Friday, May 12, 2017

Separate Insurance from Welfare

Healthcare needs to be rehabilitated by the free market. But that would require that everybody pays for their own healthcare.  This is where we need to go to get healthcare costs down.

Our current system mixes insurance with welfare and we need to separate these, so that the insurance part can work for the majority of our citizens.

Insurance policies should protect consumers from “unforeseen” expenses, like auto accident rescue and repair costs.  Insurance consumers who suffer the onset of a serious disease should be covered, but if they will require prolonged expensive treatment, they should have the opportunity to transition to Medicaid.

Health insurance should not cover “elective surgery” or other treatments that are not “medically necessary” and should carry a lifetime max of $1 million.

Health insurance consumers who have current pre-existing conditions they cannot afford to pay for should be offered admittance to Medicaid. They should not contaminate the health insurance market.

Pre-existing conditions that do not have catastrophic costs, like Diabetes II should not be eligible for Medicaid. Those patients with very serious, very expensive illnesses like cancer, heart disease, etc. should be allowed to apply for Medicaid.

Medicaid should shift their coverage to emphasize catastrophic stop loss and assign responsibility for “preventive” to consumers.

We need a federal health insurance law to give insurance companies the ability to sell insurance whatever policies attract consumer demand. The premiums should be based on the health of the consumer, not age. Like automobile insurance, health insurance should include sunk cost of current treatments for current conditions in the premium.

Consumers should have full deductibility of medical expenses restored to the IRS 1040. Consumers should be able to fund their own medical savings accounts to fund future treatment costs.  Consumers should be able to self-insure.

Fraud, price gouging and abuse need to end. Predatory pricing, defensive medicine and malpractice suits need to end.

After these reforms are adopted and are working, government needs to announce that all of their healthcare expenses will be reduced by 5% a year. The healthcare industry needs time to reduce costs to allow free market pricing.

If government really wants to pay for the healthcare of all its citizens, government will need to get better at getting providers to lower the cost of treating catastrophic illness. They will also have to figure out how to prevent fraud and lowering the costs.

The problem is that government has never been good at preventing fraud or lowering costs. Having the federal government establish healthcare welfare is sovereign suicide. We really need to return to the community-based system we had in the 1950s.

In the US, 50% of the population spends very little on healthcare because they are healthy.  This group can pay for their own expenses or buy health insurance through their companies or buy individual policies. Some of them may need insurance to pay for catastrophic expenses and insurance should pay for this.  If they get “really sick” and will require “very expensive” treatments for a long period of time, they should be able to apply for Medicaid and transition to it.
There are two sides to “pre-existing conditions”. Insurance consumers don’t want the insurance companies to refuse to pay their bills, so some form of guarantee is needed. The other side of this problem is that insurance companies need to charge somebody to get enough money to pay the claims. Logic dictates that the sick should pay for their own treatments.

Norb Leahy, Dunwoody GA Tea Party Leader

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