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Honored Advisor

Sam, your Denninger Plan

I posted this on Farm Business, a link and a paste are a terrible thing to waste  Smiley Happy 

 

https://advancedmediterranean.com/2017/05/04/karl-denninger-healthcare-reform/  

 

 

Thoughts on the Denninger Healthcare Reform Plan

The only way to improve U.S. healthcare while bringing costs down is to introduce serious competition for healthcare dollars.

This post is for U.S. citizens since the federales are going to tinker with our health insurance reform very soon. This would be a great opportunity to make helpful changes  to the system. I have no faith they will do it.

Healthcare in the U.S. consumes one of every five dollars spent in the economy. We are not getting our money’s worth, at least judging from average lifespan.

Karl Dennnger has put a lot of thought into the problem over the last decade, and has a concrete leg.... I endorse it. As you consider the possibilities, you need to keep in mind that the cost of healthcare will drop drastically. Not just by 50%. More like 80% or more. Healthcare will be so cheap you won’t even need insurance to pay for most of it.

How are these price reductions possible? Because the Dennniger plan introduces competition and moves us closer to a free market situation without third-party interference from insurers and government.

Here are the major points:

  • All healthcare providers must publicly post (e.g., on the web) prices which apply to everyone. E.g., not  a price depending on which insurance you have, whether you are paying cash up front, etc.
  • All customers must be billed for actual charges at the same posted prices at the time services or product is rendered. This removes the third party (insurer or government). You file the claim and every one pays the same price. In a way, medical care isn’t too expensive; too often it’s “free,” because someone else is paying. So there’s no comparison shopping. You see posted prices and you pay them yourself when you buy gasoline, groceries, cell phones, computers, TVs, cars, and houses. A valid and collectible bill must be consented to in writing before the service or product is provided. Actual price, no open-ended add-ons.
  • No event caused by or a consequence of treatment can be billed to the customer. (I’m not sure I like this. What about unforeseeable complications like C diff infection after antibiotics, or anaphylactic reactions to drugs? Providers could eventually get insurance to cover those costs, but it would be a brand new insurance market.)
  • True emergency patients who are unable to consent must receive the same price for same service as a person who consents to said service.
  • All medical records belong to the patient and shall be delivered to the patient (customer) at the time of service.
  • Auxiliary services (e.g., x-rays, lab work) may not be required to be purchased at the point of use. Example: an orthopedist wants you to get a knee MRI scan on his machine. You can shop around other places for a cheaper or better-quality MRI scan.
  • All anti-trust and consumer protection laws shall be enforced against all medically-related firms, and any claimed exemptions are hereby deemed void. Stiff penalties and fines for violations. Private lawyers must have access to sue.
  • You are free to purchase any medical test you want if no radiation or drug is required to perform the test. (You can already do this in Arizona, but in many states you need a “doctors order” for the test.)
  • There will be no government payments for care or products when a lifestyle change will provide a substantially equivalent or better benefit, when the customer refuses to implement the lifestyle change. (This point needs some fine-tuning. Who decides when and which lifestyle change would provide an equivalent benefit?])
  • Health insurance companies must sell true insurance, to sell any health-related policy at all. No insurance coverage for an event or condition of which you received treatment over the last 24 months.  If an adverse event occurs, insurance pays for all of it. E.g,, if you get an expensive cancer, the insurance company cannot drop you. The insurance must cover, with a selection of available deductibles, all accidental injuries and true life-threatening emergencies. Medical underwriting is permitted (e.g., insurers can charge higher premiums for smokers, couch potatoes, obese folks, etc. I have long thought that people in the top 25% of fitness, determined by a treadmill exercise test, should get a discount on insurance premiums).
  • All health insurers providers selling true insurance, in whole or in part, must provide within their “true insurance” the ability to replace like with like.” (I don’t know what Karl means by this.)
  • Medicare becomes just another insurance provider. No more Part B (outpatient services).
  • Medicaid is repealed entirely.
  • What about U.S. citizens and “lawful permanent residents” who can’t pay for care but still need attention? For true emergencies, the hospital or Emergency Department bills the U.S. Treasury, who pays within 30 days. For non-emergencies, the provider bills the U.S. Treasury and will be paid within 30 days except no billing for government payment if the condition resulted from a lifestyle decision the patient made. After the Treasury Department pays the provider, Treasury will send an invoice to the customer (patient or taxpayer), which may be settled within 90 days at no penalty. If charges are not paid, they become a tax lien subject to collection from refundable tax credits, tax refunds, other entitlement checks (except Social Security retirement), and windfall amounts (either money or property).
  • Repeal all aspects of Obamacare/PPACA.

