Thursday, September 10, 2009

what might it look like...

first off, I didn't get to hear Obama's speech, haven't read it, and have only heard a little commentary about it.


OK... lot's of folk are afraid of "government interference" in their health care. I'll drop the arguments about Medicare, the VA, and government employee's health insurance... I still think the best solution is single payer like the Canadian system but it isn't the only way to do it. Let me just throw out some suggestions of what a private option might look like and actually work.

Let the insurance companies continue to run the system but put these brakes on it...

Everyone must be insured at the same price for the same coverage. Nobody gets excluded because of pre-existing conditions, nobody has to pay a higher premium, and nobody gets dropped. The company comes up with its plan, prices it, and anybody can purchase it at that price.

Right now, the average US insurance company pays out less than 80 cents for medical care from each dollar that comes in. Medicare is about 97 cents. The French system, that cultural model of efficiency, is about 96 cent. Let's put a cap here and heck I'll even compromise some... say93 cents out of every dollar must go out for medical care. That eaves 7% to cover administrative costs and if they choose, profit. Don't get me wrong. There is nothing wrong with making profits... except when people's lives are at stake. So why get into that business? Look at the European system where private insurance companies have not for profit sections for health insurance but use that to build their business in other for-profit sections such as home owners, auto, and life insurance.

No deductibles. Either no or very small co-pays.

a single billing structure across all of the companies. A person visits the doctor and a single reimbursement form goes out to whatever company it is and they all pay the same thing. If the company does not pay the physician's office within a certain number of days, the company is fined.

Everyone must be insured. Who pays or how is it paid for? That could go any number of ways, but it must be structured to be affordable for everyone whether that is through taxes (my reference), government subsidies for those who cannot afford it or some other scheme.

move to a new community and need insurance? You don't need to wait for an "enrollment" period. If your old company doesn't do business there, you get insurance from another, no problem, no hassles.

Are there other requirements? Maybe, but these are a good start. Or just go with a Canadian style single payer system.

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