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Posts Tagged ‘Obamacare

Health Care Reform Helps Insurance Companies Profit

We could subsidize Health Care service providers:

The cost of giving every licensed physician $100,000 would only be $90 billion per year.  This sounds ridiculous and expensive.  Ninety billion dollars spent with no detailed government oversight. People would have to pay co-pays and buy medical insurance without Government assistance.  Poor folk would get the same care without a lot of paperwork.  Dissolving Medicare and Medicaid would allow a free market to sell services for about fifty bucks a month per person. Yes, current payroll deductions would continue in order to augment compensation for all medical personnel relegating catastrophic health insurance to be bundled with car and home insurance schemes.

But:

No one seems to like the idea of giving tax dollars to doctors, nurses, and healthcare professionals.  No…, no, no, we can’t do that–our politicians, (and voters), would rather give insurance companies your tax dollars.  The enlightened goal is to provide everyone with a ‘plan’.  We are fated to accept the voters demand for subsidized health care insurance.

Payment of your medical bills gives dividends to stockholders and companies who are in business to make a profit.  They need to give higher dividends, don’t they?  After all, the yearly compensation for the Aetna CEO was a paltry twenty-seven million in 2016.  Stock options helped a lot.

Our health plans subsidize insurance companies in order for them to make money from your illness.  Sounds harsh, doesn’t it?  Your medical bill – if you can figure it out – includes profit for the stockholders, compensation for insurance sales persons, insurance executives pay, insurance buildings, advertising costs, and finally – your doctor’s salary.  The bookkeeping and bureaucratic overhead alone adds only about thirty percent to your bill.  The government argues that their portion of overhead is low.  That bears some truth because the bureaucratic efforts are made by the providers, (more on that later).  The government must ensure the fair and correct spending of your taxpayer dollars and their oversight requires massive record keeping and the development of forms.  Just remember–the government is here to help… to help…to help.

Some details collected from Justfacts.com:

Roughly, 60 minutes of paperwork are performed for every hour of emergency department care, 36 minutes of paperwork for every hour of surgery and acute inpatient care, 30 minutes of paperwork for every hour of skilled nursing care, and 48 minutes of paperwork for every hour of home health care. “Each time a physician orders a test or a procedure, the physician documents the order in the patient’s record. But the government requires additional documentation to prove the necessity for the test or procedure.”

  • “Many forms … must be completed daily by clinical staff to submit to the government to justify the care provided to skilled nursing facility patients.”
  • Medicare and Medicaid “rules and instructions” are more than 130,000 pages (three times larger than the IRS code and its associated regulations), and “medical records must be reviewed by at least four people to ensure compliance” with Medicare program requirements.
  • “A Medicare patient arriving at the emergency department is required to review and sign eight different forms—just for Medicare alone.”
  • “Each time a patient is discharged, even if only from the acute unit of the hospital to the on-site skilled nursing unit, multiple care providers must write a discharge plan for the patient. This documentation, as long as 30 pages, applies to all patients, regardless of the complexity of care received within the hospital or required post-hospital setting.”
  • In addition to regulation by state and local agencies and private accrediting organizations, hospitals are regulated by nearly 30 federal agencies.

Our government cannot think about giving tax dollars to health care professionals when paper pushers are more necessary to guarantee profits for insurance companies.  The massive government database contains items for every illness to include getting bitten by a duck or walking into a lamppost. They even have an item designation for walking into a lamppost for the second time.  Yes, the government will document your lamppost ‘problem’.

Who pays for all this?  You do.  Does the doctor really make out financially?  The admin persons at the hospital can make more than a surgeon.  Do you want that Admin professional in the operating room?  Don’t worry – admin is always there in spirit.  Someone must ensure the stockholders make a profit.  Is your deductible paid?  How much will the government kick in?  Does the patient ‘plan’ ensure this procedure is cost effective?  Everyone should be concerned with the last statement.  What happens if the procedure is not cost effective?   Does the cost/benefit/risk analysis allow a bone marrow transplant for a patient deemed terminal, (without one)?  Ask the insurance company or hospital admin – the only case I know of concerns a deceased mother of two who did not meet the criteria.

Whatever health care system you like should exclude stockholder dividends.  Your bill should not include a dividend to stockholders gambling on making money from your illness.  Some CEO should not be making millions each year by managing insurance schemes that profit from people requiring medical attention.  People are actually demanding government-sponsored monopolies because politicians tell them there is nowhere else to go and no other method of eliciting professional service.

