How to Fix our Health Care System

Does everyone understand that our current health care system, in which the health care providers all get together with the insurance companies to work out how much will be paid for what, is simply a giant system of price-fixing?  The insurers and the providers all get together at conventions in places like Las Vegas, and decide what will cost how much.  There's all kinds of give-here, take-there. Scratch my back, I'll scratch yours.  And it's all worked out behind closed doors, then the insurance companies, who love to talk about actuarials as though they mean something, simply set their rates so that their bulk premium revenues outweigh their pre-arranged payment schedules, which they have pre-arranged with their partners (the health care providers). Our current system is rigged, folks! And it's all supported by vast layers upon layers of legislation put in place at the behest of lobbyists who work for the insurance companies, the pharmaceutical companies, and the big health care providers.

So here's how to fix it (and by "fix," I mean repair)

It's really easier than you might think, and it doesn't require a thousand pages of legislation to do it. In fact, it requires no government involvement whatsoever, It does, however, require that the government almost dis-involve itself completely.

Health care providers offer services. Said services must be paid for, since they cost something to provide. The free market is more capable than any other mechanism to ensure equitable provision of these services to all who need them. So here's the solution:

  1. A person who wants to go to the doctor chooses which doctor to go to, using any selection criteria he or she may desire to use.
  2. The doctor informs the patient of monetary charges for services rendered, just like a fruit vendor or internet service provider might do.
  3. The patient makes a purchase decision.

Now, of course, the wise patient will have already established a relationship with one or more care providers in the event of an emergency or urgent care requirement.  This onus naturally falls on the patient, as it is a basic responsibility of any real person in the real world.

That being said, any individual may choose to purchase insurance for the purpose of mitigating the potential high cost of health care services, were an unusual situation such as disease or accident to occur.  Said insurance involves a contractural agreement between the patient and his insurance provider, and has nothing to do with any health care provider whom the patient might patronize.

And Thus:

  1. It should be illegal for an insurance provider to be in communication with a health services provider regarding any billing issues.
  2. The doctor bills the patient in accordance to their mutual agreement. 
  3. The patient submits his doctor bills to his insurance provider, pursuant to their mutual contract.
  4. The insurance provider remits beneficiary refunds to the insured party, pusuant to their mutual contract.

Do you see how simple this could be? Do you see how much less administrative overhead costs are involved?

I'm sure questions will be raised about insurance fraud, and how to deal with it.  These answers are not only simple, but obvious, so I'm not going to bother addressing them here.

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Comments

The problem with the above is situations such as:

A neighbor has chosen not to have health care, and a terrible accident happens. Does that person get treated? If so, who pays for that bill?

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