[NautiNurse]

Good food for thought. As we work to reverse the damage done to the most advanced health care system in the world, remember this word: Catastrophic.

I've been 'splainin the precarious health insurance situation for years before King O took the throne: Imagine the cost of automobile insurance if every oil change, tune-up and new tires were "covered services."

Third party insurance should be a risk pool of funds reserved for catastrophic health events, rather than every pill, sniffle, aching muscle or annual check-up.

The healthcare insurance industry evolved into obstructing the actual costs for medical services from the public marketplace. Too many years ago, I lost count the number of times I heard, "I don't care what it costs, I have insurance."

Put healthcare decisions back where they belong--between doctor and patient and patient's wallet--and the market will absolutely respond with reduced charges for medications, diagnostic studies and office visits. Has anyone noticed what happened to out-of-pocket charges for annual screening mammograms once they were declared not medically necessary? The price dropped by 50% in this area.

Medical savings accounts should be started when young people join the labor force. Medical savings accounts should be heralded as the primary insurance for healthcare. MSA should be pre-tax dollars, no maximum annual limit, with annual rollover. Only when the finances are back in your pocket, will you make informed and sound healthcare decisions, rather than left to an anonymous insurance adjuster who will lord over which tests and treatments you may or may not receive.

Finally, the Disability Industry needs to be crushed. Attorneys today specialize in getting people declared permanently disabled. These people are sucking the Social Security and Medicare funds dry. You would be appalled by the number of twenty-, thirty-, and forty-something year olds who have won the disability lottery jackpot.

[rodguy911]

Great post NN!

Throw in those now being placed Medicaid because there are no standards anymore and you have the perfect storm to destroy health care in the U.S and the beginnings of single payer.

You and Dr.Ben Carson have the same idea:

Medical savings accounts should be started when young people join the labor force. Medical savings accounts should be heralded as the primary insurance for healthcare. MSA should be pre-tax dollars, no maximum annual limit, with annual rollover. Only when the finances are back in your pocket, will you make informed and sound healthcare decisions, rather than left to an anonymous insurance adjuster who will lord over which tests and treatments you may or may not receive.

You are in some very good company. MSA's are a great idea. Great to hear from you.

[rodguy911]

OH you must be talking about tort reform! Never gonna happen! Look who rules us! they are all corrupt lawyers! Think they will ever do anything to disrupt their cash flow? Not gonna happen.

[maica]

Imagine the cost of automobile insurance if every oil change, tune-up and new tires were "covered services."

This is the exact description of the problem we have. Throw in "free" car washes - and see how many people then wash their own vehicles, or go to the drive-thru at their local gas station. Oh no, the "free" car wash will be done at the fancy detailing operation.

If our elected representatives really wanted to improve the cost/payment structure of medical services in the USA, delinking from employment should be the basic step. Personal control of insurance dollars is the only answer.

[TomGuy]

Finally, the Disability Industry needs to be crushed. Attorneys today specialize in getting people declared permanently disabled. These people are sucking the Social Security and Medicare funds dry. You would be appalled by the number of twenty-, thirty-, and forty-something year olds who have won the disability lottery jackpot.

Unless newer rules have changed, those attorneys are paid out of anticipated future SS/Disability payments. Thus, applicant must win disability. If the applicant loses through the appeals process, the attorney gets nothing and cannot bill the applicant.

If the applicant wins, the attorney is paid out of the 'waiting year' the applicant had to endure before he/she could apply. Payments are pre-dated to the date when the applicant filed, less 4 months (IIRC) and less the legislated amount allocated to the attorney.

[ROCKLOBSTER]

Say what you will about all the mandated coverages, with the exceptions of chiropractic care and mental health.It has been shown they only add about 1-1.5% to premium.

The offset is in that the carriers in a given state can offer a standard policy rather than an infinite number of custom-built cafeteria-coverage policies.

Doubling and Tripling of premium comes from “Guaranteed Issue”. Where those with “pre-existing conditions”(AIDS and cancer patients) wait until they get sick and then buy coverage.

This scenario, through adverse selection, creates the death spiral of premium hyper-inflation and benefit reduction.

GI completely eliminates the definition of “insurance” from the so-called “healthcare” industry. They can no longer insure healthy clients against unexpected medical expenses at a reasonable price.

[bray]

Nailed it Nurse. We need free market answers to this Marxist mess.

[kabar]

Finally, the Disability Industry needs to be crushed. Attorneys today specialize in getting people declared permanently disabled. These people are sucking the Social Security and Medicare funds dry.

The DI Trust Fund will be exhausted in 2016. From the 2013 SS Trustees report:

Social Security’s Disability Insurance (DI) program satisfies neither the Trustees’ long-range test of close actuarial balance nor their short-range test of financial adequacy and faces the most immediate financing shortfall of any of the separate trust funds. DI Trust Fund reserves expressed as a percent of annual cost (the trust fund ratio) declined to 85 percent at the beginning of 2013, and the Trustees project trust fund depletion in 2016, the same year projected in the last Trustees Report. DI cost has exceeded non-interest income since 2005, and the trust fund ratio has declined since peaking in 2003. While legislation is needed to address all of Social Security’s financial imbalances, the need has become most urgent with respect to the program’s DI component. Lawmakers need to act soon to avoid reduced payments to DI beneficiaries three years from now.

[upchuck]

Bray, thanks for an insightful post. Nauti, you nailed it big time.

As a triage interviewer at a local food/clothing/etc bank, I speak with these folks 8-12 hours a week.

Disability is the new welfare. The instant someone is laid off from their job, they do two things: 1. Apply for unemployment (no complaint there, it is their right), and 2. get a disability lawyer and apply for same.

Disability is a great gig, if you can get it. And based on what I see and hear, if you’ve got a really good laywer, a completely abled person can get disability. Once you’re on it, a monthly check for life.

Nauti, you’re right; this needs to be severely cut back and more closely supervised. Unfortunately, that won’t happen until the RATS are gone.

[Yaelle]

I agree with every word.

Laws change behavior; it’s been proven. Open up doctors and medical services to the market. Lawsuits reduced to gross negligence, people take risks when they trust a doctor to make quick decisions. Patients need to take that risk if a doctor is forced to make a quick decision him or herself. Informed patients can possibly make them beforehand, but sometimes trust is needed.

If medicine were opened up to the marketplace, and insurance was for catastrophic care only, you’d find doctors charging according to where their practice was. Cheaper in the middle class areas, slightly more expensive in the worst hoods because of safety, and pricy in Beverly Hills. As everything else also is. DUH.

It’s not that hard to figure out, for all but the anointed do gooders.