All hospitals, including Non-profits, currently absorb the costs of services provided to the poor.  (Insurance covers costs in order to make a profit and do not include non-paying patients).  For example: According to the research by the research of Craig Garthwaite, Tal Gross and Matthew J. Notowidigdo, the cost of each poor patient in Tennessee is over a thousand dollars.  The hospitals lose money unless Medicaid shares the burden.  Your taxes pay for that as well.

A single payer plan will allow the Government to ‘help’ everyone by raising taxes and dictating the costs of all benefits.  ‘Medicare for all’ is a mantra for single payer advocates.  Sounds good, doesn’t it?  Cuba and Canada enjoy the benefits of single payer.  You may experience Canadian relatives taking residence in the USA in order to get medical attention but such activities would never happen if Our government took over health care and dictated the compensation to all medical providers.  Our government has a proven and cost effective record of … ‘helping’.  You can relax and feel secure when your doctor enters the operating room and tells you, “I’m from the government.  I’m here to help.”  Hopefully, you can understand the language used.

Twenty percent of our doctors currently come from foreign countries and there is a predicted shortage of doctors in our future but never fear – government insurance schemes will provide succor and it will only cost a couple TRILLION dollars.  Of course, we may have to deal with the government directing our lifestyles in order to keep premiums low and profits, um, manageable. Drinking soft drinks and eating meat may become as unhealthy as owning guns.  Government mandated bicycles could replace electric cars and who would want to go to school for 14 years to become a low paid doctor employed by the government?  A small increase in taxes, perhaps an extra TRILLION, might cover the expense but don’t worry, we can always raise taxes.

Now may we discuss subsidizing the providers instead of subsidizing insurance companies run for profit and controlled by government bureaucrats?

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Health Care and the Government

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Not approving Ryan Care was a narrow escape from an increasingly intrusive government that seems bent on controlling every aspect of American lives.

Most people would prefer to see a doctor when they have an illness or physical complaint. They would not willingly take a sick child to an insurance outlet or government building unless they had no choice. (Imagine taking a feverish baby to the DMV for treatment). Yet when you enter the doctor’s office and notice all the busy people that greet you from behind a desk – what do you think they are doing? They are filling out forms and documenting your access to insurance companies and government agencies who dictate the cost of your visit and the care you are entitled to receive.

Countries having high levels of subsidized health care, France and Italy are good examples; require that everyone pay into the government health fund. In America we all pay 1.45% of income, (hiked by an employer tax of an additional 1.45%), into our Medicare system but only people getting Social Security get the benefits. In 2015 the American Hospital Insurance Trust Fund garnered 275 Billion in taxes and spent 646 billion in services for only 15% of the population, (according to AARP).

So the illustration here is that we already have a universal insurance system that is paid into by every worker but the benefits are only distributed to retired people and the outlays for this insurance scheme exceed the inputs by about 371 billion dollars a year. The numbers get MUCH worse as they are analyzed to include every citizen.

Consider, for a moment, what insurance is supposed to provide. Health insurance is supposed to pay for the professional services, equipment, and drugs provided by licensed physicians and hospitals. In order to Control prices and services the government and insurance companies create rules, regulations, and make an effort at price fixing procedures. They require immense databases to achieve these goals and you can appreciate the health code designation of being bitten by a duck as just another line item under their scrutiny. If you think that is a bit complicated, there is another entry for walking into a lamp post. Too much? How about the designation of having walked into a lamp post for the second time?

Clearly we have too many ducks, lamp posts, and regulatory constrictions that are meant to control costs but inadvertently end up controlling lives and behavior.

Since the insurance is supposed to pay for professionals – take a look at what we could do with the 275 billion collected every year:

Give every licensed physician $100,000 …. .90 billion per year.

Give every registered nurse $30,000 ……… 90 billion per year.

Give every hospital $17 million………….…95 billion per year.

I just ran out of Medicare funds at 275 billion but our government spends over 646 billion on Medicare and adds another 546 billion with Medicaid, (2015 numbers). Where does this money come from? The general fund supplies the extra largess – – in case anyone is noticing our country currently has 20 Trillion in debt.

