According to Americans For Prosperity, it looks like the uber-Conservative state of Arizona is gearing up to impose a Health Exchange. AFP is holding a debate on the exchanges Sept 5, 2012 at the Goldwater Institute.
I really wish I could attend. This is the first public meeting that I've come across that questions the Health Exchanges.
PPACA (ObamaCare) is a network of health exchanges regulated at the Federal Level and implemented at the state level. Romney's promise to repeal ObamaCare will simply remove the Federal regulation, but will leave all the state run exchanges in place.
Romney will repeal the bill the created the exchanges, but leave the exchanges in place.
The end result of this political move is to capture the exchanges.
The Romney/Ryan administration will then seek to relabel the exchanges as the free market alternative to Obama's socialism.
The problem is that the Health Exchanges are not free market. The Health Exchanges in RomneyCare and ObamaCare create a captured market that centralizes health care and allows the ruling elite to skim billions off the system.
Wake up America. The fact that the uber-Conservative state of Arizona is following the path of RomneyCare should tell us that our nation is still headed in the wrong direction.
Both RomneyCare and ObamaCare are founded on the false assumption that insurance is the only possible way to fund health care. The goal of the Health Exchanges is to force everyone into highly centralized network of insurance options.
The best way to defeat this beast is to debate alternatives to insurance. I am still at the ready if there is any group brave enough to stand against the Democratic and Republican beast that has taken over our nation.
Friday, August 31, 2012
Thursday, August 30, 2012
Replace It With What?
I found Romney's speech (and the whole Republican National Conference for that matter) big on image, but short on substance.
I am not supporting Romney because I know that if we have just another power exchange with no substantive change in our economic theory, we will not be able to restore our nation.
The convention left us with a great image of how wonderful Romney is and how the world will end if Obama is re-elected. But there was no substance.
The closest hint of substance was a vague promise to repeal and replace ObamaCare.
REPLACE IT WITH WHAT?
The reason I am so completely dead set against Romney is that in four years of debate about health care, I have seen no substantive debate on free market health care reform.
I worked myself into abject poverty driving to Reno, Denver, Phoenix and Las Vegas to find a Conservative who would talk about substantive free market health care reform.
There may be substantive debate about Free Market Health Care reform that I don't know about. But it's not at the RNC. The Utah Freedom Conference doesn't even have free market health care on the agenda.
In Utah, the Conservative Republicans shoved a state run health exchange down our throat and actively silenced all opposition.
For those who are wondering. PPACA (ObamaCare) is a network of health exchanges regulated at the federal level but run at the state level.
Since the Health Exchanges are run at the state level, we will find that even if Romney repeals the Federal Regulations we are stuck with the corrupt and captured health exchanges.
As long as the conservative establishment steadfastly refuses to discuss alternatives to health exchanges, American patriots need to stand against the exchanges.
The exchanges are corrupt. They will collapse into socialism. The only way to restore America is to have a viable alternative to exchanges. This cannot happen if conservatives are spineless drones that will not discuss alternatives.
Yes, I know I am a pariah. I don't give a crap about myself. All I want to see is someone where talk about alternatives to insurance. (NO, A Health Savings Account tacked onto a high deductible insurance policy is not a viable alternative to insurance. The HSA+HDHC policy is a formula for disaster … which I can easily prove.).
This blog (The Medical Savings and Loan) is simply an effort to start a discussion about free market health exchanges. The theme of the blog is that the problem in health care is that we use group funding for individual consumption and that the solution is to restore the concept of self-funded health care.
While I had such hopes that Republicans would start discussing free market reforms, I am disgusted after the substanceless Republican National Convention.
On the bright side, I am happy to see that the Republican Party is full of energetic speakers and enthusiasm.
This energy will wane if Romney wins the election, just as the energy for the left has evaporated.
Doesn't anyone remember how entrenched and disheartened the freedom movement was by the end of the Bush administration? This will happen if Romney wins.
However, if Libertarians split the vote and Obama gets a Lame Duck term, then both the Republican and Democratic Party will spend four years working on freedom agendas to recapture the independents.
