A Blend of Govt and Free Market funded healthcare

June 13, 2008

Hi All.

I am interested in some feedback. I wrote on my blog about a blend of

govt and free amrket healthcare system that would maintain or return,

depending on how you look at it, control of healthcare to individuals

and doctors. My blog can be found at http://doctorsh.blogspot.com/

but I copied the text below.

--------------------------------------------------------------------

Medisave: A Blend of Government funded healthcare in a privately

controlled fund

Much of today's debate about healthcare reform revolves around two

distinctly differing viewpoints. On one side we have the call for a

government takeover of the present system, with new insurance

mandates, continued insurance management and regulation, and higher

taxes. On the other side we have the call for an end to government

regulation, an opening up of the free market, and the end of the

insurance industry's undue authority and oppressive control over

healthcare processes, without any new taxes.

Is there a way to bring the two sides together?

Let's look at some numbers:

Estimated population of the United States is 300 million.

Estimated direct government contribution to healthcare spending in

840 billion dollars.

That is about $2,800 a year per person.

Is there a way to spend that money more efficiently?

Here is my proposal:

Individually owned Medisave accounts for all United States citizens

from birth.

With no added taxes from the government, the $2,800 can be used to

purchase a catastrophic high deductible insurance policy that would

also cover the first $500-1,000 per year of preventive coverage for

well exams, Pap smears, childhood vaccines, etc.

These Medisave accounts would be individually owned and controlled

and could be managed by banks or other brokerage service centers. To

cover the costs of the deductible, patients and employers could

voluntarily contribute to the accounts. For the unemployed, there

could be more charity care and other tax deductible accounts set up.

Means testing would also be on the table for those truly in need. Any

money remaining in the Medisave accounts at the end of the year would

roll over for the following year.

Hopefully money would be saved in these accounts to fully cover any

future year deductible. Family members can use a portion of their

excess Medisave dollars for other family members or for charity to

others in need.

The Medisave accounts would be paid for by the same taxes present

today. However these monies would need to be separated from the

government's general fund to avoid having any of the funds spent on

other programs. With the accounts controlled by individuals, it would

bring an end to government lobbyists and special interests.

Tort reform would also need to be enacted to lower the costs of

defensive medicine. A fair system is beyond the scope of this article.

Lets look at the positives of this plan:

1) Lowers employer costs greatly. Employees could get more in salary

as a result. Also insurance is fully portable, and not dependent on

employment, only upon citizenship. Non-citizens can buy into the plan

at much lower costs than today's insurance premiums.

2) Ends Medicare and Medicaid and all the government regulations and

price controls and replaces them with individually controlled and

owned policies.

3) No price controls. The free market would set the costs.

Competition would open up and be fierce to increase innovation and

decrease costs. Look at all the mini-clinics opening up as lower cost

alternatives as an example of true free market competition.

4) Citizens can opt out of the plan, but what would be the advantage?

5) If individuals want to buy a Medigap policy for their deductibles,

they may buy one on the open market.

6) Insurance companies would stay in business but would have to

change they way they operate. They would no longer be in the business

of healthcare, but back solely in the business of insurance.

This proposal would cover every United States Citizen and be funded

by the government in the form of Medisave withholding deductions from

paychecks. This would replace the Medicare withholding. The

percentage needed can be calculated by a group of budget economists.

It would be budget neutral as no new funds would be needed.

Medicare and Medicaid would end along with the regulations. Patients

would have open access to any doctor or health care provider they

choose in the free market. Payment would be direct from their

Medisave accounts at the time of service or as agreed upon between

patient and the doctor or provider. There would be no third party

involved to increase costs or intrude upon the doctor-patient

relationship. And most importantly, those with medical expertise and

genuine interest in our patients' health will once again have

absolute control.

June 13, 2008

Freeze medicare current payments for office visits and

allow balance billing for E/M office codes only.

Solves everything.

Beck, M.D.

--- drhorvitz wrote:

> Hi All.

>

> I am interested in some feedback. I wrote on my blog

> about a blend of

> govt and free amrket healthcare system that would

> maintain or return,

> depending on how you look at it, control of

> healthcare to individuals

> and doctors. My blog can be found at

> http://doctorsh.blogspot.com/

> but I copied the text below.

