Health Care is Easy...

[King of the Americas]

Seriously, I have figured it out. It took me a year in grad school, but if you want, I'll help you set up a 501(c)(3) that operates as a non-profit health care savings cooperative, for your hospital district.

The model I developed for my district requires enlistees to pay a marketplace average premium price for their particular demographic, for one year. This subscription price is intended to create a fund large enough to sustain catastrophic loss. Private insurance premium prices current include- care or claims, administrative overhead, legal services, taxes, advertising, as well as profit. Government services can do the same more efficiently, because it can eliminate some of these cost drivers.

If your board members are required to volunteer, you can eliminate ALL of those problems...

After paying one year's marketplace premiums, subscribers become full-members, who's monthly premium is based on the actual health care services and medications consumed by the group the previous year.

The present re-imbersement model hospitals deal with from Medicaid, Medicare, and private insurance sources is..."inconsistent"... Hospitals actually have to do a lot of outright guessing when it comes to setting their prices, because they get repaid for the same procedure, at a different rate, depending on who is paying for the services, NOT what care the patient actually receives... As a non-profit, your organization can serve a single hospital, and negotiate/offer to pay 100% of all actual services consumed, at not only their actual price...because the hospital itself can get a tax deduction at the end of the year for donations made to non-profits!

Within your bylaws, you should include another requirements for members like 2 yearly check-ups and annual physical. This is intended to accomplish two things- early detection & create data. The data is really important as a long term cost reducer, as the ability to predict who will arrive at the hospital is the single piece of criteria missing most often.

When government and the marketplace fails, people ban together to form social groups, and the tax code both allows and encourages these actions. If you want to pay the lowest premium cost, while helping your hospital better prepare to serve your needs, create a non-profit health care savings cooperative.

Anyone here a fan of Alexis de Tocqueville?

 

[King of the Americas]

Crickets...?

:/

 

[Tony Stark]

You haven't solved anything anything. There would still be many people that would not be able to afford insurance.

And any kind of health insurance scheme needs large amounts of people to buy insurance without using it much in order to pay for the treatment the sick people need. But those that need insurance the least have the biggest incentive to not buy it. While those that need it have the most incentive.

How would a co-op make sure that enough healthy people buy insurance? They probably couldn't. The members would end up being disproportionately sick, which would force the co-op to increase premiums, which would in turn give healthy people less incentive to buy insurance.

Also, have you never heard of Kaiser Permanente? It is a 501(c)(3) that goes further than what you propose. Not only do they handle the insurance, they own the hospitals and employ the doctors (who are paid a salary). I believe they do a good job, but they still have plenty of competition from regular insurance companies and hospitals.

 

[Dr. Keith]

Also, have you never heard of Kaiser Permanente?

My first thought as well.

 

[Belz...]

Seriously, I have figured it out.

Trump had it figured out, too.

When's your "who knew?" epiphany?

 

[SOdhner]

And any kind of health insurance scheme needs large amounts of people to buy insurance without using it much in order to pay for the treatment the sick people need.

This seems like such a simple and obvious concept to me, but it's the part that a lot of "fixes" to Obamacare leave out. Not just armchair stuff, either - actual people in charge of policy. How is it that people don't get this part?

 

[Bob001]

This seems like such a simple and obvious concept to me, but it's the part that a lot of "fixes" to Obamacare leave out. Not just armchair stuff, either - actual people in charge of policy. How is it that people don't get this part?

They get it, all right, but their goal is not to cover everybody; it's to reduce government spending and lower taxes, which means kicking off as many people as possible who need Medicaid, who have pre-existing conditions etc.

 

[SOdhner]

They get it, all right, but their goal is not to cover everybody; it's to reduce government spending and lower taxes, which means kicking off as many people as possible who need Medicaid, who have pre-existing conditions etc.

Sure, but the plans being proposed are going to cause a total disaster due to not understanding this simple concept, and even if that's what the lawmakers want it seems like much of the general public don't get it.

Though maybe I'm mistaken?

 

[King of the Americas]

You haven't solved anything anything. There would still be many people that would not be able to afford insurance.

And any kind of health insurance scheme needs large amounts of people to buy insurance without using it much in order to pay for the treatment the sick people need. But those that need insurance the least have the biggest incentive to not buy it. While those that need it have the most incentive.

