Cut out the middle man: ideas to revamp the delivery of healthcare

[NYK]

ok dangerous as this is I have been thinking. I whole heartedly believe that Insurance is a scam. all it does Is make you pay for something that hasn't happened yet. We have had this for such a long time that we may not know of a better way to pay for our doctor bills. I am focusing on doctor bills at the moment and not really any other type of insurance and this is just a preliminary thought but i would still like this to be serioously considered by anyone who is sick of paying health insurance and trying to this system work. Wasington is trying their hardest to make this work but it impossible because of the huge ability for such a system to be corrupted. I have come up with a simple plan that would eleviate demands on our wallets and minds. let me know what you think. I will try to explain this as thoroughly as possible and if there any questions please ask and if you have any Ideas please to not hesitate to contribute.

Instead of having insurance that you pay every single month even though you never have gone to the hospitol, which i believe is absolutely rediculous, you should pay the hospitol itself AFTER you get sick. How can you do this when everything costs SO much? this is where the genius of my plan comes in. YOU MAKE PAYMENTS!!! how could you possibly make payments on $20,000 bills and higher? It's not that great of a burden when you break this amount over a 30 year plan. cut out the middleman pay your bills directly. the reason things are SO expensive is because we are paying the insurance comanies to pay our bills. This is not a good idea because insurance compaies can make us pay whatever they want for whatever excuse they want. they are not doctors and have nothing to except take money. that's just an extra hand that the money has to pass through. it's inefficient and as we have found out ineffective.
Now that re a lot of qustions that go along with so I have come up with a few and I will try to explain how it works as best as possible.
1. what if I can't pay right away? I have to be hospitolized for a while, say three months. this one is easy. You pay when you get out and are able to pay, i.e. when you go back to work. Even if you are not able to pay for quite a while, say for a year, due to complications or whatever. you don't pay until you can afford it. As long as you can, pay do, so if not don't stress over it, it will only make your recover that much slower.
2. what if I end up never being able to pay? well I have come up with the Idea that your community may be able to help you in dire situations such as this. that's what a community is for, right? well your bill is spread out over a large number of people i.e. those who are and/or those who are not already paying. there are options here people. one option is that those that are paying already will have added costs for those who cannot pay. this is a fact and you know it. today we pay every month to do this. there is no getting away from it. if some one wants to the math that would be great! I am terrible at these things. if you spead the bills over a large number of people those who are sick and are unable to pay are going to be shouldered by those who can. this can be done several ways. one way is by adding the bills of those who cannot pay to those who ar epaying at the moment. this works why? well say you got a thousand people paying on hospitols you spread the amount out and a small increase to those who are apaying. Also at the end of the you could have some way of haveing everyone chip in by paying a yearly tax or something of that nature. but basically i am saying it doesn't have to be a great burden and there are ways of doing this.
ok this is only two questions here but i think this is enough for an OG post. any other questions may be asked and i will atempt to answer them as best as I can and again anyone who may have answers to anyone elses questions please do not hesitate.

[Hamburglar]

So sickly people become economically impoverished while healthy people have tremendously more economic opportunity....okay. For instance, a baby would be born with debt to a hospital (which hopefully the parents would/could pay for). Then lets say that baby grows up and we find out he/she has a serious but treatable birth defect. So that person is going to owe money their whole life for being born with a defective "something". Even if they are wealthy they will be at a disadvantage (Economically) to their fellow "healthy" cohort. That would certainly be efficient, but what about equity?

[Synchronicity]

2. what if I end up never being able to pay? well I have come up with the Idea that your community may be able to help you in dire situations such as this. that's what a community is for, right? well your bill is spread out over a large number of people i.e. those who are and/or those who are not already paying.

That's the whole idea behind socialized health care. The government pays the medical fees of patients from taxes collected from the population at large for that purpose.

