Sunday, April 2, 2017

On Attacking the Freedom Caucus

Wow, the venom being aimed at the Freedom caucus in the wake of the TrumpCare vote is something to behold.

The Tea Party and freedom caucus played a vital role in tempering government expansion in the Obama years and were the primary reason for the revival of the Republican Party.

The GOP establishment sees the Freedom Caucus as a band of useful idiots who help the power mongers of the GOP when in the minority, but need to be soundly scolded and sent packing when the GOP is in power.

I have to admit. I am extremely upset with the Freedom Caucus myself.

I am not upset that the Freedom Caucus stands for liberty. I am upset that they spent seven years posturing on freedom but failed to create a viable alternative to ObamaCare.

Because the members of the freedom caucus will not discuss health care, we are stuck with TrumpCare.

TrumpCare is nothing more than ObamaCare with fewer benefits. TrumpCare, ObamaCare and RomneyCare are all the same damn thing.

Americans have a bigger reason to be upset with Trump than with the Freedom Caucus. Trump campaign slogan was to "Repeal and Replace Obamacare." His plan turned out to be little more than the to rename and rebrand ObamaCare (with fewer benefits).

Trump's campaign of "Repeal and Replace" was a lie. I am extremely upset with the lie.

Americans need to discuss health care. The only possible way to come to create a decent health care system is to discuss health care.

Trumps lie that that he had a plan to repeal and replace Obamacare made it that much more difficult to find people to discuss health care reform.

It was obvious, to me at least, that there was no substance behind Trump's campaign slogan. If Trump had a viable plan to repeal and replace Obamacare, he would have presented the plan and not just the slogan.

But, none of the GOP candidates were presenting viable paths to free market reform.

We are eight years into a health care debate, and I haven't found anyone in the GOP, with the Exception of Ben Carson, who has even the slightest interest in discussing health care reform.

I love that members of the freedom caucus is standing up for freedom.

Unfortunately, the Freedom Caucus is in a losing fight. Because Conservatives systematically fail to discuss health care, we are guaranteed to lose our liberty.

Simply standing for liberty does nothing. Simply standing for something is nothing but empty posturing. For people to realize liberty, we need leaders who actively engage in debates and who seek to solve our nation's problems with liberty.

A free society is not simply a society in which the government does nothing. A free society is one where people are engaged, at multiple levels, to improve the society.

A free society is not won through obstruction alone. It is one in which people are actively engaged in improving their personal lives and their communities at large.

The Freedom Caucus has failed to date because they have been following the Conservative methodology of obstruction and reaction. By following the path, the Freedom Caucus uses obstructions as its primary tool of engagement, the Freedom Caucus has failed to create a viable alternative to ObamaCare.

I am angry that the Freedom Caucus failed to create an alternative to ObamaCare, but, as they are the best that we have at the moment, I can't share in the hatred that Trump and the media have directed at the Freedom Caucus.

Friday, March 24, 2017

Told You So

Not that it's worth anything, but I was completely right in my predictions about the Trump Administration.

During the campaign, I kept saying that Trump did not have a plan to restore free market health care.

Sure enough. Donald Trump came out with a health care reform package that, at best, can be called "Obamacare Lite."

While Trump's plan reduces some of the benefits, some of the costs and some of the regulations of PPACA, the basic framework of TrumpCare is the same as ObamaCare (which is the same as RomneyCare).

To make matters even more depressing. The so called "Freedom Caucus" does not seem to have any substantive ideas on how to restore free market health care either.

The conservative movement has just proven itself to be as big a joke as the progressive movement.

I would be laughing, but the pathetic and disingenuous nature of the Conservative Movement is destroying our country.

Members of GOP are trying to cover the corrupt nature the conservative movement with claims that health care reform is hard.

They are wrong. If implemented correctly, free market health care reform could be delivered with minimal disruption in individual lives.

Free market reform might lead to the break up and dissolution of Fortune 500 insurance companies and it might reduce several billionaires to millionaire status, but it would not disrupt the lives of the people at large. It would actually improve the finances of most Americans.

The reason that Conservatives do not have a free market insurance plan in hand is because conservatives systematically refuse to discuss free market reform.

If there was a true discussion of free market health care; people would realized that employer based health care is an anti-market approach to health care. Employer based insurance is a revival of the feudal order. Your employer is the new feudal lord that controls your health and the person who controls your health controls your body.

A true and honest debate about free market health care would question the formulas used by the insurance industry. Such a debate would discover that these formulas do an inadequate job of providing care and have the negative side effect of concentrating wealth in a ruling elite.

