Thursday, December 3, 2020

Affordable Health Care Problem Solved (updated 2020)

The Solution to Affordable Health Care for All is Simple.

Affordable Health Care starts with doing away with letting the insurance industry dictate the price for treatment and services. Instead, the pricing for minor medical should be determined by what the market will bear.

Health insurance should be optional and only cover major medical treatment and procedures. Minor medical, such as treatment for a sore throat, should be priced according to free-market competition.

A typical doctor's visit takes about 20 minutes. Health care providers should be forced to provide quality services and a comfortable environment for their patients. Moreover, they should be transparent with their pricing, and the price should be determined by the socio-economic status of the area being served.

Amount of time U.S. Primary Care Physicians Spent with Each Patient as of 2018

It is plausible to use the analogy of food when speaking about health care: We all need food to survive, and there are several “quality” levels of food. Suppliers and vendors all strive to produce the best quality at each cost level.

For example, you can shop in many different grocery stores, and you can dine in a variety of restaurants, all for varying levels of cost.

Why not force the doctors and all their cronies to charge what the actual consumer will pay for their care and the environment they provide to the patient instead of what some insurance company's budget will pay?

Current Cost of Health Insurance Under the Affordable Care Act

In 2018, the average cost for an individual's health insurance was $440/month ($5,280/year). A family of two or more paid $1,168/month ($14,016/year).

Unsubsidized Individual Premiums Under the Affordable Care Act

Unsubsidized Family Premiums Under the Affordable Care Act

Who Has A Primary Care Provider?

In July 2018, the Kaiser Family Foundation conducted a national poll of 1,200 randomly selected adults. They found that 26% of those surveyed did not have a primary care provider. Interestingly, there was a difference among age groups: 45% in the 18 to 29-year old group reported having no primary-care provider; in contrast to the 28% within the 30 to 49-year old group; 18% of the 50 to 64-year old group, and 12% percent aged 65 and older without a primary-care provider.

Percentage without primary care provider by age
One-fourth of Adults and Nearly Half of Adults Under 30
Do Not Have a Primary Care Physician.
Source: KFF Tracking Poll

A Free Market Approach  

Imagine being free to choose your doctor for everything but major medical without insurance and pay a transparent fee for the visit, just like you do for food. Sometimes you dine at the top of the four seasons, and occasionally you eat in the basement.

Imagine having the ability to receive the attention of a doctor at a typical doctor’s office rather than wondering if your lack of the "Platinum Health Care Policy" will keep you from getting the best treatment.  

All of us are free to walk into any medical facility and receive a set price list for medical treatment (similar to the menu at a restaurant), healthcare, and pay for the services using officially recognized payment methods (i.e., cash, credit card).

Those of you wondering about malpractice are one of the reasons the doctors charge so much now. How about this, the care providers will treat their patients with the best procedures and products available? And, let’s move those complaints against providers under Tort Law, and yes, the providers will lose their license to practice and livelihood if found negligent in their treatment or care.

All physicians currently make a wage that sets them within the top 10% of all wage earners within the  United States of America.

How Much Would You Pay?

My plan would be to let physicians choose their own price for services. The smart ones would find out how much patients are willing to spend to have a clinician take a quick look down their throat, into their ears, and up their nose within 17.5-minutes. 

If you actually visit a doctor's office twice a year and pay an insurance premium of $440 per month, the office visits alone cost $2640 each. 

If you calculate this over 20 years, 18 to 38 years of age, when the person is healthiest, that a person on average will pay $105,600 for current health insurance.

That money, if invested conservatively, would earn just over $46,200 for a total of $151,800

So, even if the same person needed treatments totaling $100,000 over those 20 years, they would still have $51,800 remaining.

The Major Medical Care Issue

The problem of major-medical services must still be addressed. I believe a simple plan might be suitable to address this issue: increase the sales tax on all purchases to subsidize hospital services by 70%. The remaining 30% could be covered either as an out of pocket expense or through a private insurance policy. Which, of course, demands more consideration but to start, I believe we should:
  1. Establish private insurance companies that allow you to receive any type of medical treatment at any medical facility privatized (for profit) or public (non-profit) within the country.
  2. The purchase price of the insurance would be 5% of their income. Income could be the previous year’s annual income or the most recent pay stub. If a person does not have a pay stub, a formula could be used to determine their income: 15% of one's mortgage or rent to cover 1 adult. Each subsequent resident, you require an additional 5% of the housing payment up to a total of 35%. The 35% fee would cover 2 documented residents per bedroom. Therefore a 4 bedroom house policy could cover 8 people at 35% of the mortgage or rental note unless 5% of the total household income is established to be higher.
  3. The unemployed and homeless would be forced to rely on public medical facilities. These facilities would be established as the market dictated or use the emergency room of any medical facility. A portion of the sales tax allocated for these expenses would subsidize payment for this medical treatment.
  4. Illegal immigrants would not be eligible for the care described above. Instead, they would not be provided for in the same methods as those immigrating legally or citizens.
  5. Those on visas, resident alien status, or having otherwise entered the country legally for any length of time are eligible to use the pay for services system or purchase a short term insurance policy for a price that would be determined by individual insurance companies.
Reasonably, priced health care must first start with the reformation of malpractice insurance. Patients that are victims of malpractice should be given the right and encouraged to sue the responsible parties. However, before attempting to file suit against a medical professional, facility, and those working within the facility, there should be some screening that safeguards against frivolous litigation.

All medical professionals would be required to have some method of financially compensating victims of their malpractice. How this is determined could be by a federally mandated minimum of say $1,000,000 not to exceed $30,000,000. This fund could be provided either by an insurance company or held in a private investment account. Health care providers that choose the individual investment account must provide proof of the liquid assets quarterly to maintain licensure and operate legally.