>

--------------------------------------------------------------------

>

> Medisave: A Blend of Government funded healthcare in

> a privately

> controlled fund

>

> Much of today's debate about healthcare reform

> revolves around two

> distinctly differing viewpoints. On one side we have

> the call for a

> government takeover of the present system, with new

> insurance

> mandates, continued insurance management and

> regulation, and higher

> taxes. On the other side we have the call for an end

> to government

> regulation, an opening up of the free market, and

> the end of the

> insurance industry's undue authority and oppressive

> control over

> healthcare processes, without any new taxes.

>

> Is there a way to bring the two sides together?

>

> Let's look at some numbers:

>

> Estimated population of the United States is 300

> million.

>

> Estimated direct government contribution to

> healthcare spending in

> 840 billion dollars.

>

> That is about $2,800 a year per person.

>

> Is there a way to spend that money more efficiently?

>

> Here is my proposal:

>

> Individually owned Medisave accounts for all United

> States citizens

> from birth.

> With no added taxes from the government, the $2,800

> can be used to

> purchase a catastrophic high deductible insurance

> policy that would

> also cover the first $500-1,000 per year of

> preventive coverage for

> well exams, Pap smears, childhood vaccines, etc.

> These Medisave accounts would be individually owned

> and controlled

> and could be managed by banks or other brokerage

> service centers. To

> cover the costs of the deductible, patients and

> employers could

> voluntarily contribute to the accounts. For the

> unemployed, there

> could be more charity care and other tax deductible

> accounts set up.

> Means testing would also be on the table for those

> truly in need. Any

> money remaining in the Medisave accounts at the end

> of the year would

> roll over for the following year.

> Hopefully money would be saved in these accounts to

> fully cover any

> future year deductible. Family members can use a

> portion of their

> excess Medisave dollars for other family members or

> for charity to

> others in need.

>

> The Medisave accounts would be paid for by the same

> taxes present

> today. However these monies would need to be

> separated from the

> government's general fund to avoid having any of the

> funds spent on

> other programs. With the accounts controlled by

> individuals, it would

> bring an end to government lobbyists and special

> interests.

>

> Tort reform would also need to be enacted to lower

> the costs of

> defensive medicine. A fair system is beyond the

> scope of this article.

>

> Lets look at the positives of this plan:

>

> 1) Lowers employer costs greatly. Employees could

> get more in salary

> as a result. Also insurance is fully portable, and

> not dependent on

> employment, only upon citizenship. Non-citizens can

> buy into the plan

> at much lower costs than today's insurance premiums.

> 2) Ends Medicare and Medicaid and all the government

> regulations and

> price controls and replaces them with individually

> controlled and

> owned policies.

> 3) No price controls. The free market would set the

> costs.

> Competition would open up and be fierce to increase

> innovation and

> decrease costs. Look at all the mini-clinics opening

> up as lower cost

> alternatives as an example of true free market

> competition.

> 4) Citizens can opt out of the plan, but what would

> be the advantage?

> 5) If individuals want to buy a Medigap policy for

> their deductibles,

> they may buy one on the open market.

> 6) Insurance companies would stay in business but

> would have to

> change they way they operate. They would no longer

> be in the business

> of healthcare, but back solely in the business of

> insurance.

>

> This proposal would cover every United States

> Citizen and be funded

> by the government in the form of Medisave

> withholding deductions from

> paychecks. This would replace the Medicare

> withholding. The

> percentage needed can be calculated by a group of

> budget economists.

> It would be budget neutral as no new funds would be

> needed.

>

> Medicare and Medicaid would end along with the

> regulations. Patients

> would have open access to any doctor or health care

> provider they

> choose in the free market. Payment would be direct

> from their

> Medisave accounts at the time of service or as

> agreed upon between

> patient and the doctor or provider. There would be

> no third party

> involved to increase costs or intrude upon the

> doctor-patient

> relationship. And most importantly, those with

> medical expertise and

> genuine interest in our patients' health will once

> again have

> absolute control.

>

June 13, 2008

Tim:

Thanks for your comments. It helps with the govt funding crisis, but

does nothing for the true uninsured, nor does it get rid of the

employer mandates and insurance portability.

Steve Horvitz, D.O.

>

> > Hi All.