Well what if we doubled the tax rate for Medicare and now garnered an extra 275 billion for:

$75,000 for every licensed Nurse Practitioner…..…..8.3 billion per year.

$45,000 for every Physician Assistant………………3.2 billion per year.

Drug subsidies………………………………….….263 billion per year.

There – everyone in the USA would now be covered to some extent and to receive the subsidies all the accepting parties would have to do is not turn away any citizen from medical services. The government would no longer be in an insurance business where they have proven to be incredibly inept. The Government involvement would be relegated to a disbursement of collected funds to health professionals. The savings in paperwork, regulating, and oversight would actually save about 30% over current medical costs dictated by insurance. If the extra taxes are too big a burden consider paying the extra 275 billion from the general fund while still reducing the overhead by over half a trillion dollars per year.

Nothing is free, however, and the amounts mentioned will still not cover the total expenses. An average doctor’s earnings are about 160,000 per year and how will they make an income – not to mention the pay of specialists who spent years in getting certified?

Co-pays.

Let doctors, hospitals, drug venders, and specialists charge whatever they desire in the form of co-pays. Some doctors in Kansas are charging $50.00 per month for adults and $10.00 a month for children to cover all medical services and they negotiate a discount of over 80% for drugs used by members who pay the monthly service fee. (Only 100 patients would be needed to add 60,000 per year but facilities and staff are still an expense that requires income). Catastrophic insurance can be purchased to cover the large co-pays that may be demanded for major medical services like cancer treatments, transplants, significant surgeries, expensive drugs, or continuing services like dialysis.

In the future, one might see catastrophic health insurance ‘bundled’ with car and home insurance plans. Medicare, Medicaid, and Obamacare would be gone. Only the Medicare tax would remain. Paperwork would be an addition to the IRS tax form.

There is more the government could do of course – Allow health employees, doctors, assistants, etc. to pay minimal or no taxes for example. Tax free health saving accounts and catastrophic insurance sales across state lines could be allowed and perhaps, someday, be offered by employers that allow employees to carry the account privately or onward to new employers.

And what about the poor people who get sick but have no job, pay no taxes, and have no catastrophic health insurance? The poor will always be with us – that is why we paid the doctors up front. No citizen will be denied service by those who promise first to do no harm.

This style of funding should also spur an interest in more people willing to become doctors which are currently predicted to be 90,000 short by 2025.

Concrete and predictable medical costs have proven to be elusive when payments are made by governments and insurance companies. If someone else is paying – the billing is of little consequence to the patient. In this subsidized system, transparent costs would allow patients to seek the best service at the lowest co-pay. No two hospitals charge alike and most patients only get solid costs after services have been rendered.

No one would like to take a car to a mechanic, who never provides an accurate estimate of charges unless they knew someone else was paying, (insurance company). Fortunately, mechanic mistakes can be expensive but are not usually life threatening. Medical services, conversely, are given very little latitude where judgments fail to achieve desired results. Complex problems are weighed in terms of outcome and risks to the patient vs. costs, profits and risks to the insurance providers. Health providers do make mistakes but such errors are often the product of being human where, in the end, we all return to the manufacturer.

How to Repeal and Replace Obamacare and Avoid All the Complaints

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Think about the complaints and concerns instigated by the dire thought of repealing Obamacare:

People would lose the free services provided by Obamacare.

The Government would lose tax income provided by Obamacare taxes.

Democrats will complain and spin any replacement concepts as insufficient – and probably racist.

 

My suggestion is to consider Replacing Obamacare before repealing the act, mandates, and taxes.

Replacing Obamacare with a concrete system would allow all supporters and detractors to review the efficacy of the replacement – before – dissolving Obamacare.  The concerns of replacement aspects will be answered, improvements can be made, and costs can be determined so that health services can be available before the ACA collapses due to an inherent poor design seemingly created for income redistribution rather than health care. The added bureaucracy is astonishing, (and adds about 30% to the cost of health care).

 

The largest issue in this method is cost.  The government would be paying for two health systems during the SHORT time allowed for a comprehensive review.  Still, the added cost can be justified as the price of getting the new system right.  One might note that paying for the medical costs of disadvantaged folk is likely to be a cost in both systems so that should not be considered an additional expense.

The second largest issue is also cost – in terms of lost revenue gained by ACA taxing of citizens already taxed by Medicare.

