr. McIntyre would do the following:
1) Allow all medical school graduates to be licensed as physician’s assistants until the remaining requirements, such as residency, have been met to become a doctor.
2) End superfluous college course requirements for medical school which will enable doctors to finish school with less debt and have an easier time starting their own practice or clinic.
3) End superfluous college course requirements for nurses and class capacity should be increased to accommodate the rising demand to pursue the opportunity.
4) Residency requirements should be capped at 1 year regardless of who accredits them. End the exclusion of professionally competent healthcare providers and workers and expand acceptance of residency training to graduates of all officially recognized medical programs.
5) New York will recognize all doctors who graduate from any IMED recognized school as most states do. Licensure will be expanded by endorsement and New York will opt into the Interstate Medical Licensure Compact. (IMLCC)
6) Empower nurses from CNAs to nurse practitioners to do more while relieving their workload with more medical personnel.
Expanded access and the use of telehealth will lower costs and provide care in underserved areas. Some important fundamentals of implementing greater reliance on telemedicine include:
1) All telemedicine providers are allowed to operate in New York as long as they meet requirements to practice. We must also stop requiring them to be on a list of pre-approved sites.
2) Elimination of on-site assessment requirements for telehealth.
3) Reduced restrictions on housecalls- Similar to reduced restrictions on telemedicine, house calls should be added as another option to receive healthcare. Permissions will be given to practitioners in all Article 28-licensed health systems, as well as non-Article 28 clinics, to have the ability to make house calls and be compensated for them.