> >

> > I am interested in some feedback. I wrote on my blog

> > about a blend of

> > govt and free amrket healthcare system that would

> > maintain or return,

> > depending on how you look at it, control of

> > healthcare to individuals

> > and doctors. My blog can be found at

> > http://doctorsh.blogspot.com/

> > but I copied the text below.

> >

> --------------------------------------------------------------------

> >

> > Medisave: A Blend of Government funded healthcare in

> > a privately

> > controlled fund

> >

> > Much of today's debate about healthcare reform

> > revolves around two

> > distinctly differing viewpoints. On one side we have

> > the call for a

> > government takeover of the present system, with new

> > insurance

> > mandates, continued insurance management and

> > regulation, and higher

> > taxes. On the other side we have the call for an end

> > to government

> > regulation, an opening up of the free market, and

> > the end of the

> > insurance industry's undue authority and oppressive

> > control over

> > healthcare processes, without any new taxes.

> >

> > Is there a way to bring the two sides together?

> >

> > Let's look at some numbers:

> >

> > Estimated population of the United States is 300

> > million.

> >

> > Estimated direct government contribution to

> > healthcare spending in

> > 840 billion dollars.

> >

> > That is about $2,800 a year per person.

> >

> > Is there a way to spend that money more efficiently?

> >

> > Here is my proposal:

> >

> > Individually owned Medisave accounts for all United

> > States citizens

> > from birth.

> > With no added taxes from the government, the $2,800

> > can be used to

> > purchase a catastrophic high deductible insurance

> > policy that would

> > also cover the first $500-1,000 per year of

> > preventive coverage for

> > well exams, Pap smears, childhood vaccines, etc.

> > These Medisave accounts would be individually owned

> > and controlled

> > and could be managed by banks or other brokerage

> > service centers. To

> > cover the costs of the deductible, patients and

> > employers could

> > voluntarily contribute to the accounts. For the

> > unemployed, there

> > could be more charity care and other tax deductible

> > accounts set up.

> > Means testing would also be on the table for those

> > truly in need. Any

> > money remaining in the Medisave accounts at the end

> > of the year would

> > roll over for the following year.

> > Hopefully money would be saved in these accounts to

> > fully cover any

> > future year deductible. Family members can use a

> > portion of their

> > excess Medisave dollars for other family members or

> > for charity to

> > others in need.

> >

> > The Medisave accounts would be paid for by the same

> > taxes present

> > today. However these monies would need to be

> > separated from the

> > government's general fund to avoid having any of the

> > funds spent on

> > other programs. With the accounts controlled by

> > individuals, it would

> > bring an end to government lobbyists and special

> > interests.

> >

> > Tort reform would also need to be enacted to lower

> > the costs of

> > defensive medicine. A fair system is beyond the

> > scope of this article.

> >

> > Lets look at the positives of this plan:

> >

> > 1) Lowers employer costs greatly. Employees could

> > get more in salary

> > as a result. Also insurance is fully portable, and

> > not dependent on

> > employment, only upon citizenship. Non-citizens can

> > buy into the plan

> > at much lower costs than today's insurance premiums.

> > 2) Ends Medicare and Medicaid and all the government

> > regulations and

> > price controls and replaces them with individually

> > controlled and

> > owned policies.

> > 3) No price controls. The free market would set the

> > costs.

> > Competition would open up and be fierce to increase

> > innovation and

> > decrease costs. Look at all the mini-clinics opening

> > up as lower cost

> > alternatives as an example of true free market

> > competition.

> > 4) Citizens can opt out of the plan, but what would

> > be the advantage?

> > 5) If individuals want to buy a Medigap policy for

> > their deductibles,

> > they may buy one on the open market.

> > 6) Insurance companies would stay in business but

> > would have to

> > change they way they operate. They would no longer

> > be in the business

> > of healthcare, but back solely in the business of

> > insurance.

> >

> > This proposal would cover every United States

> > Citizen and be funded

> > by the government in the form of Medisave

> > withholding deductions from

> > paychecks. This would replace the Medicare

> > withholding. The

> > percentage needed can be calculated by a group of

> > budget economists.

> > It would be budget neutral as no new funds would be

> > needed.

> >

> > Medicare and Medicaid would end along with the

> > regulations. Patients

> > would have open access to any doctor or health care

> > provider they

> > choose in the free market. Payment would be direct

> > from their

> > Medisave accounts at the time of service or as

> > agreed upon between

> > patient and the doctor or provider. There would be

> > no third party

> > involved to increase costs or intrude upon the

> > doctor-patient

> > relationship. And most importantly, those with

> > medical expertise and

> > genuine interest in our patients' health will once

> > again have

> > absolute control.