 

Politically oriented complaints and accusations, name calling, and reports comprised of misinformation and ‘spin’ will be provided by many politicians and media pundits more concerned with gaining self serving power than serving citizens.  Such is the divisive state provided by the last decade of politicians and this proclivity will not suddenly disappear, however, logical and sincere debate should be encouraged for a short period.  Creating another 2000 page series of laws crammed into an Act cannot be allowed.

 

Sounds simple – well, no – but I believe the concept is more reasonable that Repeal and Replace.

What do you think?

Affordable Health Buffet

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Affordable health care is a confusing description that disguises a menu of government mandated insurance schemes.
Would you expect your car to be efficiently repaired by a restaurant because some mechanics may eat there? Sure, you get to pick the menu, but you pay for everything on it whether you eat or not. Mechanics are offered a buffet of gruel made from the cheapest produce and their care creates profit for the restaurant, who is the primary beneficiary of this flawed concept.
While it may be too optimistic to expect better service when you drop off your car at a government sponsored restaurant, we can all be assured the advertising will continue – Over 8 Million Served.

Medical Insurance

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Who pays for it? Everyone. It is a federal deduction that has no maximum limit although it is higher for those making over 200k per annum. Medicare and Medicaid are both insurance schemes that can be easily confused since both are considered entitlements. Medicaid is concerned with people having very low incomes while Medicare is offered for those over 65 years of age and can be identified by the tax automatically removed in each of your paychecks.
France and Italy rank first and second for medical care in the world. The World Health Organization Ranks the USA as 38th, although we are number one in per capita expenditures. Expenditures for France rank 4th and Italy ranks 11th in cost per person.
The key factor for universal health coverage is that everyone must contribute in order to have a viable national health care system. In America, everyone who works and pays taxes, contributes into our health care system as well as the social security retirement system. It should be observed that almost everyone seems to enjoy the socialist aspects of our country’s current health and retirement entitlements.
Historic Medicare costs or payouts, if you want to look at it that way, are much lower than private health insurance costs by over 25%. The federal VA also has a much better record at buying pharmaceuticals at lower prices. Overall, the Medicare system offers health services for less money than private insurers. There are quite a few reasons for higher health care costs in the private market but this demonstrates a rare occurrence where Government Management actually performs better, (cost wise), than the private purveyors. Since government run programs tend to be excessive in cost – there should be some room for improvement in both areas.
Admittedly, Obamacare was not the right answer to lower costs but the goal was desirable, albeit ineptly designed, administered, and executed under false pretenses. Perhaps, the strict adherence to a form of insurance concept may be part of the problem. Why sell insurance when we could simply pay for services and allow co-pays to be determined by the medical practitioners? By doing so, we could employ both socialistic and capitalistic models. Insurance can step back and offer co-pay insurance instead of examining and quantifying the cost and efficacy of each medical procedure by maintaining a database – (like entry W22.02XA – walking into a lamppost).
National health services can be achieved at a much lower cost than what we currently pay for individual medical insurance. I would recommend States or groups of States review experimental concepts that can be researched, analyzed, and implemented, using plain language regulations that anyone can understand. Paying for services instead of insurance, while including reforms in tort litigation, medical education credentials, and large volume purchasing of pharmaceuticals and equipment will significantly lower the costs of medical service.

