Name:   copperline - Subject:   Healthcare question Date:   10/7/2016 2:05:31 PM

1.         Setting a reasonable cost per month for health insurance would be hard, especially since the cost would mean different things to people depending on their financial situation.   Deductibles have a different purpose… they are used by insurance companies to keep people from over-utilizing their benefits… by “increasing the skin they have in the game”.   An annual deductible in the $1000-2000 ballpark seems reasonable, but $6000 per year seems excessive to me.
2.        There should be no restrictions like life-time maximums, pre-existing condition exclusions, or access to specialist care.  At some point in the continuum of care, gatekeepers may be needed to determine if/when specialist care is warranted by the patient’s condition.     In all cases you have to ask “why would you want to take insured healthcare away from people when they need it the most?”   Besides that, when someone ‘runs out of insurance’, they don’t stop needing treatment… they have to let their conditions worsen (and become more expensive to treat) and go to Emergency Rooms (where the cost of care is much higher than an MD office).
3.        Providing insurance thru employers is a flawed system.   Allowing people to purchase insurance by forming their own ‘insurance pools’ (think the government insurance exchanges), allows people to change jobs without interruptions of coverage, removes the burden of managing health insurance from employers, and allows coverage for people who are not working but not disabled.  (Think stay-at-home Moms, self-employed workers, or retirees).
4. A national single payer system (like Medicare) would ease the administrative burdens of health care providers and reduce their operational costs... right now, if 10 patients came into a doctor's office, they may have 10 different insurance plans with different forms, different procedures for requesting payment, different payment rates for procedures.   These billing differences are not minor, and billings that are not exactly what an insurer wants to see is reason for denial of payment.   For instance, a form may not be accepted if it is filled out by hand, in the wrong color ink, or the insurer rejects the procedure coding used.   Insurance companies use the variation in their billing procedures routinely to deny payments, costing either the provider who has to appeal & refile, or the patient who gets stuck.   A standardized billing procedure under a single payer would eliminate a lot of that needless complexity.

Federal retirees have a spectacularly generous healthcare plan compared to most everyone else.   Better hope that the spotlight never shines on this benefit and people start looking at this as one of those over-the-top federal giveaways.......