I feel completely disheartened with the complete lack of substance of the Republican National Convention. It is funny how my mind always grasps at straws, but the freedom of America is hanging by a thread and we have to grasp at whatever we can as it collapses.
History has shown that the Right can be as great a threat to freedom as the Left. (The Hegelian Right came before the Hegelian Left).
Until Romney gives a clear idea on what he wants to replace ObamaCare with, liberty-loving voters should plan to vote third party.
Saturday, August 11, 2012
Reforming Medicare
I applaud the nomination of Paul Ryan. He is one of the few major political candidates who is willing to take on the tough issues that face our nation. Mr. Ryan is likely to receive a great deal of criticism for his efforts to reform Medicare.
Unfortunately, there is merit to the attacks against Ryan for this effort. If Mr. Ryan cuts Medicare spending without corresponding financial reforms, then we will produce the feared result of creating a society that fails to care for its seniors.
The problem with health care can be summed up in one word::
INSURANCE
Before we can reform Medicare, we simply must create a free market alternative to employer based insurance.
Employer based insurance creates an ugly paradigm in which people receive care from their employer.
The moment a person retires, the care is gone.
This problem is inherent with group funding of individual consumption. When people move between groups, the change disrupts health care.
The solution is to create a system of individual funding of individual consumption.
I have a presentation called "The Medical Savings and Loan" in which I demonstrate that we would get optimal results in health care if we restored the concept of self funded health care. I would be happy to travel to any group in the mountain west that is willing to discuss free market health care reform. Here is my contact form:
Unfortunately, there is merit to the attacks against Ryan for this effort. If Mr. Ryan cuts Medicare spending without corresponding financial reforms, then we will produce the feared result of creating a society that fails to care for its seniors.
The problem with health care can be summed up in one word::
INSURANCE
Before we can reform Medicare, we simply must create a free market alternative to employer based insurance.
Employer based insurance creates an ugly paradigm in which people receive care from their employer.
The moment a person retires, the care is gone.
This problem is inherent with group funding of individual consumption. When people move between groups, the change disrupts health care.
The solution is to create a system of individual funding of individual consumption.
I have a presentation called "The Medical Savings and Loan" in which I demonstrate that we would get optimal results in health care if we restored the concept of self funded health care. I would be happy to travel to any group in the mountain west that is willing to discuss free market health care reform. Here is my contact form:
Sunday, July 29, 2012
HSA + HDHC Flunks the Test
When analyzing different health care policies, one must look at the way that the policy plays out with people with moderate to severe health conditions.
Insurance salesmen love to concentrate on single catastrophic events. For that matter, people have a deep fear of catastrophe; however, when I worked in insurance I quickly realized that the chronic conditions were both the most costly and hardest to handle.
It turns out that many catastrophic conditions lead to a chronic condition. In many cases the chronic condition resulting from a catastrophe costs more than the original catastrophe.
If you broke your back, the long term cost of dealing with a bad back is higher than the first surgery.
If you have an HSA+HDHC policy with a $3000 deductible and your chronic condition requires $5,000 each year; you are stuck having to pay out the full deductible each year plus the cost of the insurance.
When you have a chronic condition, you really aren't in a position to negotiate down the deductible. Once you have a chronic condition of a known cost, you are in a high risk pool. Trying to negotiate down your deductible is intellectually dishonest because the insurance company will have to pay a dollar for every dollar of reduced deductible.
So, the HSA+HDHC increases the cost that people with a moderate chronic condition must pay for health care because a person with a disease like diabetes simply must spend money on care every year.
An HSA+HDHC policy is regressive.
It is true that, if a low income worker has an HSA+HDHC policy and never has a moment of sickness in his life, the worker would make out better than with low deductible insurance. If a person has normal or higher than average medical expenses it does not work out so well.
Let's compare the experience of a person who makes $12,000 a year to a person making $120,000 a year. So, let's say the deductible was $3,000. The deductible is 2.5% of the income of the person making $120,000/year. The key feature of the HSA is the tax deduction. Our high income worker is smart to put the $3,100 in a "Health Savings Account" to get the maximum deduction.
