WHY CAN’T AN INSURANCE PLAN BE BASED UPON THE LAW OF LARGE NUMBERS BY GOVERNMENT CHARGES BUT YET UTILIZE PRIVATE INSURERS TO ADMINISTER BENEFITS.
Government invention imposing taxable fines on individuals who do not carry health insurance and mandating businesses to provide an approved health insurance plan for all employees in this economy will not cut it. The doors of businesses are closing one after another, because the stimulus plan promulgated by the government only assisted banking, which today is not lending money, or cannot lend money due to the state of the economy.
So what if we considered utilizing government along with private insurers in providing a health care plan, based upon the law of large numbers? Today, many are unable to carry health insurance and numerous more have not carried health insurance and have ended up on the welfare rows. The doctors, themselves, have the right to charge adequate fees because of their education and the fact that they have had to pay high medical malpractice insurance due to the suing practices of individuals. A ceiling is required on what may be awarded in the courts relative to malpractice claims as well as to the amount of money charged by attorneys...
First, let’s have a plan where private insurers and the government work hand and hand. And, let’s make certain we utilize the law of large numbers, including illegal aliens, if they are to receive benefits.
The insurance which should be provided through the collection of fees by the government would include those items construe d as major medical or catastrophe insurance and shall not include such daily visits to a doctor, drugs utilized for care at home, or home skilled nursing care. It should also include such items as dental surgery or eye surgery as warranted. It would, of course, include surgical, chemotherapy, hospital, renal kidney failure procedures, pace makers emergency rooms if hospitalized and blood work to name a few and it could include a coinsurance percentage up to 20% or yearly deductible such as the Medicare plans of today. For those whose faith does not condone to specific services, such procedures such as spiritual healing, acupuncture, and chiropractic services may be part of the major medical plan.
First, the government would assess specific basic fees based upon each individual to receive insurance in the form of a tax but in actuality, a premium. This deduction would be made as social security deductions are made. This basic fee would include a separate fee for a husband, a wife, and each child. And, the fee charged would be based upon an actual percentage of the wage earners gross earnings. Therefore, those making less would pay less, and those making more would pay a higher fee subject to a maximum amount so as to be fair and equitable. If an existing condition applies, a specific surcharge would apply to the individual based upon actuarial determination. Because all who are employed or unemployed would be contributing to such insurance, the costs actuarially should be far lower than the cost of health insurance purchased privately today.
Although the government would collect all taxes or fees by payroll deduction, or deduction from state unemployment or welfare checks, an agency would be formulated comprised of board members from the major health insurers. This agency would be in charge of assigning specific individuals or groups to certain private insurers who would in actuality provide the benefits for such care. The government would pay the various agencies based upon the work which is handled such as administrative, clerical, accounting, etc. Thereafter a larger percentage would be provided to each private insurer to facilitate insurance for the individuals included in their group of insureds assigned. The assignments by the agency should be balanced based upon those of higher risks and lower risks so that no one insurer has only poor risks and that each private insurer has the capability of retaining a surplus for the payment of claims as well as a surplus for administration expenses and profit.
The private insurers would be responsible for administration, sale’s representatives, customer service and claims handling. The most logical way of handling the payment of such programs would not be health maintenance organizations, but payment on a fee-for-service basis, with minimums and maximums of no more than 15-20% more than the scheduled fees paid for medical services and procedures. This would not prohibit individuals from seeking help anywhere within the United States or its territories from any doctor they would require.
As the funding grows by the collection of taxes and fees, discounts may be given if warranted by actuaries, for those who are not chronically ill.
And as to those procedures not covered by major medical plan coverage mandated or formulated in conjunction with the input of private insurers, a supplemental medical plan may be formulated in the competitive market. These plans would cover doctor visits, chiropractic visits outside of the hospital, hospice care, and home skilled nursing care, as well as disease management and drugs. The plans could be designed for consistency with perks given by the specific private insurers such as providing eye glass coverage or hearing aids. These supplemental coverages, similar to those relating to Medicare would be sold by each private insurance company based upon a fee similar to purchasing insurance today.
So why has the government decided they are going to provide health care when a plan which includes health insurance companies along with government agencies may provide a better way of serving the public at large, at a lower cost because all who are to receive benefits, must be insured under the government plan whether through some form of social insurance or through employment.
Therefore businesses can start operating based upon just general wages and services rendered, building profits. A new agency would be formulated with various branches in all states which would administer the programs through private insurers and an independent agency system. It would provide for an increase in jobs and money flow within the marketplace, as well as provide affordable insurance to all members of the public. It would diminish moral hazard for those who chronically visit doctors because private insurers are paying the bill. And, for those from other countries who do not purchase such insurance through payroll deduction or other means, there would be no insurance coverage. Thus by mandating payments be made by all, it eliminates the complaint of providing better services to illegal aliens than those of our countrymen.
Please provide your comments. Let’s work toward a plan that makes sense rather than costing us more money in stimulus payments while building businesses and the entrepreneurial spirit this country was built on.