[NYK]

So sickly people become economically impoverished while healthy people have tremendously more economic opportunity....okay. For instance, a baby would be born with debt to a hospital (which hopefully the parents would/could pay for). Then lets say that baby grows up and we find out he/she has a serious but treatable birth defect. So that person is going to owe money their whole life for being born with a defective "something". Even if they are wealthy they will be at a disadvantage (Economically) to their fellow "healthy" cohort. That would certainly be efficient, but what about equity.

well, yes. at the base. the thing is is that people with disadvantages would be forced to over come these obstacles. this system would allow for those at a disadvantage to ask for assistance from the local community or even reach out further if needed. if the defect is treatable but the person would die with out the assistance, it is up to them or in the instance of a child the parents resposibility to keep their life. It would be easy enough to say that the whole sytem would be able to take care of it all at the same time but the thing is is that you literally get into parts of pennies per person. how do you ask ask several million people to pay half a cent for one person. Yes you could probably put these people in a group and say the accumulated costs would be such and such but again you have the problem of corruptability and it would take too long to find the gold needle in the haystack. this way if it is left up to the individual it allows the person to possibly grow and sustain life but only if the person is atleast capable of being supported. by this i mean that they literally have to have others that are close to them and are able to help them. it would atleast minimize the "I don't know who you are but i pay half my salary so you can live." some people just can't afford to do this.

I will take this one step further. let's say that a child is born, let's say prematurely and has difficulties breathing on it's own. the baby has to be put on a life support system. initial costs would be expensive the use of the machines and the man hours it take to support this life. unfortunatly this is real life and the parents that this is gonna cost too much. what could they do? this is where the community comes in with options. thye can ask for help. others who are able and willing to help. those that have the means to support such things. those that ARE healthy and have the necessary monetary means. yet again this is real life and bad things happen and all those who are willing are not able, lets say due to a surge of birth defects and hard times,and noone is able to help. this is where the parents have to make the decsion to try and keep this child or just say that this is a very unfortunate circumstance and that they literally have to try again. I know this sounds cold and harsh but these things do happen. but with the more people that are able to help those that come into this world with such difficulties the better chanc there is of survival. As for long term debilitating issues, these are treated the same. those who accumulate too great of a need and are not able to contribute worthwhile, unfortunatly, do have a less chance for survival. I don't know how to say it anyother way.
the way the current system is setup it only brings those who would be able to help themsleves, unable. that's why we need to change this. as it is right now we are one legged people carrying eachother around and are not able to help ourselves. unless we are able to help ourselves how can we expect to help others and live a productive life.

---------- Post added 03-01-2010 at 01:07 PM ----------

That's the whole idea behind socialized health care. The government pays the medical fees of patients from taxes collected from the population at large for that purpose.

but isn't taxation without representaion illegal? If I have to pay a medical tax out every paycheck and I never get sick or have an accident, would I not feel wronged? I know that some say that it is inevitable, you will get hurt and you will get hospitolized for something in your lifetime. for one thing it's not right to sit around and think that I am gonna get hurt someday. honestly that depresses me. I would rather be armed with the knowledge that if i do get hurt i can do something about it and that others will help me IF i need it. I know it sounds good to think that if I pay my taxes I will be safe but it's not the right frame of mind. Again because of the easiness that corruption is able to manipulate this type of system. for one... do you trust the government? for another... do you trust the people in the government? to both of these i say "No." why do i say this? because they came up with insurance. It does make me sick and whether or not anyone else realizes this it mekes them sick too. how? because we have to worry and stress about it. Stress is a major cause of illness and weakness. if you think you are sick then you are sick. the way the system is setup now we are told that we are sick, ALL THE TIME!!! I can't turn on my T.V. and not see something about H1N1, which i think is a load af crap so that big pharma can make bucks. I may be wrong but I would like to be proven such and you know that's an Impossiblity because of double blindness. who the hell knows whats in those needles. who the hell knows whats in the needles of yesterday. thye have been doing this for decades. and if you believe that they would not jack some people up to push their product the i would have to say that you are triple blind. I am not adressing any one individual but to all that have been bamboozled by our current system of things. insurance comapnies corrupt. they corrupt our medical system. i could really go into a rant but i will refrain from reitteration.
back to your comment. yes socialized health care is a good idea but taxation without representaion is still illegal. therefore it anyone who wishes to contribute to such an organization of funds to help those across the nation should be free to do so but I say "Do not force me to pay taxes life is hard enough."

[Hamburglar]

well, yes. at the bas
....... As for long term debilitating issues, these are treated the same. those who accumulate too great of a need and are not able to contribute worthwhile, unfortunatly, do have a less chance for survival. I don't know how to say it anyother way.
the way the current system is setup it only brings those who would be able to help themsleves, unable. that's why we need to change this. as it is right now we are one legged people carrying eachother around and are not able to help ourselves. unless we are able to help ourselves how can we expect to help others and live a productive life.
yes socialized health care is a good idea but taxation without representaion is still illegal. therefore it anyone who wishes to contribute to such an organization of funds to help those across the nation should be free to do so but I say "Do not force me to pay taxes life is hard enough." edited down for length...