As for the low income worker, $3k is 25% of his total yearly $12k paycheck. The tax deduction ain't worth bug squat because the marginal worker pays no taxes. The worker would be stupid to put money in a tax free health savings account.
Try living on $12K a year, the poor guy probably isn't going to be able to put any money aside to pay for the deductible and will be in a terrible crunch if health care problems occur. The working poor with high deductible insurance feel locked out of the system.
In our next thought experiment, imagine the bossman comes into the shop and says that, "to lower our health care expenses, we are going to raise your deductible from $300 to $3000, but to make it up to you we will give you all $500 that you can put in a Health Savings Account."
With this plan, the people in the shop who have health conditions will lose $2,700 in the deductible increase. A person with a chronic condition just lost $2,700 a year for life. Everyone else gets just a token pay increase that fails to cover the deductible.
The switch from a low deductible to high deductible leaves people feeling insecure and put upon with the people who have chronic health conditions complaining to the heavens.
The workers in the company will simply see the HSA+HDHC policy as a cheap attempt to cut costs in a manner that hurts the most vulnerable in the group.
I read the reviews of Health Savings Accounts coupled with high deductible insurance. People in the upper middle class praise the idea because they get a tax deduction. The working poor stress the deductible and see it having a negative effect on people with health conditions, and complain about the idea.
I suspect that if you analyzed HSA+HDHC policies over a large population base, you will find that the policy is regressive. This structure transfers wealth from the poor to the rich.
Please note, I am not a big fan of redistributing income. But the whole point of a Health Care policy is to transfer resources from the healthy to those in need. If a plan is not doing that, then it is best to get rid of the plan.
Simply tacking a Health Savings Account to high deductible insurance does not play out that well among the working poor.
I am a big fan of self-funded health care. If we want to use savings accounts, we need to form a health care system, from the ground up, around the savings accounts, which is what I did in the Medical Savings and Loan. This program removes insurance from the equation. Each person gets a pile of money in a savings account and access to a loan reserve. People with an unusually high ratio of health expenses to income will have access to grants.
The most important issue when judging a health policy is if the policy actually reduces costs.
Yes, it is true that low income workers with high deductible insurance will skip preventative and routine care. Skipping preventative care does not save all that much money. It just means people suffering from things they could have prevented.
The really big cost overruns in health care happen with the big expenses. High deductible insurance might encourage people to skimp on small items, but the abuse will continue on big items and might even grow.
Hospitals are notorious for creative billing. Imagine a patient with a $3,000 deductible who had an incident costing $3,333. Both the patient and doctor know that the patient was put upon to pay the $3k deductible. With that deductible paid, the inclination is to just load the bill with everything.
Care Providers are keenly aware of whose paying the bill, and most clinics are not above playing games where they shift costs to deep pockets.
A system with an HSA and high deductible insurance fails the three most important tasks: The program does not cut costs. The program does not handle chronic conditions well and the program is unnecessarily regressive.
Saturday, July 28, 2012
Hyperbolic Function
If you made big database that recorded people's total health expenses charted against total wealth (total lifetime income + inheritance), you are likely to see a hyperbolic equation.
In most cases, people's total health care expenses will range from 5% to 15% of their total wealth. There will be a small number of people whose health expenses way exceed their ability to pay.
A primary job of the Medical Savings and Loan is the chart the curve. The program has health care advocates whose function is to record people's income and expense. They will report this info to actuarial firms that will munch the data and report back to the advocates telling us what it reasonable expenses and what is extraordinary.
In contrast, insurance is totalitarian and evil. Insurance says that because some people have expenses they cannot pay, the kollective must take ALL of the health care resources of everyone in the nation and put those resources in a pool controlled by the ruling elite. To fund the health care of the small percentage of people who cannot do so on their own, insurance tells us that we must force all the people could self fund their care into subservience.
Now, the simple hyperbolic graph above is very simple. If a group was interested in pursuing the cause of liberty, the group would spend a great deal of time collecting data on health care and mapping out real equations.
It would be a really fun and fruitful investigation. If there is anyone on this planet who is interested in freedom, they could contact me.