True free market reform would not start with a discussion of regulations, but would start by creating new mechanisms for funding health care.

This silly thing I created called "The Medical Savings and Loan" was based on such a debate.

What I do in this program is break apart an insurance pool into individual accounts. The system funds care through a combination of savings, a loan reserve and generous grants. The system is administered by a new position called "The Health Care Advocate."

The system can be created organically from scratch, or it could be created by taking an existing pool.

If we created the MS&L from existing pool, we would see that the M&SL would have the same amount of resources as a health insurance pool. I can prove that the actual allocation of funds would be more equitable than an insurance company. Since people would start negotiating prices with health care providers, it is likely to dramatically drop the cost of care.

If I could find people willing to sit down for an evening and talk health care, I can prove that not only is free market health care reform possible. I can prove that the distribution of care would be more equitable.

Donald Trump is correct about one thing. All plans have winners and losers.

There is one group that would lose a substantial amount of money and influence.

The group that would be harmed by the Medical Savings and Loan is called "The Ruling Elite."

Progressives like to call this group "The One Percenters."

The insurance industry transfers trillions of dollars from the working and middle class to the ruling elite.

Creating an alternative to insurance would stopped this artificial transfer of wealth.

The wealthy and powerful people who control our nation would lose wealth. They would lose power. The leeches in our society who feed off the transfer of wealth from the people to the elite would lose as well.

It would be chaos in the Congressional Lobby as people who make their money by leeching off a corrupt health care system see their once lucrative pools of capital dry up.

Everyone else, of course, would benefit.

Personally, I don't care if billionaires see their position diminish. I care about the people, not the elite.

I have no problem supporting ideas that stop the artificial transfer of wealth from the people at large to the elite.

Unfortunately, the leaders of the Conservative movement care more about the elite than about the people. The very nature of the Conservative Movement is to favor the elite over the people.

The non-debate surrounding TrumpCare simply proves, once again, that the conservative movement is inherently corrupt. While conservatives are known to posture about free market reforms. They are unwilling to debate or even consider reforms that stop the transfer of wealth from the people to the elite.

So, while I deserve bragging rights and say "I Told You So." I actually feel extremely depressed because our nation is still on the Road to Serfdom. The election of the GOP simply changes the names of our feudal lords. It does not free the people.

Wednesday, November 23, 2016

On Insurance Workers

This is an interesting Tweet from Dr Shane:

"for every two doctors in the U.S., there is now one health-insurance employee—more than 470,000 in total" David Goldhill #DPCrising

Dr. Shane and David Goldhill blog about the rising costs of health care regulations.

I want to approach the number of insurance positions from a different perspective.

I once worked in insurance. My experience was that insurance employees are wonderful people who really want to help people with health care.

I see 470,000 wonderful people, most of whom are trying to make a positive difference.

The reason I left the insurance world was because I realized that the nature of insurance prevented me from making the positive difference that I imagined insurance offered.

The problem is not with the people, but with the configuration of insurance.

In the current system, our health care dollars sit in enormous pools. The money in this system flows from powerful insurance pools to industrial style hospitals.

A bureaucracy configures itself to the flow of money.

The careers of these 470,000 people end up aligning with the needs of the the insurance pool and not the the needs of the people.

The reform I propose is called: "The Medical Savings and Loan."

This reform starts by giving policyholders a medical savings account. All medical transactions flow through the account.

We replace the insurance pool with a thing called a loan reserve. Policyholders buy a share in a loan reserve. This reserve has about the same amount of money in it as the insurance pool.

When a person needs care, the money comes from their savings account. If there is not enough money, they can get an interest free loan from the pool. People who make enough to repay their loans are expected to repay the loans. Those who cannot receive grants.

The Medical Savings and Loan changes the flow of the money.

As bureaucracies shape to the flow of the money, the flavor of these 470,000 positions will change. The worker's efforts will start aligning to the needs of the people.

To emphasize this re-alignment, I created a new title: "The Health Care Advocate."

The driving mantra of the Medical Savings and Loan is: Those who can self fund their care should. The system redistributes money for those who cannot.

The Health Care Advocates help policyholders set up their savings plan. When people need care, the advocates help people find doctors and help in the negotiation of prices. When needed the advocates will apply for loans and grants.

Because the money flows from personal accounts to health providers, the work of these professional changes.

If we simply changed the structure of our health care system from pools to personal accounts, we could force a complete re-alignment of the insurance industry and all the positions in it.

