Tuesday, May 9, 2017

Healthcare Conundrum

Replacing Obamacare, By Howard Audsley

Any plan that includes coverage for "pre-existing conditions" is not "Insurance".

Insurance Defined: A social device for spreading the chance of financial loss among a large number of people.

In a nutshell, what the crux of the problem of ACA is the notion that coverage should be provided for pre-existing conditions. *That is not possible*.

In all future discussions of the ACA and Repeal and Replace options, one simple concept needs to be clearly understood.  Any plan that includes coverage for "pre-existing conditions" is not "Insurance" as defined above. Pre-existing conditions are not a chance of loss, rather are a guaranteed loss.

So, NO health insurance model that includes coverage for pre-existing conditions is ever going to work.

We don't expect an insurance company to sell car insurance AFTER* a person totals their car, or sell life insurance AFTER* a person dies. Yet, we insist on coverage for pre-existing conditions when it comes to our health care coverage.

Again,*it isn't insurance so we should stop calling it that and more importantly, stop looking for "insurance" solutions. They don't exist.

It is SOCIALISM* at its finest.

People wanting coverage for pre-existing conditions want the ability to *transfer the staggering cost of serious medical issues to a larger group of people that DON'T HAVE those problems. They want to contribute $1 to some group fund in exchange for the guaranteed ability to extract some untold and unlimited amount in exchange.

Should that be $1 in and $5 out? $50 out? $500 out? No limit out? Clearly the math for this will never work.  No gimmicks or tweaks can fix this.

*So, **any solution to this dilemma is not an insurance product. The only solution is to pool a large enough group of folks paying into a system that the contributions of the healthy pay the expenses of the sick.

What we are describing is a single payer system, where the total costs of the group are spread over the group and it costs what it costs, and each person pays accordingly.
But do they? *No, they do not. Some have more ability to pay than others, so they are asked to contribute more

It’s EXACTLY the same as Communism - each PAYS according to his ability - each RECEIVES according to his need. This also means: If you decide not to work, you don't have to PAY! Hmmmm.......

How much more is "fair" when one pays none and another pays for 10 or more? Is that fair?  Some say YES and some say NO. What a person says is "right" probably depends on if he is on the giving or getting end.

Almost all universal single payer systems are run by government, but almost all of them eventually bump into the reality that it is easier to spend more than you can take in. So, some means of rationing of care has to be implemented  either  Life-time limits, limits per occurrence or by refusing to pay for hopeless causes.

The plans can offer treatments for an aggressive cancer, but if they put you on a 6 month waiting list when you only have 3 months to live, you are not likely to get any treatment.  But hey, it was free!

So in the US, what single payer government run options are available? A quick study suggest that no fewer than 5 or 6 health care and treatment plans are already offered by the US Government.

We already have Medicare for the elderly; Medicaid for the poor, young and disabled; the VA system for veterans; plus we also need to remember that all US Government employees get coverage as an employee benefit? In addition, retirees and some others can purchase coverage through these systems.

Since what is needed is to find a home (a single payer) system for the 30 million, why not in one of the existing government options?

The most promising one is simply to use the same option the original ACA used.  Roughly 50% of all persons enrolled under the ACA were put on Medicaid.  If that was good enough for those folks, it should be good enough for all remaining enrollees_.

As for what it costs, do the same for those folks as the government does for it's retirees, etc.  Allow those folks to buy in to Medicaid. As with all programs, it costs what it costs.

Figure out what it costs and that is what you charge.

If they want coverage, they can get coverage, but they have to get it through Medicaid.

Let that existing government program be the single payer everyone is asking for. It exists in all 50 states, so it is already offered across state lines .All about it is known and again, it is already being used to cover the majority of ACA enrollees so, I'm not sure how those on the left could argue with this plan.

Problem solved!

Howard Audsley, ARA Audsley & Associates 9700 Bowling Lane Columbia, MO 65201

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