Use a spell check. You just killed Stephen Hawking-kudos.
You do not, obviously, understand the principle of "taxation without representation". That statement was used to reiterate the fact that British Americans wanted to have a seat in Parliament-they were shot down, ergo...Just because you don't LIKE your representation does not mean that they do not have the right to tax you-this stands the test of reason-which is likely why the SCOTUS has upheld taxation since 1789.

Anyways, I'd like to see what the medical industry would look like after your policy were enacted....To make a bold prediction: It would crumble in less than a decade due to a lack of customers and begin catering to those who have the ability to pay, elite (the top 20%).

Here is an interesting graphic showing mortality and income inequality:
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[NYK]

i'll get to my dislikes of the graph that i saw in a moment. the question here is whether or not if someone had to pay a sum of money every month so that they can say they have insurance or not and because of this they say that they will PAY a part of your bill and leave the rest of it up to you to pay any way. On top of all that you still have to pay because when you get hurt your premiums go up!!! how freakin ridiculous is that?!? you end up paying way more than it was originally worth because of inflation and whatever other reason you or a person with the power to effect exactly how much you want to paid for doing absultely nothing but put price tags on things. but you say, what about equipment and utilites and manpower and all that stuff!?" I says "how much?" you tell me exactly how much that costs. and you can take this to those guys at the insurance companies and shove it down their throats because I can guarantee that it's less that what they get paid! and you what? It doesn't even matter if i'm right about how it costs because THEY PUT THE PRICE TAG ON IT!!!!
now as for the graph. it's bopkiss. and yes I am gonna piss some people off by saying this because you know that the less people get sick the cheaper it will get. SUPPLY AND DEMAND. if I am wrong then so is our system.

---------- Post added 03-01-2010 at 06:57 PM ----------

actually i do have another question. honestly and sincerely i want you to tell me how inequity fits into the whole thing. is it because of people who don't pay or is it inequity from the insurance business? if it's insurance inequity, which is what i am thinking, you can void that from the graph because that factor has nothing to do with my policy.

[Thinker]

The whole idea of insurance started from a co-operative approach to risk.
The original insurance companies were not-for-profit and essentially spread risk across many contributors.

The introduction of a profit motive changed the emphasis and moved it away from spreading risk, to making profit from risk.

[NYK]

as a direct recognition of the fact that the hospitol does not represent me as such that i do not have a contract with them. the do not have the right to tax me. only and ONLY my representative has that option and I say as a free man "If my representative makes a binding contract to a company that is not currently representing me then that should mean that my representative has the right and power to keep me from being taxed by that company so as to adhere to the LAW OF THE ORIGINAL CONSTITUTION. if I have to write to my representative it would be a bad day, for this should never, have never, had to been done.

---------- Post added 03-01-2010 at 07:45 PM ----------

The whole idea of insurance started from a co-operative approach to risk.
The original insurance companies were not-for-profit and essentially spread risk across many contributors.

The introduction of a profit motive changed the emphasis and moved it away from spreading risk, to making profit from risk.

Indeed that was a noble Idea. but it has been twisted and tortures into a fat sucking industry. so that people who eat too much, yes I am fat but i live and die with it, can get their crap sucked out of for cheaper than it costs to process. who does this type of stuff? people who have too much money and get bored so they start looking at thin people and say "oooh, i wanna be thin too!!!". so they go and get lipo-suction and cosmetic surgery so they can LOOK like they don't look!!!.
first off this is a life-style consideration and yes if you look pretty they will put you in movies but damnit every working stiff out there is paying for it! yes you have the right to look pretty but I honestly don't wanna pay for it and i bet my neighbor don't neither cuss he as strapped or even more so than I am.
I can't think of any better way to it.

[Hamburglar]

you might really like this article.

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[Synchronicity]

but isn't taxation without representaion illegal?

We do have representation. All of us. It includes elected representatives in the local, state, and federal levels of government (which include city councils, state legislatures, and Congress, respectively). It is understood by our political system that all citizens are given a voice (and a vote) in the government as a prerequisite of having to pay taxes in order for the government to operate and provide the services we decide it should.