How would a co-op make sure that enough healthy people buy insurance? They probably couldn't. The members would end up being disproportionately sick, which would force the co-op to increase premiums, which would in turn give healthy people less incentive to buy insurance.

Also, have you never heard of Kaiser Permanente? It is a 501(c)(3) that goes further than what you propose. Not only do they handle the insurance, they own the hospitals and employ the doctors (who are paid a salary). I believe they do a good job, but they still have plenty of competition from regular insurance companies and hospitals.

Haha, we can accept tax-free donations, and extend coverage to those who can't qualify otherwise!

Yes, I have heard of that model. Mine is a form of how they began.

 

[Bob001]

Sure, but the plans being proposed are going to cause a total disaster due to not understanding this simple concept, and even if that's what the lawmakers want it seems like much of the general public don't get it.

Though maybe I'm mistaken?

The Repub lawmakers might or might not know, but they clearly don't care. Some part of the public, including in Trump Country, is starting to realize what they could lose, and that's why some congressmen are starting to worry about 2018. But it's a foundational Republican premise that there are "makers" and there are "takers," and the takers shouldn't get a damn thing from the makers.
https://www.washingtonpost.com/news...grams-that-affect-up-to-a-fifth-of-americans/
https://www.washingtonpost.com/graphics/politics/trump-budget-benefits-cuts/?utm_term=.14687c88efe2
https://www.washingtonpost.com/news...ugh-to-be-poor/?tid=hybrid_collaborative_2_na

 

[King of the Americas]

Trump had it figured out, too.

When's your "who knew?" epiphany?

Except the plan he supports reduces coverage.

 

[bobdroege7]

Yeah, its easy, health care is 17% of GDP, so your health care premium should be 17% of your income.

Problem solved

 

[Crossbow]

Haha, we can accept tax-free donations, and extend coverage to those who can't qualify otherwise!

Yes, I have heard of that model. Mine is a form of how they began.

So, ...

Your plan to cover poor people is to have rich people donate the money that is needed to pay for the coverage of the poor people.

For some reason, I would not expect such a plan to be successful.

 

[acbytesla]

So is Middle East peace.

So is Middle East peace according to the orangutan.

 

[ddt]

And any kind of health insurance scheme needs large amounts of people to buy insurance without using it much in order to pay for the treatment the sick people need. But those that need insurance the least have the biggest incentive to not buy it. While those that need it have the most incentive.

This.

You only can have an affordable health care system if you simply require everyone to buy insurance.

Secondly, on top of that, you need a risk equalization pool. For instance, in the Netherlands, 50% of the funding of healthcare insurance is collected by the Tax Office and distributed among the (private) insurers based on the risk profile of their clients. If you leave out this essential part, insurers will try to game the system and only/mainly attract young, healthy clients in order to make a hefty profit. Or you could just do away with the insurance part and go for an NHS-style system (or "Medicare for all").

ETA: and really, we've discussed all this ad nauseam on this forum when Obamacare was in the works.

 

[King of the Americas]

Yeah, its easy, health care is 17% of GDP, so your health care premium should be 17% of your income.

Problem solved

This guy says plainly smart things...

 

[King of the Americas]

So, ...

Your plan to cover poor people is to have rich people donate the money that is needed to pay for the coverage of the poor people.

For some reason, I would not expect such a plan to be successful.

No my plan if for a social group to share coolly the costs of the actual care and services their group receives.

My plan eliminates ALL of the cost drivers not direct associated with health care.

 

[Crossbow]

No my plan if for a social group to share coolly the costs of the actual care and services their group receives.

My plan eliminates ALL of the cost drivers not direct associated with health care.

Due to your poor spelling, your incoherent writing and your lack of understanding of the issue that you speak of makes me think that your OP is quite incorrect.

 

[Bob001]

No my plan if for a social group to share coolly the costs of the actual care and services their group receives.

My plan eliminates ALL of the cost drivers not direct associated with health care.

How big is your group? What are you going to do if some members require expensive, long-term care for chronic conditions? State-wide premiums for one company just went up in Iowa partly because one patient was racking up bills of $1 million per month. Can your plan handle that? And how big is your provider network? Will a large number of local doctors and hospitals accept your plan? Or are your members restricted to using one hospital and the docs who practice there?

 

[xjx388]

My plan is even easier than all that. You choose any provider you want, go to them for treatment and then pay them. Kind of like how we deal with food distribution and housing. We have a safety net for the poor and everyone else pays for what they use. You can't get simpler than that.