Sunday, November 10, 2013

Health Care Comprimise?

At some point, perhaps we'll get to an environment where solutions to health care industry issues can be logically and calmly discussed. One such idea might go something like this:

The 'no consideration of pre-existing conditions' is one quite popular provision of the Affordable Care Act (Obamacare). There is obviously demand for it. But, can it be provided in a sustainable (profitable) manner? I believe it can, with one condition. Consumers must be able to choose and providers must be able to offer, coverage for conditions a la carte, with prices reflecting the actual cost of treating everyone in the pool with said condition. No mandatory coverage.

Of course, the incentive from the consumer standpoint would be to not buy a particular condition coverage until after you've come down with the condition. This could still work. One condition could be a limited annual sign up window. You'd be responsible for your own expenses for up to the first 9 months or so, if you choose to wait. Also, plans would be based on actual costs, so your monthly premium might be quite high, but you'd only carry coverage for as long as you needed treatment for the condition.

This is very close to a direct purchase situation, except that the monthly price for treatment is based on the average monthly cost of treating everyone with the condition rather than the individual case. Providers could be organized as mutuals or trusts (as an option in addition to for-profit companies) and enabled to invest premium surpluses in order to offset treatment costs. Companies or coops could specialize in a particular condition and provide treatment directly for a flat periodic rate in a competitive marketplace. Of course this would not preclude other ideas/products for the provision of health care from entering or remaining in the market. The point is to expand the realm of possibilities, not restrict it.

Maybe this proposal is a real possibility. Maybe it can't work for some reason I haven't seen. But, if our goal is to actually create a healthy, vibrant, growing, innovating, thriving health care market, things like this will have to be objectively evaluated on their merits, not based on the logo sported by the individual who proposed it.

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