[LaoTzu]

I like the idea that instead of being insured by an 'insurance company' , you pre-pay your bills (like insurance) directly to the hospital.
The only problem I see is that it's not easily transferable to another locale without some sort of bureaucracy in place (like what an insurer provides).

So, in a sense; you are back to square one.


The idea behind single payer is this: you pay directly to the government (through taxes) your insurance costs. They pay the hospital you are served by. Easy-peasy.
You pay a little for elective-unnecessary stuff, and for some prescriptions.
Everyone gets whatever treatment they require, regardless of class.
It is almost guaranteed that most everyone would pay less through taxes than they would in current premiums, because of the shared burden; removed profit for insurers; and a large purchasing block who can dictate pricing.


For the US, I would suggest a two-tier system where those who choose to, can forgo the 'insurance-tax' and can pay for their services. (It would not do for countries that already have universal health-care)

[mormeguil]

There is also the advantage that insurance also split the cost of very costly procedure over all the persone who risk to have it.

Making insurances compagnies cooperative may be a way to do things more easily and make it less of a "scam" while also keeping what most people seems to like about the system.

[pip]

The introduction of a profit motive changed the emphasis and moved it away from spreading risk, to making profit from risk.

This is the fulcrum upon which the issue rests.
Greed and the pursuit of wealth is the source of a great many problems, none of which need exist at all.

The idea behind insurance is sound - spread risk over a wider 'area' so it has less impact, but using it to make money just gives an incentive to screw people over for no other reason than they cease being people and become instead expliotable resources.

[phej]

It is almost guaranteed that most everyone would pay less through taxes than they would in current premiums, because of the shared burden; removed profit for insurers; and a large purchasing block who can dictate pricing.

Please explain why premiums have gone up in Massachusetts? One of the misfeatures of healthcare funding in the U.S. is that there is an overabundance of treatment. Changing the payment scheme won't magically fix it.

This is the fulcrum upon which the issue rests.
Greed and the pursuit of wealth is the source of a great many problems, none of which need exist at all.

How is greed a source to the world's problems? It's a feature of humanity that isn't going away. So if anything, systems ought to be designed with it in mind that it happens.

[NYK]

Does anyone know who controls the costs of what medical spending on equipment? Also I would like to know what the average lifespan of the equipment currently used and currently being paid for.

---------- Post added 03-02-2010 at 08:55 AM ----------

you might really like this article.

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Very much, I enjoyed the article. thank you. It as brought up several Ideas and questions.

[NYK]

national organization of medical salary and income control?

Would it be possible to create a system so that doctors and all of the personnel in the medical business, be paid by a salary as an industry standard? If not Is it possible to do legally? If so let it become a national trend. It would behoove to those whom it concerns for this to be done for it will decrease costs as proven by such medical practitioners in mayo, Florida and other places. the title is not a set name for the organization.

---------- Post added 03-02-2010 at 08:38 AM ----------

medical group payment pools?

[NYK]

healthy or just insensitive limits?

Is it wrong to believe that if you have a medical bill that you have never paid on cause you to have trouble being seen by a doctor?

Should this even end up causing you to be completely refused even at a critical point in time and why?

[plotthickens]

Better would be to kill private insurance. When someone's making money between you and your doctor, your bill will be bigger and the doctor's salary looks huge.

[ArtistTyrant]

Ah, yes, kill private insurance, so that the only insurer is the government, because they totally have an obligation and a responsibility to not only insure you, but to give you the best insurance possible. /sarcasm

[plotthickens]

Why do we need insurance?

[Latro]

Distribution of risk is a good thing economically. If only a sparse set of people is going to need $50,000 of medical treatment in a span of a couple months, but no one knows if they will be that person, then using insurance or a similar system to distribute that risk is a good thing. The problem with health insurance IMO is that it covers too much of the little things, things that are not risks in effect. This creates an artificially twisted market, where the consumer isn't really in a position to shop around, and also does not easily notice where their health insurance money is going. This enables the health care provider to just continue to jack up prices and in turn enables the insurance company to just continue to jack up rates. So the economics of the situation, without price competition, deteriorate, and eventually you get a massive chunk of your country's GDP spent on health care for little reason.

