Fix health care - keep it private but out of insurance hands

[Hyperion]

I believe health insurance is for the most part a scam. Health savings accountant and flexible savings account offer a more reliable alternative for 90% of the adult working-age population. At the moment they're mostly insignificant and secondary plans attached to cafeteria plans, but I believe with some legislation changes (the "use it or lose it rule" being abolished, allowing part of the funds to be covered by low-risk interest-bearing accounts) can make them competitive with regular health insurance.

Think about your average American: relatively healthy with some yearly hiccups. Four doctor visits a year, at most? One or two prescriptions that may need to be refilled for six months tops? If you're paying $2,000 a year, plus all of the other associated fees for doctor's visits, why not simply save up money in these accounts? With an estimated $150 billion subsidizing different health care agencies under Obamacare, why not instead provide a progressively-inclined rebate that matches contributions up to a certain amount? Say you get .50 cents for every dollar you contribute if your salary is $50,000. If you save up $1,000, then you get an extra $500 by the government that can only be put in these accounts. For an average 20-30 year old, that's all a person needs. It will probably be too much and will roll-over into the next year. For a family of 4, let's say you save up about $5,000; then you get $2,500. This can be adjusted and played with so that infants are also provided with an additional rebate protection.

Out-of-pocket prices will deflate as insurance companies lose out in the market. The attractive HSA options gives complete control over use to the individual or family; private sector job growth would grow in the issuance and tracking of purchases to make sure they're reasonable health expenditures, but that will be (again) in competition with health insurance job growth.

Meanwhile combine Medicare/Medicaid into one public option that is offered for seniors, the disabled, severely sick, and qualified poor and work out how to fix the prices by lifting price controls on foreign drugs, allowing seniors to shop outside of the U.S., and raising the qualification age. Heck, you can even implement a new tax bracket for those making over $800,000 and come up with nearly $10-20 billion in additional revenue depending on the going rate and enforcement patterns. Structure the public option so that it's beneficial for doctors and hospitals to enroll voluntarily: it can provide less profit-per-customer but the customer base is much larger. With all other current insurance models out of the way, this becomes even more attractive.

Basically, relegate health insurance to the public option and terminal care. Monthly expenditures would decline to the going rate of vision care (about $10/month). Most people between the ages of 18-50 are merely providing a profit to the insurance companies. The insurance model is built on getting more money out than what consumers put in. It's a giant scam unless you really, really need it, and even then why not offer terminal insurance and the public option if a pre-existing condition?

[Dennis]

Why not just shift to universal care and provide a tax deductible option for any private care utilized? That seems more simplified to me than hassling with trying to make insurance work.

[J.K. Gregg]

Or maybe stop subsidizing health care, artificially inflating the demand.

[The Dharma Bum]

[Indy]

Tell me again why we don't just have single payer?

I don't want to hear the arguments about how gov't is evil and that's why, etc., etc.--I want to hear why that's a bad idea when it seems to simplify so many things?

[dontworrybehappy]

The only gov't involvement in health care I support, and its really not even gov't involvement honestly, is every child receiving a free HSA upon birth. And allow that childs parents to put some amount, say 300 a month, before tax income, into that childs HSA which earns a little interest. When they come sick, they use what's in the HSA first. If that child builds a substantial savings and then gets deathly ill, the money to pay for a good portion of treatment is already there. And upon turning 18 they can keep the HSA open or withdraw the funds and close it.

I support that, but nothing else.

[Indy]

So you support parents... paying themselves for their child's health care. Revolutionary.

"Free HSA"? Is there another kind?

All for the low, low price of only $300/month. Priced to move!

[Medius]

Health Insurance isn't a scam, it just isn't designed to do what people want it to do.

If you want all people to have all the care they will ever want, you don't want insurance. You want them to have money in their hands to pay for stuff.

If you want all people to have all the care they will ever need, you have to define need, limit care, and then you can create a shared pool, however, it is still not insurance. Insurance must maintain the risk pool, which means selectively removing people that throw the risk pool out of whack.

The real problem with the whole thing is that people are looking at healthcare as one big problem with one big solution. It isn't.

-Emergency Care - Car accidents, heart attacks, things that require immediate intervention.
You can pay for these things out of insurance because they are infrequent, however, for universal coverage, insurance is a bad option. The risk pool on a universal pool is 1. It isn't risk, it is cost. This is a good target area for just flat out creating a tax infrastructure.

-Catastrophic Care - A massive one time or long-term chronic issue that is extremely expensive.
These are the best things to put under insurance as they are very infrequent. However, if you expect universal coverage, you have to look at a taxing pool.

-General Care - Preventative and maintenance care, non-essential.
This does not belong under insurance at all. The only way to curb costs on this is to give this cost to the people and let them make the decision on what to get and how. Having this under insurance inflates the price for everyone.

[Precocity]

[Indy]

We're already paying gobs in taxes--why not get something back for that money?