Reuters reports that President-elect Barack Obama has begun laying the groundwork for overhauling the troubled U.S. healthcare system, reaching out to interest groups and building grass-roots support for the huge undertaking.

Senate Majority Leader Tom Daschle, will participate in a healthcare reform debate in Colorado on Friday that is expected to begin detailing the plans for change.

Obama’s internet site www.change.gov asks people to submit ideas for changing the costly and inefficient system that leaves tens of millions uninsured.

Here is my idea:

Service Contracts: a business practice often used in equipment repairs.

This is when a business pays a monthly fee to be covered by a service, and is not charged for each occurrence.

In other words it is like you pay $30 dollars a month to have all you house repairs taken care of… water heater, oven, refrigerator, furnace, central air, at no charge to you. Something breaks, just pick up the phone…you have already paid for it. Of course, most service contracts do not cover parts, just the labor… Which is still a savings at prices as high as $90 an hour. Something breaks, you pay just for the part…

The alternative is to pay nothing until something goes wrong, and then, your out of pocket expense is not affordable. Time to sell the house.

The nice part of having a service contract is that you can better budget the cost … The nice part of being a vendor involved in service contract, is that you have a financial incentive to insure that nothing breaks . Since no additional money will come in for labor, one’s time is better spent on accounts not having service contracts… where one can charge labors, while still having the $30 dollars a month entering the cash stream from everyone on the contract….

Whereas if you are not on a service plan, each time you come in, there is an overwhelming incentive to find something to keep you coming back… “Grandma, your thiggilywatt on your dashometer is not working (really?). Can we schedule an appointment next Thursday so we get it fixed for you? It could be dangerous, you know….”

So Healthcare Service Contracts?

Idea is this.. The doctor of your choice gets paid $2000 to keep you well… If you get sick, he treats you at his cost. Daughter has the flue, in and out. Measles or Chicken Pox? in and out.. Problems with the bowels? Early colonoscopy and early removal of polyps.

As with insurance, the healthy pay the cost of the sick. If the doctor ever wants a date with the golf course, he has an incentive to keep you from getting sick…

That test he prescribes, if truly needed, is cost effective for him. It would cost him more not to test and pay for your operation much later… Likewise, to test someone for Gary Bauer syndrome, just to get some extra cash, winds up costing him money … The very rare chance that you might catch that disease, makes testing for it, rather silly .. especially if the doctor has to pay for it….

So paying $2000 per patient, and the doctor covers everything else, minus parts and pharmaceuticals, gives us a start towards changing our medical system…

At 300 million people in our country, the total cost would at $2000 each would be $600 billion a year.

U.S. healthcare costs now account for about 16 percent of U.S. gross domestic product — or $2.3 trillion — a proportion projected to grow to 20 percent or $4 trillion by 2015.