Sunday, November 14, 2010

What do you see as the purpose of health insurance?

What do you see as the purpose of health insurance? Should there be limits on the amount of health care provided? If yes, what criteria should we use to ration health care? If no, how should health care be financed so that everyone has access?
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The purpose of health insurance, is to transfer the risk of a serious health condition to the insurance company, while allowing me to still get care. There ARE limits on the amount of health care provided. We DO ration health care, now. If you want to give the whole world access, to American health care, obviously, financing would come FROM AMERICANS. The government doesn't make any money!! So, even to cover the illegals in our country now, fully, and the Americans that are uninsured, everyone that HAS insurance - including the employer group plans - would probably have to pay double. According to consumer reports, in 2005, our health costs in America, were over $7,000 PER PERSON, for one year. That's for every man, woman, and child. Clearly, the main focus has to be changing insurance to NOT pay for preventable things, or to make the individual contribute heavily towards preventable things. Obesity, smoking, uninsured pregnancy are all skewing the numbers upwards, but it's that very last year of life for our elderly (which is usually covered by Medicare, Medicaid, or absorbed by the care providers) which is most expensive. It's a very fine line, trying to decide how much a life is "worth". The very best answer I've ever seen, was written by another user here - "Spock". Here's his plan: 1. all medical providers are required to have, adhere to, and make available for public inspection a single price list, by procedure, which shall apply to every patient without exception. public inspection shall mean via an Internet available and searchable database maintained by each state. 2. every insurer and third party payer of every stripe, including Medicare and MediCaid, may determine for itself the level of payment it will provide to each and every provider in similar circumstances [by zip code of location and type of facility], with patient to pay any amount beyond this that provider requires. These two together set up the needed conditions for successful doctor shopping. your voluntary procedures like LASIK have price competition because people can shop for them. Asking people to shop for price while they have an emergency or urgent medical need is completely stupid -- thus the requirement of all providers that they have one price for all patients. 3. all medical records to be kept in one central database, accessible by all providers. patients who opt out of the database may be assessed by providers for such added costs as the provider believes necessary in the circumstances and insurers need not cover such costs. this may require that primary care physicians be paid a fee to enter patient's ordinary care data into the database and all other providers to pay a fee for using the database. item 3 reduces the cost of duplicate care by providing all medical records for patient to each provider. Many, many patients can not recall who they saw for what reason five years ago, nor why drug Z's use was stopped. This is especially prevalent in the elderly, who are our biggest per person users of medical care. 4. Physicians are required to prescribe generic drugs unless there is a medical reason not to and pharmacists shall fill all prescriptions with generics unless physician has indicated the name brand is medically necessary. 5. Continuing prescriptions may be filled by pharmacists for up to 5 years without a new Rx. 6. Prescriptions shall be valid in all 50 states for any drug that is legal in that state as long as physician has a valid license in the state where he is located. [physician license database is already online searchable and should include sample of signature.] 7. narcotics prescriptions shall require validation of Rx by pharmacist by indirect enquiry to physician's office via state database. items 4 thru 7 are designed to control cost of drugs. 8. all citizens are entitled to have, own and use an HSA [health savings account]. existing legislation is sufficient. Persons who do not have employer provided insurance may purchase such insurance, and contribute to an HSA, with tax deductible funds. such deduction goes on form 1040, not on schedule A. Amount of same to be not less than 2/3rds the average cost for similar age person as provided by all employer plans in same zip code for prior year. Congress may aggregate data further as it sees fit as long as difference in costs does not exceed 15% per person. [Similar to the aggregation used for travel lodging, meals, and incidental expenses.] purpose -- obvious. levels the playing field between employees with insurance and the self-employed. 9. abusive substances plan. For every abusive substance as determined by medical research, explicitly including tobacco and alcohol, plus illegal drugs and perhaps calories [obesity and diabetes are fast growing medical problems in America], a separate fund to provide medically needed care shall be established by the industry producing the abusive subs
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