mikewille

I like to compare the health care industry to the auto industry. If you buy a car you must have basic liability coverage. The rest of your plan is up to you. High premiums and low deductibles or low premiums and high deductibles. Discounts for being accident free and for being in low-risk categories, like being married, or not being a teen-aged male. And if you get in a bunch of wrecks, expect your rates to go up, and possibly be dropped. Then since you need to have coverage, you have to go with a high risk provider, who will charge a ton, but allow you to be covered. Your insurance also covers the costs of uninsured drivers who avoid the system until they get caught.

The concept is that you buy insurance when you buy the vehicle. You don’t get into a wreck, and then call State Farm and ask to suddenly have coverage, now that you see you need it. You may be accident free your whole life, but you still had the insurance. You can’t participate in driving without it. Yet you do not have to drive, so you can opt out if you want.

When I hear “horror stories” of people who don’t have insurance, I dig to understand the whole story before deciding if it is really a story of a bad system, or of a bad individual. The person who found out they needed some expensive tests or procedures now suddenly goes out and gets denied coverage. Well of course! They should have had insurance before they got sick.

The resolution to this national crisis is to open up health care to the consumer market as opposed to being employer-based. People have been trained that if you have a job, then you can see the doctor for the cost of a co pay, and if you don’t have a job, go to the ER and either pay cash or let the hospital pick up the tab. This then raises hospital costs which then drives up insurance costs.

Part 2 of the resolution of this national crisis is to do business with medical providers in a similar way that we do business with our vehicle mechanics. You can go in with insurance or as a cash customer. Either way, the prices are posted on a board at the check in counter and a full pricing schedule is available for you to take home. Estimates are provided, but final costs are based on actual work done. In the event that a mechanic finds something that was left off of the estimate, they must get permission to do the extra work. Without permission, the customer can refuse to pay for services not on the estimate. In the end, the customer is told up front what will and what will not be done, the costs are explained, and then the bill is paid, either in cash, a payment plan, or by insurance.

The current health care method hides most costs from consumers so the public is unaware on their own costs. Also when insurance is paid by an employer, the employee and their family thinks of medical costs as free or cheap. This makes the cash market seem incredibly expensive to someone who is looking for insurance or paying cash to a doctor outside of the employer based system.

Yes, a group of healthy people are needed to make up an insurance pool, that way the sick are the exception not the rule. But a group could be made up of members of a neighborhood that go to a local insurance rep, or members of a church, or members of a book club.

I agree that preexisting conditions should no longer be grounds for denial or cancellation, so Part 3 of the resolution of this national crisis to allow insurers to set rates for customers based on the conditions that they have, but not be canceled or denied. Also allow for insurance riders to exclude certain coverage with the trade off of a lower premium. This method works for the auto industry!

Oh, and yes, this means I am willing to say that not everyone is entitled to every medical procedure that they want, or that someone else thinks they should have. Are you? Or do you think Survival of the Fittest does not apply to humans?