Health  Care  Solutions


RECOMMENDATION:  Eliminate the Unnecessary Middlemen:

Have you ever considered the millions of people that work in the medical insurance business?
Are they really providing you a necessary service?
Are they really helping to keep down costs?
Are they really simplifying things, or increasing the unnecessary bureaucracy and cost?
Do we need all of these unnecessary middlemen?
Why not pay medical providers directly (like it used to be)?
 
PROBLEM:     Government  and  insurance  companies set up a bureaucratic system with themselves as middlemen, resulting in:
(01) skyrocketing costs;
(03) increasing medical insurance premiums;
(04) increasing malpractice insurance for health providers;
(05) increased taxes;
(06) institutionalized medical fraud; massive Medicare fraud;
(07) proliferation of fraud, and ridiculously high, multi-million dollar judgments (making the ambulance chasing lawyers rich mostly);
(08) an over-complicated system, confused by too many parties with conflicts of interest;
(09) insurance companies making medical decisions instead of your doctors;
(10) medical care quality becoming increasingly expensive and dangerous growing corpocrisy, corporatism, corporate welfare, and influence of government by corporations;  pharmaceutical corporations and the FDA are becoming pill pushers while hundreds of thousands of Americans are being killed in the U.S. (annually);
(11) complicated billing;
(12) ALL attempts to control costs have failed, since government or insurance companies are the guarantors of final payment;

SOLUTION:     Direct-Pay, Non-Profit  MEDICAL  FUND  PLAN(s):
(01) non-profit Direct-Pay Medical Fund Plan(s) can be created by any level of government and/or health care providers, and may be administered by the health care providers and/or government(s);  if a non-profit Direct-Pay Medical Fund Plan can not provide better (or equivalent) health care insurance cheaper than for-profit health care insurance, then there's something significantly with that government which needs addressing too (such a not repeatedly rewarding irresponsible, incompetent, FOR-SALE, and corrupt incumbent politicians with 85%-to-90% re-election rates);
(02) it is audited and monitored by an independent organization and/or government;
(03) participation is voluntary;
(04) However, since some people will try to abuse the system:
  (a) for 1st time participants, there are no coverage restrictions due to pre-existing conditions (up to the lifetime limit, L times the current median income (e.g. L=50));
  (b) there is a one-year minimum participation period; the balance of insufficient months will be added to the waiting period for former and returning participants;
  (c) for former and returning participants, pre-existing conditions are not covered for 1 year and there is a 6 month waiting period (plus any balance from part (b) above, up to a maximum waiting period of 1 year);
  (d) for the unemployed, but previously employed, their monthly premium is based on the larger of their last annual income in the last 3 years, or the median income;
  (e) for 1st time participants that are also unemployed, their monthly premium is based on the median income;
  (f) some people will still be unable to afford to participate, and that is the purpose of the welfare systems, which could extend this coverage to include the truly needy; but the two systems should not overlap because it will lead to complications which breed more abuses;
(05) it eliminates all reliance on both the government and insurance companies (unnecessary middlemen between health providers and patients);
(06) it eliminates insurance company bean-counters from making medical decisions;
(07) it reduces costs, since government and insurance companies are not the guarantors of final payment, and are not taking a huge cut for themselves;
(08) it greatly simplifies billing;
(10) it reduces fraud because there will no longer be an ignorant and indifferent middleman that doesn't care about fraud, and merely raises insurance premiums or raise taxes to cover the increased costs;
(11) Monthly premiums would be a flat percentage of annual income (to be neutral, rather than progressive or regressive).
For example:   (
1/12x  (N of gross income per person) x  (1  +  number of dependents)  ; 
Therefore, if
N% = 4.5 % , the monthly premium for 1 person with a gross annual income of $42K would be = (1/12) x (5.0% of $42K) x (1 + 0 dependents) = $157.50 per month
(12) The monthly premiums (above) could probably be smaller if the system is well managed, transparent, obtains high participation, and covered medical problems are reasonable (i.e. elective cosmetic surgery, and frivolous procedures are not covered);
(13) Unfortunately, there must be an lifetime limit of coverage which is L times the current median income (e.g. L=50); otherwise, a very tiny number of unfortunate situations would bankrupt and collapse the system.  Hopefully, costs will become more reasonable in a better managed system with the elimination of the unnecessary middlemen and cheaters.
(14) This plan could possibly also cover prescriptions; or a prescription plan similar to the medical plan could be implemented for an  Rx FUND PLAN.
(15) Medical Liability Reform is needed also;  some lawyers are getting unjustly enriched by capitalizing on other peoples' pain and misery, and driving some good doctors out of the profession.  The solution should not be caps on awards to plaintiffs, but reasonable caps on the attorneys' portion (e.g. limit per year to 20 x the median income + expenses; 20 x $40K would be $800K; that should be plenty to still encourage attorneys' to take on such cases).  Unfortunately, there are some instances of attorneys' making tens of millions in one year on one case.  There have been instances of some attorneys making billions on class action suits against tobacco companies.  Lottery type awards of that magnitude appear to be an abuse of the system; and possibly a  manifestation of unchecked greed.  One year in Washington D.C., all neurosurgeons were being sued.  While malpractice certainly occurs, it seems unlikely that all neurosurgeons in Washington D.C. deserve to be sued.
(16) The wealthy may choose not to participate, since N% (e.g. 2.5%) of a $1 Million income is $25K per year in premiums, but that's OK since the wealthy only account for less than 10% of the entire U.S. population (i.e. 40% of all wealth in the U.S. belongs to only 1% of the U.S. population).  That is, 80% to 90% of the U.S. population would participate.  The wealthiest 10% of the total U.S. population owns 70% of all wealth in the U.S.   80% of the U.S. population only owns 17% of all wealth in the U.S.   60% of the total U.S. population only owns 5% of all wealth. 
(17) If the system is efficient and reasonably managed, the N% percentage could possibly be reduced considerably. Also, health care is just one of many abuses hammering most Americans.  Health care costs may become more affordable if these many other abuses and problems are also adequate addressed.  195,000 people are killed each year in the U.S. by preventable medical mistakes. Thatís appalling. In the 8 years between 1999 and 2007, over 1.5 million people were killed by preventable medical mistakes. That is more than all the 917,316 American soldiers killed in all American wars (American Revolution (4,435), the War of 1812 (2,260), the Indian Wars (1,000), the Mexican War (1,733), the Civil War (462,000), the Spanish American War (385), WWI (53,402), WWII (291,557), Vietnam War (58,209), Korean War (36,574), the Iraq Gulf War (529), and the current Iraq and Afghanistan wars (5,232 as of 18-OCT-2009))  combined Compare those 195,000 killed by preventable medical mistakes to the 43,000 people killed annually in the U.S. in automobile accidents.
(18) We need more doctors and health care providers.  But there are some that want to limit the number of new students, pharmacists, etc.  We need to create more schools and create incentives to increase the numbers seeking a career in the medical profession.  Currently, the U.S. medical schools graduate only about 16,000 doctors each year.  That number has been almost constant for over two decades.  There are 20,000 first year residencies available each year.  Where do the additional 4,000 doctors come from?  They are coming from overseas (e.g. Pakistan,  India, the Middle East, etc.).  Also, the number of students in American medical schools preparing to become primary care physicians is going down (not up).  The basic laws of supply and demand help explain another of many reasons for exploding health care costs. 