> >

>

June 14, 2008

Steve,

I beleive the gov't funding crisis is the primary

problem. If that were fixed the other things would be

easier to fix.

TSB

--- drhorvitz wrote:

> Tim:

>

> Thanks for your comments. It helps with the govt

> funding crisis, but

> does nothing for the true uninsured, nor does it get

> rid of the

> employer mandates and insurance portability.

>

> Steve Horvitz, D.O.

>

> >

> > > Hi All.

> > >

> > > I am interested in some feedback. I wrote on my

> blog

> > > about a blend of

> > > govt and free amrket healthcare system that

> would

> > > maintain or return,

> > > depending on how you look at it, control of

> > > healthcare to individuals

> > > and doctors. My blog can be found at

> > > http://doctorsh.blogspot.com/

> > > but I copied the text below.

> > >

> >

>

--------------------------------------------------------------------

> > >

> > > Medisave: A Blend of Government funded

> healthcare in

> > > a privately

> > > controlled fund

> > >

> > > Much of today's debate about healthcare reform

> > > revolves around two

> > > distinctly differing viewpoints. On one side we

> have

> > > the call for a

> > > government takeover of the present system, with

> new

> > > insurance

> > > mandates, continued insurance management and

> > > regulation, and higher

> > > taxes. On the other side we have the call for an

> end

> > > to government

> > > regulation, an opening up of the free market,

> and

> > > the end of the

> > > insurance industry's undue authority and

> oppressive

> > > control over

> > > healthcare processes, without any new taxes.

> > >

> > > Is there a way to bring the two sides together?

> > >

> > > Let's look at some numbers:

> > >

> > > Estimated population of the United States is 300

> > > million.

> > >

> > > Estimated direct government contribution to

> > > healthcare spending in

> > > 840 billion dollars.

> > >

> > > That is about $2,800 a year per person.

> > >

> > > Is there a way to spend that money more

> efficiently?

> > >

> > > Here is my proposal:

> > >

> > > Individually owned Medisave accounts for all

> United

> > > States citizens

> > > from birth.

> > > With no added taxes from the government, the

> $2,800

> > > can be used to

> > > purchase a catastrophic high deductible

> insurance

> > > policy that would

> > > also cover the first $500-1,000 per year of

> > > preventive coverage for

> > > well exams, Pap smears, childhood vaccines, etc.

> > > These Medisave accounts would be individually

> owned

> > > and controlled

> > > and could be managed by banks or other brokerage

> > > service centers. To

> > > cover the costs of the deductible, patients and

> > > employers could

> > > voluntarily contribute to the accounts. For the

> > > unemployed, there

> > > could be more charity care and other tax

> deductible

> > > accounts set up.

> > > Means testing would also be on the table for

> those

> > > truly in need. Any

> > > money remaining in the Medisave accounts at the

> end

> > > of the year would

> > > roll over for the following year.

> > > Hopefully money would be saved in these accounts

> to

> > > fully cover any

> > > future year deductible. Family members can use a

> > > portion of their

> > > excess Medisave dollars for other family members

> or

> > > for charity to

> > > others in need.

> > >

> > > The Medisave accounts would be paid for by the

> same

> > > taxes present

> > > today. However these monies would need to be

> > > separated from the

> > > government's general fund to avoid having any of

> the

> > > funds spent on

> > > other programs. With the accounts controlled by

> > > individuals, it would

> > > bring an end to government lobbyists and special

> > > interests.

> > >

> > > Tort reform would also need to be enacted to

> lower

> > > the costs of

> > > defensive medicine. A fair system is beyond the

> > > scope of this article.

> > >

> > > Lets look at the positives of this plan:

> > >

> > > 1) Lowers employer costs greatly. Employees

> could

> > > get more in salary

> > > as a result. Also insurance is fully portable,

> and

> > > not dependent on

> > > employment, only upon citizenship. Non-citizens

> can

> > > buy into the plan

> > > at much lower costs than today's insurance

> premiums.

> > > 2) Ends Medicare and Medicaid and all the

> government

> > > regulations and

> > > price controls and replaces them with

> individually

> > > controlled and

> > > owned policies.