My personal opinion is that there should be a "limit" (not necessarily a legal limit, but at least tax penalties for breaking this "limit") on what health insurance policies can cover. Say...oh I don't know...$1000 minimum, or something like that. (I have no idea what the exact numbers would need to be; to be honest it would probably need to exceed $1000). If you can work it out properly you could probably make it so that only the really impoverished couldn't afford health insurance this way, and then you could expand Medicaid (which has ludicrous rules about income; you pretty much can't live on the income range that Medicaid allows) to encompass those people.
Why do we need insurance?
If you get into a bit of detail about economics, you find that redistribution of risk is a very useful tool economically. The middle man makes money, yes, but what you're missing in the "insurance inevitably makes the consumer pay more" argument is that the game is not actually zero sum in every case. Introducing insurance frees up money for investment that would otherwise have to be saved up for emergency situations. That money creates more money, and so you have now created wealth. Some of that gets soaked up by the insurance company, yes, but history indicates that the amount of wealth generated tends to easily exceed the amount that the insurance company itself takes in. The case of modern health insurance as it is now is essentially an exception to this.

[Melchizedek]

Your idea to revamp health care is just health care without insurance. That already exists, and it wouldn't really get rid of all the costs. Revamping health care would be more like tort reform or changing the way health care is administered.

[LaoTzu]

Ah, yes, kill private insurance, so that the only insurer is the government, because they totally have an obligation and a responsibility to not only insure you, but to give you the best insurance possible. /sarcasm

Why do you hate democracy?



/sarcasm

[Hamburglar]

Does anyone know who controls the costs of what medical spending on equipment? Also I would like to know what the average lifespan of the equipment currently used and currently being paid for.

---------- Post added 03-02-2010 at 08:55 AM ----------



Very much, I enjoyed the article. thank you. It as brought up several Ideas and questions.

My father is the Director for Biomedical Engineering at a local non-profit hospital. Usually equipment requisition is instigated from the Doctors to the CFO, then the CFO will task my father with figuring out the cost per year and w/the expected life of the product being purchased. He spends a great deal of time making sure that he gets the best product at the best price. Hospital equipment is not cheap, and often time a lot of hospitals will lease it. But the average life span is VERY LONG for most equipment, because people like my father and his crew diligently keeping them maintained and fixing them when they can.

[NYK]

I like the idea that instead of being insured by an 'insurance company' , you pre-pay your bills (like insurance) directly to the hospital.
The only problem I see is that it's not easily transferable to another locale without some sort of bureaucracy in place (like what an insurer provides).

that is a good Idea. I don't believe that would be too difficult to attain. all one would need to do is set aside the money in a savings account of some type and draw the money out you have saved and put it toward your medical bill. Have the company you work for match what you put into the account, like 401k but not exactly, and you got a working system.

So, in a sense; you are back to square one.


The idea behind single payer is this: you pay directly to the government (through taxes) your insurance costs. They pay the hospital you are served by. Easy-peasy.
You pay a little for elective-unnecessary stuff, and for some prescriptions.
Everyone gets whatever treatment they require, regardless of class.
It is almost guaranteed that most everyone would pay less through taxes than they would in current premiums, because of the shared burden; removed profit for insurers; and a large purchasing block who can dictate pricing.

why have the government do this? having a medical tax only allows those who can access pooled monies, the government, to spend it anyway they choose. They can SAY that they would pay your bills but in practice it leaves huge reserves to dip into which is just way to tempting to those who just want to "get little out and pay back later". having a large pool like this controlled by the government is a bad Idea but if it were controlled by an organization, that has no control of cost, could very well be ideal.


For the US, I would suggest a two-tier system where those who choose to, can forgo the 'insurance-tax' and can pay for their services. (It would not do for countries that already have universal health-care)

having anyone control the costs of medical care other than those who practice it is generally a bad idea. as long as "insurance" and "tax" have control of cost I don't see any way to lessen the cost.

---------- Post added 03-04-2010 at 08:49 AM ----------

How is greed a source to the world's problems? It's a feature of humanity that isn't going away. So if anything, systems ought to be designed with it in mind that it happens.

that is like saying I should go ahead put some of my belongings on my front porch every month so that someone can easily come pick it up because they're gonna break into my house and steal my things anyway. Greed IS a real problem just like disease and lax regulations of government spending.