 

 

 

15 Replies
Senior Advisor

Re: Sam, your Denninger Plan

Well this is going to wreck Jen's day. Karl is right. It is competition that delivers a quality product at an affordable price.

Senior Contributor

Re: Sam, your Denninger Plan

You must hate all humans, It's a human right for every person to have a doctor paid for by mean rich people.   

 

 

 

 

Good job

Senior Contributor

Re: Sam, your Denninger Plan

Read KD 's latest article from yesterday on health care.
Also maybe cash for care becomes a viable alternative before shelling out $ 30,000 in premiums.
Anyone know much bout the Oklahoma Surgery Center??
Fly to Japan for a $150 MRI??
Veteran Advisor

Re: Sam, your Denninger Plan

Why would ANYTHING you speculate on happening, ruin my day? By the time all this gets settled, I'll be on Medicare. Remember - only a vocal 4% of the population is on Obamacare. 4%....I have health care....what you do - is your problem.

What I see is you farmers on here, want me to subsidise your health care, just like I already do your crop insurance, where America picks up most of the tab. Most farmers in America are rich....whether you think so or not. You have assets that the "normal" American does not....yet you want the less fortunate in America, to pay your bills.

Whatever....

Tick Tock......BONGx3!!!!

Jen
Senior Contributor

Re: Sam, your Denninger Plan

Senior Advisor

Re: Sam, your Denninger Plan

Very interesting web site.

Advisor

Re: Sam, your Denninger Plan

Read somewhere last night where someone said that"not being rich is the ultimate pre-existing condition".

 

But for as much as has been said about this House bill it is in fact, technically,  people serving in Congress keeping campaign promises. 

Veteran Advisor

Re: Sam, your Denninger Plan

Some of the above is already available

Lab tests...walkinlabs or directlabs, the first is LabCorp the second is quest. You can order
Your own labs and you get the results, and
Prices are modest

Cheap imaging....and there are a couple others.
They have a Dr that will give the order. Some
Locations ct less than $200, MRI less than
$300...and that includes reading it.
It was in the ACA and medicare that in a couple
More years that prices would be transparent
So you could shop.
Medicare already has caps...it called "allowable charges"
Senior Advisor

Re: Sam, your Denninger Plan

"Remember - only a vocal 4% of the population is on Obamacare. 4%....I have health care....what you do - is your problem."

 

Just a hypothetical -- WHAT IF it was your problem -- 

- what if you didn't have a job/retirement plan that provided you with health insurance options, you simply had an individual policy purchased on your own, you are self-employed, assume you have some health issues, and let's just assume you're still 5-10 years or more away from retirement?

- what if your insurance provider suddenly sent you a letter saying they were no longer selling health insurance, were not "marketing" policies to another provider, and your insurance policy was being cancelled effective end of month?

- what if, due to ACA requirements/restrictions/costs or other reasons, no insurance companies were selling individual health insurance plans in your area, outside of the "marketplace"?

- and, finally, what if the only reasonable immediate option available was the "marketplace", in which only 1 insurance company participates in your area, no choices?

 

Would that place you in the 4%? What would you do for health insurance?  How do you avoid a break in your health coverage?  Does any of this affect your views on ACA, relative to pre-ACA?  What should/could be done to make things better?  Would you wind down your self-employment, just to get a job that provides health insurance, and what about having some health issues, pre-existing conditions?  Or would you self-insure with savings (pay the ACA penalty) until you qualify for Medicare, hoping nothing major (expensive) happens to you in the meantime?  And, of course, we'll assume that the current House proposal is a non-issue (won't happen).