> > > 3) No price controls. The free market would set

> the

> > > costs.

> > > Competition would open up and be fierce to

> increase

> > > innovation and

> > > decrease costs. Look at all the mini-clinics

> opening

> > > up as lower cost

> > > alternatives as an example of true free market

> > > competition.

> > > 4) Citizens can opt out of the plan, but what

> would

> > > be the advantage?

> > > 5) If individuals want to buy a Medigap policy

> for

> > > their deductibles,

> > > they may buy one on the open market.

> > > 6) Insurance companies would stay in business

> but

> > > would have to

> > > change they way they operate. They would no

> longer

> > > be in the business

> > > of healthcare, but back solely in the business

> of

> > > insurance.

> > >

> > > This proposal would cover every United States

> > > Citizen and be funded

> > > by the government in the form of Medisave

> > > withholding deductions from

> > > paychecks. This would replace the Medicare

> > > withholding. The

> > > percentage needed can be calculated by a group

> of

>

=== message truncated ===

June 14, 2008

I'd even take this a step farther and say the 10.6% cut is OK as long

as we allow balance billing.

Beeman

>

> > Hi All.

> >

> > I am interested in some feedback. I wrote on my blog

> > about a blend of

> > govt and free amrket healthcare system that would

> > maintain or return,

> > depending on how you look at it, control of

> > healthcare to individuals

> > and doctors. My blog can be found at

> > http://doctorsh.blogspot.com/

> > but I copied the text below.

> >

> --------------------------------------------------------------------

> >

> > Medisave: A Blend of Government funded healthcare in

> > a privately

> > controlled fund

> >

> > Much of today's debate about healthcare reform

> > revolves around two

> > distinctly differing viewpoints. On one side we have

> > the call for a

> > government takeover of the present system, with new

> > insurance

> > mandates, continued insurance management and

> > regulation, and higher

> > taxes. On the other side we have the call for an end

> > to government

> > regulation, an opening up of the free market, and

> > the end of the

> > insurance industry's undue authority and oppressive

> > control over

> > healthcare processes, without any new taxes.

> >

> > Is there a way to bring the two sides together?

> >

> > Let's look at some numbers:

> >

> > Estimated population of the United States is 300

> > million.

> >

> > Estimated direct government contribution to

> > healthcare spending in

> > 840 billion dollars.

> >

> > That is about $2,800 a year per person.

> >

> > Is there a way to spend that money more efficiently?

> >

> > Here is my proposal:

> >

> > Individually owned Medisave accounts for all United

> > States citizens

> > from birth.

> > With no added taxes from the government, the $2,800

> > can be used to

> > purchase a catastrophic high deductible insurance

> > policy that would

> > also cover the first $500-1,000 per year of

> > preventive coverage for

> > well exams, Pap smears, childhood vaccines, etc.

> > These Medisave accounts would be individually owned

> > and controlled

> > and could be managed by banks or other brokerage

> > service centers. To

> > cover the costs of the deductible, patients and

> > employers could

> > voluntarily contribute to the accounts. For the

> > unemployed, there

> > could be more charity care and other tax deductible

> > accounts set up.

> > Means testing would also be on the table for those

> > truly in need. Any

> > money remaining in the Medisave accounts at the end

> > of the year would

> > roll over for the following year.

> > Hopefully money would be saved in these accounts to

> > fully cover any

> > future year deductible. Family members can use a

> > portion of their

> > excess Medisave dollars for other family members or

> > for charity to

> > others in need.

> >

> > The Medisave accounts would be paid for by the same

> > taxes present

> > today. However these monies would need to be

> > separated from the

> > government's general fund to avoid having any of the

> > funds spent on

> > other programs. With the accounts controlled by

> > individuals, it would

> > bring an end to government lobbyists and special

> > interests.

> >

> > Tort reform would also need to be enacted to lower

> > the costs of

> > defensive medicine. A fair system is beyond the

> > scope of this article.

> >

> > Lets look at the positives of this plan:

> >

> > 1) Lowers employer costs greatly. Employees could

> > get more in salary

> > as a result. Also insurance is fully portable, and

> > not dependent on

> > employment, only upon citizenship. Non-citizens can

> > buy into the plan

> > at much lower costs than today's insurance premiums.

