I can cut approximately 25% off Medicare right now without jailing one person, without breaking one monopoly, without doing one single thing to the actual health providers -- although all of those things should and in fact must happen.
In the private sector I can have a similar, but smaller (percentage-wise) impact. Ditto for Medicaid. The budget impact of this change would be roughly -$400 billion annually, which is wildly better than any projected "growth" addition (it would add to more than $4 trillion over 10 years.)
You simply have to allow me to make the following policy change with regards to one disease -- Diabetes:
- For those with Type II diabetes we will provide unlimited metformin (cheap, off-patent generic medicine that costs pennies a day) to anyone with the disease.
- We will provide no other care of any sort for Type II. You want or "need" it, pay cash or die. Period.
- We will also make changes to how we deal with Type I diabetics' insulin requirements, as detailed below, that will cut said requirements dramatically.
Now before you scream in horror that I'm a monster, listen up.
Instead of medicine and, inexorably, amputations, dialysis, hospitalization and death we're going to prescribe a lifestyle of eating no more than 50g of carbs a day, all in green vegetables high in vitamin C (e.g. broccoli, brussels sprouts, etc.)
Caloric intake is to otherwise be 70% saturated (animal) fat and 20% protein. Sugars, grains and starches, including but not limited to "white" foods (pasta, potatoes, breads, etc) are all prohibited. Zero-calorie / zero-carb spices and condiments are unrestricted, of course.
In short you eat (and don't eat) what's described in this post, less the fruits (since they are all fairly high-glycemic and the vitamin C requirement is taken care of.)
For most Type II diabetics eating this way will reduce their need for other drugs, including insulin, to a literal zero and since their blood sugar will normalize their need for many-times-a-day testing will also disappear, getting rid of both the pain of sticking one's finger repeatedly and the cost.
For those who it doesn't the metformin is there to help.
We will also accommodate all actual, documented exceptions -- that is, those people for whom this lifestyle change legitimately doesn't work.
Those who claim "it doesn't work" will be locked in an isolation ward where they will be fed that diet for two weeks (with no access of any sort to any other source of sustenance) and be able to prove that for them, individually, it doesn't work. If they're right then they will get whatever medication or other intervention is necessary provided they keep to the lifestyle change. But if that empirical test shows that it does work (and it will for virtually everyone) then their ass will be discharged, the fact that they refuse to change what they eat will be noted in their chart and further complaints of "impossibility" will be ignored.
Type I diabetics will find their insulin requirement cut to a tiny fraction of what it is now and again those who claim "it doesn't work" will be subjected to the same empirical, isolation ward test -- with the allocated and paid for insulin amount (and/or other intervention measures) set by the results of said test.
If you are insulin-compromised but choose not to eat this way -- if you cheat, if you want those Doritos, potatoes, pasta, breads, cereals, sugars and similar, then have at it -- but you will get no medical care paid for by any insurance, by Medicare, Medicaid or otherwise. You may buy whatever you want with your own money but there will be zero further support from the government or anyone else.
When diabetes causes gangrene in your feet you can use your own chainsaw to cut them off and your belt can be used as a tourniquet until you can sew the gaping flesh shut with your own hands. When it causes blindness you cannot collect disability because you intentionally caused your own disabled state. When it causes kidney failure you can pay for the dialysis yourself or die. When the complications from all of the above kill you, tough crap.
If you're Type I your reimbursable amount of insulin under Medicaid, Medicare or private insurance will be limited to that which is required by a 50g/day carb load comprised of all low-glycemic green vegetables -- and not one unit more. If you want to eat carbs or load up with excess protein (which gets turned into glucose in the body!) you pay for both the carbs and/or protein and the insulin. Again, if you argue that the provision for what your coverage provides is too low or it's "unsafe" for your personal metabolic situation you get to do two weeks in said isolation ward and prove it. The results will go in your chart as irrefutable and individual evidence as to your actual requirements.
Not everyone is the same -- but the exceptions must be proved empirically, not just by what you claim.
It's simple, really: If you consume no carbohydrates of note and no fast carbs at all, along with little or no excess protein you need very little insulin. If you have damaged your endocrine system so badly that you actually need injected insulin as a Type II diabetic then you will need a tiny fraction of what you use now and you can pay cash for it.
If you haven't, and most Type II diabetics haven't you will need no "advanced" medication at all and most Type II diabetics will need no medication of any sort as their blood glucose will immediately return to the normal range.
At the same time you will lose the extra weight if you have it, your blood pressure (if it's high) will probably come down and the odds of you needing any other sort of medical intervention -- all of which are a consequence of something bad going wrong with you such as a heart attack, stroke, blindness, kidney failure and similar -- will go through the floor.
If you're Type II over time your endocrine system might heal. Or it might not.
But whether it does or doesn't isn't the point, nor is it the goal.
The point is that we're blowing over $200 billion a year in Medicare alone because people who are diabetic will not stop eating fucking bread, pasta and potatoes while demanding that we pay for their pig-headed, self-destructive behavior!
That's not a disease it's a choice and by God we have to stop doing that crap right damn now.
Will Price and Trump mandate this?
You know good and goddamn well neither will mandate any such change so fuck them both.
Our current medical scam "system" is nothing more than feeding addicts -- sugar and carb addicts -- and then providing support for continuing addiction despite the fact that we know it is killing those who are addicted and have already had that addiction do severe harm to their bodies while stealing roughly four hundred billion dollars a year from everyone in the country.
We are, effectively, feeding crack addicts government-sponsored crack and forcing the public to pay for both the crack and the harm to the body that it does.
It's time to cut that crap out and indict, try and hang those who demand that it continue.