In article , Go Fig
wrote:

In article , Guy
wrote:

If this money could be saved, think of what the U.S. could do with it.
It
could be used to insure the estimated 40 million people presently
uninsured

third have an automatic dishwasher.

Do you think any of those 41 million may have opted to roll the dice
and have a new 42" Plasma TV versus paying for a health insurance
policy ?

Some indeed may. But there are also some, such as myself, that were
slammed simultaneously by the tech crash and a financially messy
divorce, and are uninsurable through private plans due to preexisting
conditions.

A good deal of my work has been with healthcare, and I see cost shifting
and cherry picking as major problems with a profit-based health payment
system, especially one dependent on employers. There are several basic
economic problems with the current system.

First, there's no classic free market. In a classic free market, prices
come as a result of interaction between provider and consumer. In the
American system, however, the market interaction is between employers,
for which healthcare is a cost of business (dare I even suggest an
implicit tax), and third-party payors, who have multiple incentives to
cut their costs and prices: shareholder value, and price competition to
the employers.

Add to this unfunded mandates like EMTALA, and drastic differences in
what people pay to providers based on the payor negotiation. As a
personal example, my cardiac pacemaker had a "list price" of $24,000.
Between provider reimbursement and my co-pay, the hospital got $1600.
As an individual, I would have been charged the full $24K.

I am a diabetic, dependent for control on oral medications. The last
year was bad enough financially that I could not afford reasonable
laboratory monitoring. Now, I've run out of refills, and am scrambling
to get a discount plan in place so I can get prescriptions for a new
supply. Uncontrolled blood sugar is an invitation to even more expensive
complications. But unless I can get the discount soon, the options are
to wait three months for a clinic, and gamble I don't go into
complications that an emergency room WILL have to accept, even though
they won't be reimbursed.

Now, I'm not a general believer in uncontrolled self-prescribing, even
though that stings in my own case -- I have sufficient medical training
to know what to do and when to call for help. Last Friday, I tripped
and thoroughly banged my knee. The last time I did this (damaged the
knee worse, true, but was also in diabetic control), I wound up with
three weeks of a painful and expensive leg infection. Even now, I know
that a reasonable standard of practice might be to reduce the risk of
secondary infection with an inexpensive antibiotic (and, obviously, the
more expensive diabetic control drugs would help), but I can't get the
medication.

I have built hospital information systems where we had to maintain 400
different contract prices for the same procedure, obviously meaning that
the hospital had had to do 400 negotiations with different providers.
How that makes for administrative efficiency is beyond my ken

I think a 100% tax deduction for a catastrophic coverage is a very good
idea, as well and a true Medical tax free savings account.