> > 2) Ends Medicare and Medicaid and all the government

> > regulations and

> > price controls and replaces them with individually

> > controlled and

> > owned policies.

> > 3) No price controls. The free market would set the

> > costs.

> > Competition would open up and be fierce to increase

> > innovation and

> > decrease costs. Look at all the mini-clinics opening

> > up as lower cost

> > alternatives as an example of true free market

> > competition.

> > 4) Citizens can opt out of the plan, but what would

> > be the advantage?

> > 5) If individuals want to buy a Medigap policy for

> > their deductibles,

> > they may buy one on the open market.

> > 6) Insurance companies would stay in business but

> > would have to

> > change they way they operate. They would no longer

> > be in the business

> > of healthcare, but back solely in the business of

> > insurance.

> >

> > This proposal would cover every United States

> > Citizen and be funded

> > by the government in the form of Medisave

> > withholding deductions from

> > paychecks. This would replace the Medicare

> > withholding. The

> > percentage needed can be calculated by a group of

> > budget economists.

> > It would be budget neutral as no new funds would be

> > needed.

> >

> > Medicare and Medicaid would end along with the

> > regulations. Patients

> > would have open access to any doctor or health care

> > provider they

> > choose in the free market. Payment would be direct

> > from their

> > Medisave accounts at the time of service or as

> > agreed upon between

> > patient and the doctor or provider. There would be

> > no third party

> > involved to increase costs or intrude upon the

> > doctor-patient

> > relationship. And most importantly, those with

> > medical expertise and

> > genuine interest in our patients' health will once

> > again have

> > absolute control.

> >

>

June 14, 2008

Taking a step back, it would be good to ask what we are trying to

solve with the new solution. There are several problems with the

current system:

1. Government Funding Crisis

2. Physician incentives to provide service and enter the medicine field

3. The true uninsured

4. Employer mandates

5. Insurance Portability

6. Provide quality care across population (infant death mortality and

other common measures that are used to compare other systems).

I agree that Tim's and my stance on balance billing would only solve

#1 and #2. But the overall problem ends up being the same question of

how to eat an elephant. Solving #1 and #2 would be an easy to

implement first step (or bite) out of the problem. I would advocate

the staggered approach (smaller bites) to improvement.

Beeman

> >

> > > Hi All.

> > >

> > > I am interested in some feedback. I wrote on my blog

> > > about a blend of

> > > govt and free amrket healthcare system that would

> > > maintain or return,

> > > depending on how you look at it, control of

> > > healthcare to individuals

> > > and doctors. My blog can be found at

> > > http://doctorsh.blogspot.com/

> > > but I copied the text below.

> > >

> > --------------------------------------------------------------------

> > >

> > > Medisave: A Blend of Government funded healthcare in

> > > a privately

> > > controlled fund

> > >

> > > Much of today's debate about healthcare reform

> > > revolves around two

> > > distinctly differing viewpoints. On one side we have

> > > the call for a

> > > government takeover of the present system, with new

> > > insurance

> > > mandates, continued insurance management and

> > > regulation, and higher

> > > taxes. On the other side we have the call for an end

> > > to government

> > > regulation, an opening up of the free market, and

> > > the end of the

> > > insurance industry's undue authority and oppressive

> > > control over

> > > healthcare processes, without any new taxes.

> > >

> > > Is there a way to bring the two sides together?

> > >

> > > Let's look at some numbers:

> > >

> > > Estimated population of the United States is 300

> > > million.

> > >

> > > Estimated direct government contribution to

> > > healthcare spending in

> > > 840 billion dollars.

> > >

> > > That is about $2,800 a year per person.

> > >

> > > Is there a way to spend that money more efficiently?

> > >

> > > Here is my proposal:

> > >

> > > Individually owned Medisave accounts for all United

> > > States citizens

> > > from birth.

> > > With no added taxes from the government, the $2,800

> > > can be used to

> > > purchase a catastrophic high deductible insurance

> > > policy that would

> > > also cover the first $500-1,000 per year of

> > > preventive coverage for

> > > well exams, Pap smears, childhood vaccines, etc.

> > > These Medisave accounts would be individually owned

> > > and controlled

> > > and could be managed by banks or other brokerage

> > > service centers. To

> > > cover the costs of the deductible, patients and

> > > employers could

> > > voluntarily contribute to the accounts. For the

> > > unemployed, there

> > > could be more charity care and other tax deductible

> > > accounts set up.

