The first
step should be to remove all penalties and allow the Obamacare participants a
chance to purchase cheaper major medical plans or open medical savings accounts
and allow them to cancel their overpriced Obamacare coverage.
The next
step is to repeal Obamacare in its entirety to remove costly rules and
regulations imposed on healthcare providers, employers and insurance companies.
These
changes should allow health insurance consumers a chance to migrate off of Obamacare
coverage and select cheaper coverage that may include lifetime maximums and
coverage maximums and medical necessity requirements. Items covered should not
be “bundled”, but should allow individually priced coverages to be chosen in a
“cafeteria” fashion, so that consumers can customize the coverage they buy. The
use of “annual elections” should be abandoned so that consumers can change
insurance plans with a 30 day notice and they don’t have to re-assert their
coverage. If a consumer chooses a plan,
it should remain “in force” until the consumer takes action to cancel the
insurance or modify the coverage.
Insurance
companies should have the right to establish limited rules to prevent consumers
from “gaming” the system. Maternity coverage should be required to be in effect
9 months ahead of expected delivery dates.
All premiums should be based on risk and be determined by past claims
like auto insurance. Those consumers who have diseases they have been treating
should have the cost of those treatments added to their premium until those
treatments stop. Those consumers who
have purchased “rescue and repair” major medical coverage should not be denied
coverage based on their medical history so that medical and hospital bills are
covered for serious illness and accidents.
There are
two major groups of consumers for healthcare. One is the group who receive
their coverage through their employers where premiums are based on the
experience of the group. The other group
is comprised of consumers who buy “individual” policies. Consumers who have experienced low healthcare
utilization should get the lowest cost.
Hospitals
should require indigent patients to secure loans to pay for treatments before
they are admitted. Those patients who fail to do this should be referred to
hospitals that serve indigent patients and receive charity funding.
We have
already tried to base premiums on age, but that doesn’t take actual utilization
into account for the 50% of the population deemed as “healthy”. We have already tried to cost-shift costs to
the young and the healthy like we did under Obamacare and that was an
unacceptable disaster. Going forward, we need to base premiums on risk and for
healthcare that translates to past utilization.
Norb
Leahy, Dunwoody GA Tea Party Leader
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