Damn, three night's in for a thumb, I got sent home in the rain after shattering my ankle, fibula and tibia after a bad jump.
I agree with much of what you say there. I have never understood the state paying for either fertility or viagra issues. While ED might be a real issue with some people, I don't know that it is a state issue.
And you are correct on the suits. As I said prior, some of the proposals have very strong tort reform to keep premiums for malpractice down to a reasonable level and keep doctor's worrying about the care of their patients instead of their mp premiums or the next lawsuit. Bev and Jim pay $240K a year in malpractice insurance [and that is with NO claims against them].
I think that you are looking the correct direction. From what I read, anecdotal stories like this are throughout most of the plans.
You asked how do I propose fixing the problem.
The answer is simple you don't throw out the baby with the bath water. The system is not all bad and you must take an iterative, well planned approach. Just because something does not work as well as it should does not mean you replace it with a system that is even more screwed up than the current one. Which is exactly where the current Medicare, Medicaid, and VA systems are. The waste is horrendous in these systems.
It takes a combination of fixing both the private healthcare market and the current publicily funded programs.
You also use a carrot and a stick method for all of those involved in the system from the patients, to the medical professionals, to the health insurance companies.
You must have tort reform as part of the process.
You punish the health insurance companies if they try and pull the crap the BC/BS of CA did with asking doctors to look for reasons to disqualify insured paitents.
You remove fertility & ED coverage from the "standard" plans. If individuals are interested in this you implement a premium upcharge.
Birth control is now covered.
You hold Doctors & Hospitals responsible for the orders they write. If someone is in a coma ordering PT & OT does no good.
If a patient is pronounced brain dead by the medical staff and there is concurrence with a second opinion you only allow x number of days before the plug is pulled. You do not allow the family or gov't to step in and keep this person "alive" for years at a cost of hundreds of thousands of dollars a year.
You check citizenship when someone is admitted to a hopital without insurance. If the person has no insurance and is not a citizen you do the "basics" and deport. By the basics I mean you treat any life threatening illness, set a broken arm and cast it, etc.
If someone is a smoker or morbidly obese you charge a premium.
If someone if morbidly obese you do not perform joint replacement surgery until after XXX amount of weight is lost. You do how ever provide assistance to help these people lose weight.
You bring common sense back to the system.
There are plenty of opportunities to improve the system without creating another, huge gov't entitlement program.