---------- Post added 03-04-2010 at 09:00 AM ----------


My personal opinion is that there should be a "limit" (not necessarily a legal limit, but at least tax penalties for breaking this "limit") on what health insurance policies can cover. Say...oh I don't know...$1000 minimum, or something like that. (I have no idea what the exact numbers would need to be; to be honest it would probably need to exceed $1000). If you can work it out properly you could probably make it so that only the really impoverished couldn't afford health insurance this way, and then you could expand Medicaid (which has ludicrous rules about income; you pretty much can't live on the income range that Medicaid allows) to encompass those people.

even if it were up to the individual of exactly how to pay for the bill would be great idea! let's say that i DO have a thousand dollar or less bill I have to pay for some routine check up stuff that found something and I have to meds and such. should I not have the option to pay that to the hospitol at a reasonable monthly rate? tell your insurance company to F- off you can take care of the bill without raising your premium. As a matter of fact this is exactly what I am proposing only it affects ALL medical bills. large amounts of money should take large amounts of time to pay. having everything happen RIGHT NOW is only wishful thinking whether you know know your still paying for that first medical bill you ever paid and you will be paying on it for the rest of your life WITH INTEREST.

---------- Post added 03-04-2010 at 09:11 AM ----------

Your idea to revamp health care is just health care without insurance. That already exists, and it wouldn't really get rid of all the costs. Revamping health care would be more like tort reform or changing the way health care is administered.

This IS how you change how health care is administered. yes with out insurance those who deliver lower quality health care would have the BBB up their own keisters with probes looking for problems. And on top of that if a practice does bad work people would likely stop going and it would fail anyway. therefor quality and cost would go down overall due to the lack of corruptibility of the middle man,thus removed, which is one less @$$H073 I have to pay.

---------- Post added 03-04-2010 at 09:59 AM ----------

My father is the Director for Biomedical Engineering at a local non-profit hospital. Usually equipment requisition is instigated from the Doctors to the CFO, then the CFO will task my father with figuring out the cost per year and w/the expected life of the product being purchased. He spends a great deal of time making sure that he gets the best product at the best price. Hospital equipment is not cheap, and often time a lot of hospitals will lease it. But the average life span is VERY LONG for most equipment, because people like my father and his crew diligently keeping them maintained and fixing them when they can.

That is indeed a good line of work but let me ask you this. since your father repairs and maintains the equipment would it not be redundant to also have insurance on those machines...just in case they break?
I hope you don't mind if I use your fathers work in an analogy. the human body is very much like a machine. It has joints and valves and such. and when it breaks down some one has to be paid to fix it, much like your father. now this has to be paid somehow right? does it make sense to have to pay someone to pay for the repair or just pay pay the person that did the repairing? No it doesn't and in a lease situation it makes even less sense. because you are already paying someone for the maintenance, i.e. your doctor, and to have to pay someone to make sure it get's paid makes no sense whatsoever. unless you have enough people that can't and don't pay for their bills. this is a problem that cannot be resolved.

I don't mean to sound harsh but if you can't afford something then you can't get it. I don't have a car because I can't afford it. I can't afford surgery so I don't get it. I don't have insurance because... you guessed it... I can't afford it. If get hurt...tough luck. If i could live just five more minutes for every thousand dollars i pay, I guess I would be screwed. And you know what, I'm ok with that. I was not born fortunate. I have lived a poor life. but I cannot expect those who cannot afford to pay for their own, like myself, to pay for mine. It just don't work that way. I know to this that people will say "won't that mean that the rich will live healthier lives?" yes it does. but this IS a free country and if you happen to have been born fortunate and have enough money to live a happy and healthy life, kudos, but don't add insult to injury by trying to make those who are less fortunate have to pay into a scam so that you get richer and I poorer and ride the back of justice and law while doing so. It's sickening. So just to let everyone know it IS ok to kill someone that is too rich and too selfish but not for just one of those reasons. Even though you may disagree, for whatever reason, you know this to be true. because what good is a big fat pig if you just let it get old and stringy and no good anyway? maybe you could use the parts for some good but to get the most out of it you must act while the meat is fresh and distributable among those who are hungry...I don't care who you are it's good eatin'. but i digress and ramble about things that are a bit off subject, my apologies.
There is a difference between controlling wealth and having wealth. having wealth can be fun but controlling wealth is essential and rightly honorable. I believe that those in power today do not understand this simple concept because they use the money as if it were their own. this is wrong because it leads to selfish gain. if the money is merely controlled it can be directed properly. and if it's directed improperly... well death doth knock at every door.

[themuzicman]

NYK has the right idea, but he fails to recognize that Insurance is a valid product. He is correct in that our current health insurance (as most people have it) is a fraud.

