Tuesday, July 7, 2009

Maybe It's Broken, Maybe It's Insurance

Everyone talks about how the U.S. health care system is broken.

Or that's what they'd have you believe anyway. The filibuster-proof Congress is busy trying to ramrod yet another entitlement program down our throats in the form of "universal health coverage".

These poor people can't afford insurance, so let's insure everyone at taxpayer expense and squeeze out the private market -- that's the end game; what's going through Congress now is the opening chess move.

So, the system is broken, right? Maybe parts of it are, but maybe not the part you thought. Everyone is focused on getting insured. Extending insurance. Providing a single payer insurance system.

What if we just chucked the insurance part and hooked up the doctors and patients directly. That's what a group in Seattle is experimenting with: flat-rate, no limit primary care.

[Reuters] Qliance says it is a private alternative to the failures of insurance, which have made health care President Obama's top legislative priority in Congress, with a price tag of $1 trillion or more.

Qliance customers pay $99 to join, then a flat monthly rate of $39 to $119, depending on age and level of service. Patients can quit without notice and no one is rejected for pre-existing conditions.

Patients must go to outside brokers and qualify medically to buy catastrophic care. One broker said a 30-year-old could expect to pay $133 per month for such care, and a 60-year-old nearly $400, plus substantial deductibles.

Qliance patients get unrestricted round-the-clock primary care access and 30-minute appointments.

"Why would a doctor not want to see sick people? That doesn't make sense, unless you're an insurance company," Bliss said.

He rejected the idea that unrestricted access causes overuse, calling that "nonsense promoted by insurance companies .... There's nobody I've ever met who gets their pleasure by seeing doctors."

Bliss said dumping rigid, convoluted insurance requirements and paperwork saves large amounts of money.

I know with the turmoil of the Y2K scare, the Dot Com bust, the housing bubble break, and the financial meltdown and recession, I have toyed with the idea of reverting to barter for services. Hey, Doc, have a look at my sick kid, while I secure your IT infrastructure. I've never done it, but I have thought about it. The tax implications have shied me away from it.

But the overall concept remains: challenge the assumptions. If you think X service is too broken, too unethical, too intrusive, maybe we should start an alternative that we can all get behind.


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