Written by poyhonen

December 9, 2014 at 11:18 pm

Spending Despite Representation

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Spending Despite Representation
Our framers considered that the congress should represent the citizens while the senate would represent the states. Money affairs were allocated to the people through the votes of their representatives, thus avoiding taxation without representation.
According to Article 1, Section. 7, “All Bills for raising Revenue shall originate in the House of Representatives.” It was the duty of the house to control the purse strings of our republic.
The inevitable outcome of our system of checks and balances encourages gridlock and inefficiency in government but it also encourages compromise and, in the past, it was successful at preventing the rise of tyranny in America. For example: No president can declare war without the funds to support such activity and thus the activity of war is determined by the representatives of the people. As Madison explains in the Federalist Papers, “Each branch of government is framed so that its power checks the power of the other two branches; additionally, each branch of government is dependent on the people, who are the source of legitimate authority.”
Within the branches of our government, congressional powers are divided between the Senate and the House of Representatives. Powers reserved to the Senate include approval of treaties, confirmation of presidential nominations, and the power to try impeachments, whereas only House has the authority to initiate impeachments and originate all revenue-raising bills.
Recently, we were faced with a potential gridlock where the executive branch joined with the Senate to fund bills established by a previous Congress. The gridlock potential was based upon the House of Representatives denying funds to support the Affordable Care Act, (ACA). The passing of the Affordable Care Act was initially instrumental in converting the House of Representatives from a Democrat Majority to a Republican Majority as the Democrats who supported the act were replaced by a majority of voters who disagreed with their representatives.
This new group of representatives voted to defund the ACA. Of course their vote never passed the Democrat dominated Senate and the gridlock became quite concrete. Our president, Democrat Senators and Representatives, allied with most of the News Agencies to denounce the House for doing the job they were elected to perform, that is, control the purse strings of the Republic.
To make matters worse, a stopgap budget bill needed to be passed by the end of September. Huge spending increases initiated by Democrats required additional funding and an approval of more deficit spending in order to borrow more money to pay for Democratic initiated programs that require more money than our country has or could lawfully borrow. (Stopgap bills are required since the Democratic controlled Senate has not passed a budget since 2009). Republican House members were alarmed because there has been no budget passed during the last four years and the national debt has increased by over 5.3 Trillion Dollars.
The House of Representatives had promised the American voters to lower spending, borrowing, and get our budget under control. The largest duck in the pond, regarding spending was the ACA and the house put forth a bill that would fund the government with the exclusion of the Affordable Care Act. The Senate disapproved. The liberals became mobilized to condemn Republicans for not funding  the ACA, calling them traitors, terrorists, hostage takers, saboteurs, arsonists, and murderers. The president joined in the name calling and the press was only too happy to absorb, join, and disseminate the progressive propaganda. The airwaves became flooded with misinformation, blaming the House for putting the nation at risk. The Senate spurned any House bill that would fund the government and avoid a shutdown. The Senate dictated that the House would fund ‘Obamacare’ or the Senate would vote for a government shutdown. Not only would the Senate veto any House bill, they would also blame the House for the results of the Senate vote that shutdown the government. They would allow no compromise.
At first, the House stood firm, facing the lies which spurred public perception to blame them if the government was forced to shut down. Meanwhile, the President continued with his policy to make Americans endure pain for daring to curtail his spending. He closed national parks, paying to barricade open parks that required no government expense. He kept veterans from their memorial. Treatments for Children with cancer provided by the National Institute of Health were curtailed, (Obama threatened to veto a Republican compromise to fund the Institutes). The liberal press continued to bombard the public with a creative and false description of Republican caused atrocities.
Eventually the House lost integrity from within and caved into the progressive agenda. The Checks and Balances put forth by our founding fathers will now require that the Senate and House must both be controlled if meaningful budget controls are ever to be enacted. The, Obama enacted, painful measures will hopefully, be set aside as the Americans have demonstrated appropriate fealty.
The National debt now stands at over 17 Trillion Dollars and the money presses are still running.

Obama Care – The Good, The Bad, and The Ugly

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Obama Care – The Good, The Bad, and The Ugly
The Good:

The Affordable Health Care Act, ACA, ensures citizens have coverage without regard to preexisting conditions, offers ‘free’ medical procedures like mammograms, disallows insurance companies to drop patients who become high risk, and does away with annual and lifetime limits of coverage. All insurance companies are kept at bay, (by federal regulators), with regard to rate hikes, and are served by exchanges where consumers are provided assistance in choosing the best options available within their state. All insurance plans offered after 2014 will offer the same benefits, rights, and protections, (unless the insured is obese or a smoker). Citizens earning less than 400% of the established poverty level will receive government support for the payment of premiums. Children can stay on their parents plan until they reach 26 years of age.
The CBO predicted costs of the ACA have been lowered by 137 billion over the period 2014-2023 and this number is being used to demonstrate the savings of ACA, which is funded by taxes, spending cuts, reformations to the health care industry and an excise tax on the insured who choose the higher end plans which cover 80, (Gold), to 90%, (Platinum), of the out of pocket expenses.
“Bronze” plans, which cover 60%, of out of pocket health care costs, for individuals are expected to cost between $4,500 and $5,800 a year in 2016. But if you make less than 4 times the Federal Poverty Line – FPL – (about $45,000 for an individual in 2012), you’ll pay less by virtue of receiving tax credits. Someone making up to 133% of the FPL will get credits so that his net payment will be only 2% of income, while those making 300% to 400% of FPL will pay 9.5% of FPL. State subsidies and federal tax credits will help low income individuals to keep a typical families medical insurance cost to less than 8% of income. Total insurance costs for are expected to decrease by 7-9% due to ACL.
Gold and Platinum health plans can cost up to a maximum 12% of the insured persons income with an additional 40% excise tax. This feature, along with a 3.8% capital gains tax and a 3.8% additional income tax help redistribute income to offset the costs of medical coverage for lower income people.