Insurance is essentially paying for the transference of risk. You ask an insurance company to assume your risk, and you pay them to do so. Now, for $50 doctor visit (high risk, low cost) that makes no sense. But for a $200,000 heart bypass surgery (low risk, high cost) it makes perfect sense. You pay the insurance company $100 to protect you against it, and they collect $100 from 30,000 people, and pay off the 1 person who actually uses it, and keep the rest.

The thing to keep in mind is that on average insurance always costs more than just paying for it yourself. So, if the incidence of an event is high (say, monthly or annually), or the cost is low ($15 for antibiotics), then insurance doesn't make sense.


So, the solution is for insurance to cover catastrophic, unexpected, and relatively low risks costs. This is where it makes sense to spread our costs. To spread costs for a doctor visit is one part stupid, one part expensive, and one part explosive to medical care costs.

The current bill under consideration only makes everything worse by extending insurance for events that ought not be insured to more people.

If you want to fix the current system repeal the insurance tax exemption that companies get for offering various health insurance. We already have the alternative in place (thanks to REPUBLICANS), namely Health Savings Accounts (which DO roll over year after year.)

[Wolfmoon]

IMHO, all insurance companies should be non-profit entities supported by the people they insure. In private health insurance companies, where profits are valued above all else, the goal is to increase shareholder value (as well as the standard of living for the executives within the company) by increasing revenue and limiting costs. This is done by denying claims, making huge deductibles the norm, not insuring pre-existing conditions and any other number of tricks used by private insurers.

Almost the opposite is true of the medicare system where providers are paid by procedure performed, in the medicare system there is motive for providers to request too many procedures and fraud is hard to control.

What a messed up system :rolleyes:.

[Krazy P]

At the risk of using a high profile individual as an example, the head of the current administration in the U.S. (I dare not speak his name), recently had a check-up and got a virtual colonoscopy. The interesting thing is that this would not and is not available "normally" because of cost factors.

The real issue with the health care market is the disconnection between the buyer and seller on price. If I don't have to pay, I not only will not care about the cost of the procedure, I will consume more of the product. In one state in our great nation, Indiana, the Health Savings Account Plan was implemented with state employees. The plan has been shown to reduce costs, reduce over-consumption of health care, and increase consumer satisfaction. It is not theory, but fact. There is real data and real consumers and real doctors who are using this program today. (By the way, state employees also increased their take-home pay because they got to keep what they saved).

[NYK]

NYK has the right idea, but he fails to recognize that Insurance is a valid product. He is correct in that our current health insurance (as most people have it) is a fraud.

Insurance is essentially paying for the transference of risk. You ask an insurance company to assume your risk, and you pay them to do so. Now, for $50 doctor visit (high risk, low cost) that makes no sense. But for a $200,000 heart bypass surgery (low risk, high cost) it makes perfect sense. You pay the insurance company $100 to protect you against it, and they collect $100 from 30,000 people, and pay off the 1 person who actually uses it, and keep the rest.
what if you never have that heart bypass? where does the money go? should it be willed? more importantly, who would save up for a heart attack? and even a better question! Why is that man still alive!!

The thing to keep in mind is that on average insurance always costs more than just paying for it yourself.

true...but if you CAN pay for yourself you should feel free, if you need to ask for help feel free, if you can give help and you don't... would you still feel free?

So, the solution is for insurance to cover catastrophic, unexpected, and relatively low risks costs. This is where it makes sense to spread our costs. To spread costs for a doctor visit is one part stupid, one part expensive, and one part explosive to medical care costs.

Is it so hard to believe that with my system that my system would decrease fraud and crime rate? is it difficult to believe that bad people will die? I know these are rudimentary questions but honestly i believe it will drive down inflation. taking a burden in your hands and living and dying with that burden requires humility. as long as we do not accept this responsibility we will never become healthy as individuals, communities and humans.

If you want to fix the current system repeal the insurance tax exemption that companies get for offering various health insurance. We already have the alternative in place (thanks to REPUBLICANS), namely Health Savings Accounts (which DO roll over year after year.)