Another huge cost that many Americans choose to ignore is illegal immigration.  Hundreds of hospitals are closing their doors.  Between years 1993 and 2003, 60 hospitals in California closed, and 24 others were near closure, and it is because half of their services were unpaid, and a huge percentage of those not paying are illegal aliens. If illegal aliens were not a major portion of those not paying for health care services, why are most of the hospital closures in border states (i.e. California, which the highest number of illegal aliens also has the highest number of hospital closures)?  In year 2005, in only one city in Texas (Laredo), there are 2,000 anchor babies born annually to illegal aliens in the Laredo Medical Center maternity ward, only one of hundreds of U.S. maternity wards, paving the way for blue
PassPorts for the parents.

This plan is also likely to fail if the U.S. continues to do nothing about the abuses that are hurting many of its systems (e.g. education, health care, lawlessness, regressive taxation, wars, inflation, economy, election problems, massive debt, and government bloat, corruption, and waste).

BENEFITS of Direct-Pay  MEDICAL  FUND  PLAN(s):    
(01) Eliminates the unnecessary middlemen (government and insurance companies);
(02) Participants can pay directly into a Medical Fund Plan that is managed by the medical providers themselves, by people with medical knowledge and backgrounds, which will reduce the number of health care workers being hired away by an insurance company to validate services and costs;
(03) It will save money due to inherent improvements in several areas (direct pay from salaries; simplified billing; reduced fraud; no middlemen; less bureaucracy; little or no government meddling; no need to pay salaries to employees of insurance companies and government employees);
(04) Better health care would result since Insurance companies are not trying to make medical decisions;
(05) There is no need for middlemen (government and insurance companies) to be profiting from people seeking health care coverage;
(06) It won't solve everything, but it would be a big step in the right direction. What we're doing now isn't working; 
(07) The medical community should seriously consider it, before the government takes over and creates a socialized health care system (which would not be ideal either, but would not be as bad as what we have now); that is, if the medical community can not find the will to deal directly with their customers, then the government will do it for them, and the medical community is not likely to happy with it; 

 


   
The Problem and the Solution (account for the human factor)
CONGRESS' To-Do List (see what Congress has done since the NOV-2006 election)
The Growing Disparity Trend (these did not all come about by mere coincidence over the last 30+ years)
Irresponsible Incumbents (what irresponsible incumbent politicians do while troops risk life and limb)
PROs and CONs (why to stop re-electing irresponsible incumbent politicians)
National Debt (it will take 143 years to pay off the National Debt)
Debt and Excessive Money-Printing (Inflation, Massive Debt, and Excessive Money-Printing)
Consider the Following Scenario (must we always learn the hard way)?
Plunder of the Environment (population, arable land, over-fishing)
Solutions (common-sense, no-brainer reforms that politicians resist)
Help  Educate  Others (peacefully force government to be responsible and accountable too!)
Badly-Needed, Common-Sense Reforms
The Cheater's Dialectic (learn to recognize their manipulation)
Frequently Asked Questions