In most cases, people's total health care expenses will range from 5% to 15% of their total wealth. There will be a small number of people whose health expenses way exceed their ability to pay.
A primary job of the Medical Savings and Loan is the chart the curve. The program has health care advocates whose function is to record people's income and expense. They will report this info to actuarial firms that will munch the data and report back to the advocates telling us what it reasonable expenses and what is extraordinary.
In contrast, insurance is totalitarian and evil. Insurance says that because some people have expenses they cannot pay, the kollective must take ALL of the health care resources of everyone in the nation and put those resources in a pool controlled by the ruling elite. To fund the health care of the small percentage of people who cannot do so on their own, insurance tells us that we must force all the people could self fund their care into subservience.
Now, the simple hyperbolic graph above is very simple. If a group was interested in pursuing the cause of liberty, the group would spend a great deal of time collecting data on health care and mapping out real equations.
It would be a really fun and fruitful investigation. If there is anyone on this planet who is interested in freedom, they could contact me.
Tuesday, July 24, 2012
The Company Store
Labor historians like to point to "The Company Store" as an example of institutionalized abuse of labor.
In this arrangement, workers would be paid in script that is only good at the company store. In some cases the company store would establish lines of credit for the worker.
The idea of a company store sounds wonderful at first. Imagine if all the people working for a company pooled together their resources, they should be able to buy more goods at a lower price.
In practice "The Company Store" provide to be rife with abuse. Since The Company Store had a captured market, they did not compete on price or value with the merchants on the open market.
In the worst cases, workers became indebted to the company store and were reduced to the status of indentured servant.
Employer based health care has revived the concept of The Company Store for health care.
Obama's PPACA is a program that mandates by law that you be forced to buy your health care from a Company Store like arrangement.
Democrats wave Mao's Little Red Book and promise a socialist paradise if we just nationalized The Company Store and had people indentured to the nation/state.
Arrrgggjhhhhhh!
Why are we repeating the failed model of The Company Store in health care?
If any one would like to talk alternatives, I am at the ready. Here is my Contact Form.
In this arrangement, workers would be paid in script that is only good at the company store. In some cases the company store would establish lines of credit for the worker.
The idea of a company store sounds wonderful at first. Imagine if all the people working for a company pooled together their resources, they should be able to buy more goods at a lower price.
In practice "The Company Store" provide to be rife with abuse. Since The Company Store had a captured market, they did not compete on price or value with the merchants on the open market.
In the worst cases, workers became indebted to the company store and were reduced to the status of indentured servant.
Employer based health care has revived the concept of The Company Store for health care.
Obama's PPACA is a program that mandates by law that you be forced to buy your health care from a Company Store like arrangement.
Democrats wave Mao's Little Red Book and promise a socialist paradise if we just nationalized The Company Store and had people indentured to the nation/state.
Arrrgggjhhhhhh!
Why are we repeating the failed model of The Company Store in health care?
If any one would like to talk alternatives, I am at the ready. Here is my Contact Form.
Sunday, July 22, 2012
A Sad Conclusion
In the 1980s I realized that the problem in health care was the use of group funding of individual consumption. The solution is to restore the concept of individually funded health care.
An HSA + High Deductible Insurance is still an insurance policy. The HSA/HDHC model is mathematically problematic especially when you consider chronic conditions.
I created a logical structured called "The Medical Savings and Loan." This program holds that those who can self fund their care should. It creates a system with large savings accounts a loans to help people self fund care and creates a system of grants for those who need assistance.
The MS&L will have the same amount of money as an insurance company of similar size. Because all spending is direct fee for service care, I contend that people will get more care for the same price.
I believe that the research I did on this plan could help in the effort to repeal ObamaCare.
The weakest part of ObamaCare is the insurance mandates. The insurance mandate is premised on the assumption that group insurance is the only viable mechanism for funding health care.
The Medical Savings and Loan is built from the ground up around savings accounts. It is radically different from insurance.
I contend that, if there was a socially accepted alternative to insurance, that we would destroy the justification for ObamaCare, the health exchanges and much of the insanity surrounding insurance regulation.