I'd rather shoot a politician as to talk to one. instead of putting a piece of insurance and tax mixed together in some kind of hedonistic perversive bond of pig fat sucking hell of the mind of satan to bring daeth to all humanity. Let's put the WHOLE SYSTEM of tax and insurance on the block and get rid of both systems entirely! this STYLE of tax is wrong we should go with that taxation of frivolous behavior only. no housing tax (that includes the view tax(what the hell is that about?)). no tax for transportation lest it be long distance and leisurely. no tax for learned informations. no tax for food. (taxing it is like wipping your but with it before I eat it). no tax on necessary medical S.O.P. or immediate life threatening moments as deemed by those who are familiar with the life. If there are none who are familiar, assets may be questioned due to unfamiliarity.(yes, people are assets). no other taxes my be put onto the public lest they are in congruency with the previous sentences that have the "no" and "tax" placed in such an order as to confirm the idea of having a tax set upon no other word or space in the sentence as long as the sentence is of complete thought.

[phej]

what if you never have that heart bypass? where does the money go? should it be willed? more importantly, who would save up for a heart attack? and even a better question! Why is that man still alive!!

It's called insurance and the transference of risk. If you believe with certainty that you will not have an expensive procedure, then do not enter into the insurance contract. But, do not cry if you do have an expensive procedure, but cannot cover it because you didn't get insurance. This is why prices for premiums vary. In a similar fashion, my actuarial life span is almost 90 years. Does this mean that I will die at the age of 90? No, it's just that a group of people with similar characteristics will die on average at the age of 90.

As for where does the money go? Why does it matter? But if you must know:

2009 Berkshire Hathaway Annual Report (To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.)

[..]Insurers receive premiums upfront and pay claims later. In extreme cases, such as those arising from certain workers’ compensation accidents, payments can stretch over decades. This collect-now, pay-later model leaves us holding large sums – money we call “float” – that will eventually go to others. Meanwhile, we get to invest this float for Berkshire’s benefit. Though individual policies and claims come and go, the amount of float we hold remains remarkably stable in relation to premium volume. Consequently, as our business grows, so does our float.

If premiums exceed the total of expenses and eventual losses, we register an underwriting profit that adds to the investment income produced from the float. This combination allows us to enjoy the use of free money – and, better yet, get paid for holding it. Alas, the hope of this happy result attracts intense competition, so vigorous in most years as to cause the P/C industry as a whole to operate at a significant underwriting loss. This loss, in effect, is what the industry pays to hold its float. Usually this cost is fairly low, but in some catastrophe-ridden years the cost from underwriting losses more than eats up the income derived from use of float.[..]

[zibber]

Everyone should pay a percentage of their income towards the maintenance of a universal health care system. There is enough to go around and there is no need to whine unless you are economically privileged. The problem right now is that all the economically privileged people form a huge cartel that is essentially in charge of both policy and popular opinion, working against efforts towards a solidary system from the inside as well as making people who are barely (or not at all) economically privileged afraid of something that would be best for the great majority.

[SirJac]

Personally, I think the most efficent healthcare system would be a 2tier system. First tier would be a basic public healthcare system, almost like what Canada has now but missing some of the covered treatments that aren't as fundamental to basic health. This would be funded by taxes and would be a manditory pay in. The second would be a purely private system where user pays upfront and has whatever advantages the private system can come up with over the public system (better care, shorter waits, more options etc.).

The reason why the first tier must be manditory pay in is so that the private system does not bleed the public system dry by offering basic treatment for costs lower then can be offered by the public system due to it's need to use the same fundng to cover more expensive operations. Without manditory pay in, the private sector would be able to force public healthcare premiums to go up until maintaining a public healthcare is no longer viable.

On the other hand, with manditory pay in, any time someone opts for private care fewer resources are used in the public healthcare and as a result the cost of maintaining public healthcare will decrease. Also, should any private healthcare provider have a cost advantage over public healthcare to deliver a particular treatment, public healthcare can pay them instead of provide the treatment themselves and realise further cost reductions.

This would cut into the insurance buisness, but not eliminate it. Instead of covering the costs of basic treatment, insurance could still be used to cover non-essential or enhanced treatment through either the public or private system.

IMO this would lead to much more efficient and robust healthcare system then is found in either Canada or the US.

[Wien1938]

Good God... I'm actually agreeing with Zibber again...

Arguing from a British perspective, the ideal of nationalised healthcare is the soundest and most efficient approach. The principle is simple. The costs of the NHS are paid from general taxation. Why is this fair? Because all benefit and this contributes to the health of our society (social, physical and economic).

I believe this is part of the what we might call the Commonwealth in political theory.