Silicon Investor (SI) -- The First Internet Community

STOCKTALK

We've detected that you're using an ad content blocking browser plug-in or feature. Ads provide a critical source of revenue to the continued operation of Silicon Investor. We ask that you disable ad blocking while on Silicon Investor in the best interests of our community. If you are not using an ad blocker but are still receiving this message, make sure your browser's tracking protection is set to the 'standard' level.

Politics : Foreign Affairs Discussion Group -- Ignore unavailable to you. Want to Upgrade?

To: Katelew who wrote (215006)	1/26/2007 1:41:04 PM
From: neolib	Read Replies (1) \| Respond to of 281500

One last question, if it were up to you, how would you design a universal coverage program? Who's covered, who pays for it, what's covered, etc. ...just the basic details. I freely admit that it is a difficult problem, but IMO, people are so badly off on the basics that solutions are not likely. However, if I were to try it would look something like this. 1) Mandatory Coverage: Everyone MUST carry a minimum level policy. This is like the requirement for driving a car. The minimum policy must have pretty good catastrophic coverage ($500K or $1M). Please note that this is actually relatively cheap. This is the fundamental purpose of insurance, converting the catastrophic unlikely payments into reasonable periodic payments. 2) Mandatory Costs Estimates from Heath Care Providers: All non-emergency health care treatment must involve written cost estimates with both provider and customer signing the document prior to treatment. 3) Competitive Insurers: Anyone can set up an insurance company and compete. I would support good oversight and regulation of the industry however. I don’t trust unbridled commerce at all. 4) Portability: As a result of 1) & 3) preexisting condition clauses are illegal, anyone can change companies at any time, provided they are switching to equivalent plans (similar deductible, etc). Very small insurance companies might be excepted, or methods of reinsurance in the industry might be required. 5) Higher Deductibles: How low the deductible needs to go should be a function of income or means testing. If you are very poor, you will need low deductibles, if you are better off, there should be legal minimums (i.e. you can’t buy lower deductible coverage). This may seem counterintuitive to many, but it is the best cost containment method. However, a reasonable degree of flexibility should exist. 6) Hybrid Insurance Methods: We need more financial instruments which result in the same effective coverage, but blend MSA style systems with pure insurance approaches. 7) Uniform Tax Treatment: It is absolutely criminal that the current system differentiates based who pays. The tax implication needs to be linked to the policy holder, not the payee. 8) Prevention Intrusiveness: Insurance companies are allowed to conduct periodic random checks of their customers aimed at improving system efficiency through better prevention. Things that come to mind would be someone showing up at your door unannounced and tallying the contents of your fridge & cupboards to determine the health of what you are eating. In the land of the free & the home of the brave I’m sure this won’t go over well, but though luck IMO. 9) Risk Pools linked to behavior: There must be allowance for different risk pools, but not for genetic factors. I know, a can of worms, but 8) does no good with out 9). 10) Yearly financial summary: Something equivalent to W2/or 1099 statments should be provided to all customers, showing their yearly total health care costs. 11) Medical Records: Customer owned, and easily assessable. I’d add two additional items, but they have quite the can of worms of their own: 12) Excellent procedure documentation, such as A/V recording of all procedures, which become part of the patient record. 13) Provider Database: The performance of providers should be available to the public. Imagine the AMA agreeing to this: LOL! Now, as to who pays: The customer of course. For those too poor to afford it, assistance similar to assistance for food, shelter or any other such, would be needed. This comes in one way or another from wealth redistribution, typically through state or federal taxation. There is zero reason to include this redistribution explicitly within the health care system. Let in remain in the tax system.