Tuesday, February 19, 2013

Health Information

My goal for the last five years has been simply to have a meeting in which people spoke about free market health care reform. The goal of this blog is simply to show the types of arguments that one might make if a group of people sat down to discuss free market health care reform.

Personally, I am floored by the fact that, after five years and hundreds of pleas to every "conservative" group within an 800 mile radius of Salt Lake City, I've been unable to find anyone brave enough to discuss free market health care reform.

To all of you so-called conservatives out there: If you have zero interest in even discussing free market health care reform, then you should shut up and support Obama in his effort to nationalize health care.

If you are unwilling to spend an afternoon talking about alternatives to ObamaCare, then you have no business campaigning against Obama.

I put together a program to start a dialog about free market health care. I've avoided putting the program online because I want a dialog and not another monologue.

I decided to tear a page from the presentation and present it below. This part of the presentation talks about the proper role of medical savings accounts.

The Medical Savings Account

I've been upset with the low quality of the health care debate. I believe that, in the information age, our health care debate should be information driven. The health care debate should start by discussion how we gather health information and how we decide if a plan is effective.
So, let's start with question: How would you go about collecting information about your health?
Imagine for a moment that you spent decades meticulously collecting information about your every health expenditure. You kept this information in an audited database.
This database would provide you with some great information about your health care needs. However, the information lacks context. The information you gather does not tell you how you fare in regards to others.
Now, imagine that ten thousand people gathered meticulous records about their health expenses and shared that information.
This second idea is absurd. The idea that ten thousand people would spontaneously start recording their health expenses is absurd. The idea that ten thousand people who created their own database would be able to share their information is even more absurd.
Now, imagine that you had a savings account and that every single one of your health transactions took place through this account. One could add a simple document management program with an itemized detail of the billing and the savings account would be an impressively detailed and accurate record of medical expenses.
If all of your health transactions flowed through an account in your name, then that account would become a de facto record of your health experience.
Now, imagine that ten thousand people had similar accounts and that they agreed to allow actuaries access to summary information about the accounts?
These individually owned medical savings accounts would become accurate records of our health experiences. Since each account is an audited record of individual health experiences, we could use the medical savings accounts as a basis for judging the effectiveness of our health care decisions.
In the insurance paradigm, payments flow from an insurance pool to the health care provider. The insurance company records information about health transactions that take place through their pool. If you move between pools or spend money outside the insurance system, then this information is excluded from your record and you have an incomplete health record.

To make matters worse, the insurance company holds your personal health information as a proprietary secret. Insurance companies might calculate your individual risk profile, but they don't want you to know this information because the imbalance in information gives them an edge in negotiation.

My thoughts on health care reform start with the notion that all of your health care transactions should take place through an account in the individual's name and under the control of the individual. If all transactions took place through individual accounts, then the individual accounts become accurate and audited records of the individuals health experience. If individuals had access to this information, then they could use the information in the accounts to help guide health decisions. Finally, if each person had an account that was under their control, then we would have an information base that we could use in judging the effectiveness of programs and in making health care decisions. The insurance paradigm creates a fractured view of the individual.

The first reform I wish to put forward is the idea that each individual in our society should have a medical savings account and that all of their health transactions should be driven through this account. It is basic information science. If each person had their own account and all transactions took place through the account, then these accounts would become accurate and audited health records.

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