Our problem isn't that people in insurance are bad and evil. The problem is the flow of the money.

Follow the money. The way the money flows creates an inefficient system.

If the money flowed from personal accounts to providers; then we would see these jobs align with the needs of the people.

Insurance companies have the job of protecting the pool. Health Care Advocates have the job of helping people maximize the return from their health care dollars. These advocates would be like personal financial assistants. Changing the flow of mone changes all the positions in health care and this improves care.

I think it is wonderful that 470,000 have jobs in insurance. I have no desire to make these wonderful jobs go away. I want to see their jobs aligned to the needs of the people and not the needs of an insurance company.

Thursday, November 17, 2016

A Doctor on America's News Room

I walked by a TV set and saw some talking heads on Fox actually talking about health care reform. The people may have been Bret Baier and Dr. Marc Seigel.

I am ecstatic. Most conservatives I know are intent on preserving Obamacare (under a different name) and refuse absolutely to discuss free market health care reform.

Sadly, what the doctor said was idiotic.

The doctor said the two keys for health care reform were tax deductions and the ability to buy insurance across states lines.

I wanted to scream. Tax deductions only help those who have active income streams. The people who are most in need of help have no income.

Buying insurance across states lines is going to make health care a nightmare.

The biggest problem is that interstate insurance companies do not have contracts with local health care providers.

If your employer decides to save money by buying insurance across state lines; you are likely to find that few local health care providers are willing to take you case because they do not have a contract with your insurance company.

This next paragraph might sound strange to readers, but it is the basis of insurance.

Group insurance works as follows. A group of people place their health care resources into a pool. When individuals need care, they and their doctor file an insurance claim against the pool.

The insurance claim is a lawsuit which is overseen by the court system. Currently the jurisdiction takes place at a state level.

I need to repeat this: An insurance claim is a lawsuit. You put your money in a pool and you must sue the pool to get the money back out to pay for care.

The reason that medical billing is so bizarre is because it is designed for processing through the legal system.

The current system is nuts.

Insurance companies and doctors try to streamline the claims by creating local buyers network. In these networks, insurance companies negotiate the prices of goods and services with local doctors.

These insurance networks are, theoretically, the cost saving mechanisms of insurance.

Insurance companies often have large directories showing which doctors are "in network." These doctors have negotiated with the insurer to provide care at a set price.

When your employer decides to save some money by buying insurance across state lines, you will find that there are few "in network" doctors.

Having few in network doctors means you will not receive the care you desire.

If your employer buys insurance across state lines, you might find that many doctors refuse to accept your insurance because they do not want to take on the hassle of filing an insurance claim in a different state.

Anyway, I was ecstatic to see people on TV discussing health care reform.

Yes, I was disastisfied with the discussion, but people have to go through multiple discussions to find a good solution.

A discussion about free market health care reform must go deeper than talk about tax deductions and state lines. We need to discuss the foundations of health care. If anyone wants to engage in a substantive discussion about health care reform, they could contact me. I have research on hand that would serve as a basis for an illuminating discussion.

Sunday, November 13, 2016

Nationalized Health Care Regulation

Prior to ObamaCare, Insurance was regulated at the state level.

Sadly, state regulators tended to become the lapdogs of local insurance companies. State level regulations tended to align with the desires of insurance executives and not with the needs of the people.

I want to point out that this problem arises from the nature of health insurance. Putting all of our health care dollars in huge insurance pools creates powerful entities that can bully the state.

The US founders did not want an overbearing Federal government. This is why they created a Constitutionally limited Federal Government.

The founders wanted a system where the individual states could experiment with different ideas about local governance.

ObamaCare wrested control from the states and gave it to the national government.

BTW, the process of wresting control of an industry and giving it to the national government is called: "nationalization."

ObamaCare nationalized insurance regulation.

Repealing ObamaCare means denationalizing insurance regulation and returning it to state control.

Donald Trump's going on air and saying that he seeks to keep provisions of ObamaCare means that we will keep regulation of insurance at the national level. It also means that we lose the ability for the states to become laboratories of local regulation.

I did not jump on the Trump bandwagon during the campaign because I did not hear the campaign give specifics on health care reform.

The only specific Donald Trump gave was the idea that companies should be able to sell insurance across state lines.

So, lets jump back to the question of state regulation. It turns out that regulations dramatically affect the performance of a pool.