The Bad:
Average cost for insurance will go up for men by 97% and by 55% for women. Health and Human Services did report an overall decrease of 16%, which is a bogus number not based on any actual costs. Misinformation constitutes one of the worst attributes of the ACA implementation. The misinformation comes from both political parties and almost all the news agencies.
Rising costs cannot be avoided. If you had no insurance before ACA and wish to avoid costs by choosing to not having insurance you will be penalized for not having insurance. Everyone will pay something unless your financial situation is very low.
If your current income is low, keeping it low will garner more benefits than working towards higher wages and better paying jobs. This creates a counterproductive environment that is supported by ACA and other progressive handouts.
The ACA system is extremely complicated. Petitions for waivers allow small businesses to acquire low cost insurance during the transition period of ACA implementation. The waivers are reviewed and granted to make sure businesses don’t become devoid of insurance. It is assumed that, as ACA implementation continues, tax incentives will allow the waiver beneficiaries to join the mainstream. This is just an example of the complicated effects of Government intrusion into small business while trying not to destroy small businesses in the process.
ACA continues the move towards a centralization of medical health care and services. This is an inherently bad concept because innovation has disappeared when the services are centralized as they are in Europe. Corruption, waste, and rationing accompany centralized health care. The largest negative impact that impeding innovation is that the loss of innovation will not be recognized or missed.
Regulators always, Always grow their organizations. Management and overhead costs will rise as the organizations swell and grow more regulations. The concept is insidious and is guaranteed. Since ACA is now considered a tax, higher taxes are a future feature that will compete with health care rationing in an attempt to keep costs down.

The Ugly:
A great deal of the rhetoric concerning the fallacies and efficacy of Obama care are false. Some statements are misleading while others are outright fabrications and the B.S. flows from both political parties and all of the news agencies. The divisive result upon our culture is ugly. Who would want to raise their children to become politicians? The personal diatribes against individuals is vitriolic and usually does not support any semblance of problem solving. This article won’t address fixing the demeanor of our politicians and news agencies but will remain focused on the Affordable Care Act, A.K.A. Obama care.
To be succinct; ACA is ugly because it is a stupid solution to the costs and distribution of health care. It only serves to give control of personal lives and behavior to a centralized authority that may or may not be benevolent.
ACA attempts to control health insurance. Most people would prefer to have health services instead of insurance. Read that last sentence again, slowly. If your leg is broken do you want to see an insurance agent or a doctor? Isn’t it obvious that ACA is aimed at the wrong target, (unless you are seeking to control the lives and behavior of your fellow citizens). If the state is concerned with the cost of health services then why would they add a huge complex bureaucracy to ride on top of the means for paying for such services? i.e. Insurance. The insurance paperwork, regulations, and bookkeeping already add 20 – 30% to the costs of health care today. ACA would force everyone to pay for more paperwork and bookkeeping plus additional regulations. More regulators produce more regulations which must be reviewed and enforced by an ever expanding bureaucracy. If you think that is implausible, look up W61.61XD. W61.61XD is a billable ICD-10-CM code that can be used to specify the ‘approved’ medical diagnosis of being bitten by a duck.
Yes, I believe ACA is ugly, ignoble, and serves as a means that could be used to force our society down undesirable paths while disenfranchising innovation. Ugly and dangerous.
Even this unknown analyst can, and has, proposed a system that allows insurance to be bypassed. Subsidizing health services rather than insurance will allow innovation while actually reducing the costs of services that may be provided to everyone, at their choice. The concepts have been discussed in past articles and limit the scope of such activities to State participation and execution. This blog is one small voice – surely there are others, having significant audiences, that can bring such concepts forward. A debate centered upon Health Services reform Vs. Affordable Health Insurance would be efficacious and enlightening for our society.