My goal since 2008 has simply been to find people in the GOP willing to discuss the plan and to discuss how it could be used to help defeat PPACA.
In this time, I live in Salt Lake and have contacted ever GOP group I can find. I've been unable to get a single person from the Utah GOP to discuss the idea.
I spent every last penny I had traveling to Reno, Denver, Phoenix and Las Vegas to find someone willing to talk about alternatives to insurance and free market health care reform.
I will be willing to borrow money and travel if I could find a GOP group brave enough to discuss alternatives to insurance. If you have a group interested in free market health care concern and will comment to a meeting, please contact me. (I bite and growl, but not all that hard).
Having spent well over $5000 and 4 years of time, I've only been able to get person to talk to me, and I didn't get any follow through from that conversation.
In every other case, I was put to the door the moment people realized that I want to see self funded care established as an alternative to insurance.
The fact that I get put to the door every time I mention that I want a system that establishes self-funded care as an alternative to insurance has led me to conclude that the GOP is not interested in talking about self-funded alternatives to insurance.
I have followed the healthcare issue since the 1980s. The GOP has a long history of passing half-baked solutions to fix insurance.
The fact that I have never found a member of the GOP willing to discuss alternatives to insurance and that the GOP keeps passing government programs trying to fix the obvious flaws of insurance has led me to conclude that the GOP is in the pockets of insurance.
(Tax deductions for Health Savings Accounts in conjunction with high deductible insurance is not an alternative to insurance. The HSA+HDHC of the MMA is a fundamentally flawed program that only supports the upper middle class and extremely wealthy.
An HSA + High Deductible Insurance is still an insurance policy. The HSA/HDHC model is mathematically problematic especially when you consider chronic conditions.
I created a logical structured called "The Medical Savings and Loan." This program holds that those who can self fund their care should. It creates a system with large savings accounts a loans to help people self fund care and creates a system of grants for those who need assistance.
The MS&L will have the same amount of money as an insurance company of similar size. Because all spending is direct fee for service care, I contend that people will get more care for the same price.
I believe that the research I did on this plan could help in the effort to repeal ObamaCare.
The weakest part of ObamaCare is the insurance mandates. The insurance mandate is premised on the assumption that group insurance is the only viable mechanism for funding health care.
The Medical Savings and Loan is built from the ground up around savings accounts. It is radically different from insurance.
I contend that, if there was a socially accepted alternative to insurance, that we would destroy the justification for ObamaCare, the health exchanges and much of the insanity surrounding insurance regulation.
My goal since 2008 has simply been to find people in the GOP willing to discuss the plan and to discuss how it could be used to help defeat PPACA.
In this time, I live in Salt Lake and have contacted ever GOP group I can find. I've been unable to get a single person from the Utah GOP to discuss the idea.
I spent every last penny I had traveling to Reno, Denver, Phoenix and Las Vegas to find someone willing to talk about alternatives to insurance and free market health care reform.
I will be willing to borrow money and travel if I could find a GOP group brave enough to discuss alternatives to insurance. If you have a group interested in free market health care concern and will comment to a meeting, please contact me. (I bite and growl, but not all that hard).
Having spent well over $5000 and 4 years of time, I've only been able to get person to talk to me, and I didn't get any follow through from that conversation.
In every other case, I was put to the door the moment people realized that I want to see self funded care established as an alternative to insurance.
The fact that I get put to the door every time I mention that I want a system that establishes self-funded care as an alternative to insurance has led me to conclude that the GOP is not interested in talking about self-funded alternatives to insurance.
I have followed the healthcare issue since the 1980s. The GOP has a long history of passing half-baked solutions to fix insurance.
The fact that I have never found a member of the GOP willing to discuss alternatives to insurance and that the GOP keeps passing government programs trying to fix the obvious flaws of insurance has led me to conclude that the GOP is in the pockets of insurance.
(Tax deductions for Health Savings Accounts in conjunction with high deductible insurance is not an alternative to insurance. The HSA+HDHC of the MMA is a fundamentally flawed program that only supports the upper middle class and extremely wealthy.
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