Lets say Nevada regulations said the maximum deductible was $5,000 and California set it at $6,400. A pool in Nevada would behave differently from  one in California.

The goal of selling insurance across state lines requires that the Federal government becomes the primary regulator of insurance.

This is why I was complaining before the election. Trump's statement that he would repeal ObamaCare was different from his statement that he wanted companies to be able to buy insurance across state lines.

I am really sad that things are turning out the way that they are. But the only way we could free market heatlh care reform is if people spoke with one another. But there is no way that this could happen in the current political climate.

Saturday, November 12, 2016

Trump plans to keep portions of Obamacare

My criticism of Donald Trump was that he did not present a coherent alternative to PPACA and I have yet to see anyone in the GOP talking about substantive health care reform.

In interviews with Wall Street Journal and others, Donald Trump said that he planned to keep key provisions of Obamacare.

This style of politics is precisely what happened in the Bush presidency. GW Bush made a few allusions to free market health care reform. There was never any serious discussion of alternatives. In the end, GW Bush dramatically expanded the role of the Federal Government in health care.

It is not too late. I still contend that, if a group of people met and discussed free market health care reform. That group could prevail.

But, as long as conservatives refuse to even discuss free market health care reform, we will have no option but to continue with PPACA and all of the inequities that PPACA creates.

Thursday, November 10, 2016

American Needs a New Health Care Plan. The first step is to talk.

Funding health care is a business problem. It is not a political problem.

I've complained that Trump does not have a clear plan for repealing Obamacare.

This really is not a problem. As I said in the opening sentence. The solution should come from the private sector and not the president.

The big problem we face is that there are no viable business solutions on the table.

This is an easy problem to solve: A half dozen people could sit at a table. Talk about free market health care reform. They would write up and publish a business plan.

At this stage in the game the six people don't even have to be serious about starting a business.

The way I see this going is that group meets. The group draws up a business plan for funding health care. The group then creates an advocacy group for this business model.

Back in the 1980s I worked designing program for an insurance firm. I concluded that insurance fails to give us the health care that we need. This is easy to prove.

So, I created an alternative to insurance which I called "The Medical Savings and Loan."

This MS&L funds health care with a combination of savings accounts, a loan reserve and grants. The center piece of the plan is a new position called "The Health Care Advocate." The advocate replaces insurance agents and claims adjusters.

I created the MS&L as a mechanism for breaking apart insurance pools into individual accounts. A defining characteristic of the program is that the money flows from individual accounts to the health care provider.

This simple change opens up a huge debate about the nature of insurance. Since the money for care is flowing through individual accounts, the MS&L creates a better picture the health care that we need in our society.

It turns out that, in free society, the vast majority of people (over 90%) could self fund their care. The mantra of the MS&L is simply: "those who can self fund their care should."

The program has a generous system of grants to help those who cannot self-fund their care. The mathematical model I created indicates that the MS&L is likely to get more money to the people in critical need than group health insurance.

Since the money is flowing through individual accounts, the MS&L will restore the pricing mechanism in health care which will lower health care costs.

Of course, delivering health care is about people and not mathematics. The central piece of the MS&L is a position called "The Health Care Advocate."

The business model I want to create is for the advocate. The advocate replaces the health insurance agent.

The presentation I have starts with the MS&L as a mathematical model, but it ends up talking about the advocate and the human side of health.

Anyway, if there was someone interested in discussing health care reform, they could contact me. I have some wonderful ideas that could profoundly affect the health care debate.

The down side. I live in Utah, but I am willing to travel. If a person can guarantee a group of six people willing to discuss and work for free market health care reform, I would be willing to take out a loan to travel and meet the group.

The upside of living in Utah. We have great skiing. If people want to have a ski vacation and talk about free market health care reform when they are off the slopes. I could work that out. The only problem. The snow isn't here yet.

To recap:
  • Trump does not have a plan for repealing Obamacare.
  • Not a problem: Funding Health Care is a business challenge and not a political one.
  • What needs to happen is for a group meet to create an alternative model for funding health care.
  • The group would create a business model.
  • After creating the business model the group would create a non-profit advocacy group to promote the model.
  • The advocacy group would select a spokesperson. That spokesperson would go to TV stations and talk about the model.
  • The spokesperson would meet with leaders in their state and might even go to Washington to meet the president and people in Congress.
Funding health care is a business challenge. It is not a political challenge. The first step to facing this challenge is for a group of courageous people to sit down and discuss alternatives to group health insurance.

There may actually be wonderful rewards for anyone who is brave enough to think.