> > > Means testing would also be on the table for those

> > > truly in need. Any

> > > money remaining in the Medisave accounts at the end

> > > of the year would

> > > roll over for the following year.

> > > Hopefully money would be saved in these accounts to

> > > fully cover any

> > > future year deductible. Family members can use a

> > > portion of their

> > > excess Medisave dollars for other family members or

> > > for charity to

> > > others in need.

> > >

> > > The Medisave accounts would be paid for by the same

> > > taxes present

> > > today. However these monies would need to be

> > > separated from the

> > > government's general fund to avoid having any of the

> > > funds spent on

> > > other programs. With the accounts controlled by

> > > individuals, it would

> > > bring an end to government lobbyists and special

> > > interests.

> > >

> > > Tort reform would also need to be enacted to lower

> > > the costs of

> > > defensive medicine. A fair system is beyond the

> > > scope of this article.

> > >

> > > Lets look at the positives of this plan:

> > >

> > > 1) Lowers employer costs greatly. Employees could

> > > get more in salary

> > > as a result. Also insurance is fully portable, and

> > > not dependent on

> > > employment, only upon citizenship. Non-citizens can

> > > buy into the plan

> > > at much lower costs than today's insurance premiums.

> > > 2) Ends Medicare and Medicaid and all the government

> > > regulations and

> > > price controls and replaces them with individually

> > > controlled and

> > > owned policies.

> > > 3) No price controls. The free market would set the

> > > costs.

> > > Competition would open up and be fierce to increase

> > > innovation and

> > > decrease costs. Look at all the mini-clinics opening

> > > up as lower cost

> > > alternatives as an example of true free market

> > > competition.

> > > 4) Citizens can opt out of the plan, but what would

> > > be the advantage?

> > > 5) If individuals want to buy a Medigap policy for

> > > their deductibles,

> > > they may buy one on the open market.

> > > 6) Insurance companies would stay in business but

> > > would have to

> > > change they way they operate. They would no longer

> > > be in the business

> > > of healthcare, but back solely in the business of

> > > insurance.

> > >

> > > This proposal would cover every United States

> > > Citizen and be funded

> > > by the government in the form of Medisave

> > > withholding deductions from

> > > paychecks. This would replace the Medicare

> > > withholding. The

> > > percentage needed can be calculated by a group of

> > > budget economists.

> > > It would be budget neutral as no new funds would be

> > > needed.

> > >

> > > Medicare and Medicaid would end along with the

> > > regulations. Patients

> > > would have open access to any doctor or health care

> > > provider they

> > > choose in the free market. Payment would be direct

> > > from their

> > > Medisave accounts at the time of service or as

> > > agreed upon between

> > > patient and the doctor or provider. There would be

> > > no third party

> > > involved to increase costs or intrude upon the

> > > doctor-patient

> > > relationship. And most importantly, those with

> > > medical expertise and

> > > genuine interest in our patients' health will once

> > > again have

> > > absolute control.

> > >

> >

>

June 14, 2008

:

Thank you for your comments.

Balance billing for Medicare is fine with me but only as an

incremental step and still does not have a true free market.

The Medisave would truly move us to cover the 6 points you mentioned,

while taking the bureaucracy and third party middlemen out of most of

the equation.

I am rooting for the Medicare pay cut and I hope that the other third

parties follow suit. It may finally wake up our profession to drop

the third party payment scheme.

But in a political election year, if we can come up with a plan to

cover the uninsured and be budget neutral, and if it comes from our

profession as opposed to the lawyers and politicians, we have a

chance to move change in the proper direction.

Steve Horvitz, D.O.

> >

> > > Hi All.

> > >

> > > I am interested in some feedback. I wrote on my blog

> > > about a blend of

> > > govt and free amrket healthcare system that would

> > > maintain or return,

> > > depending on how you look at it, control of

> > > healthcare to individuals

> > > and doctors. My blog can be found at

> > > http://doctorsh.blogspot.com/

> > > but I copied the text below.

> > >

> > ------------------------------------------------------------------

--

> > >

> > > Medisave: A Blend of Government funded healthcare in

> > > a privately

> > > controlled fund

> > >

> > > Much of today's debate about healthcare reform

> > > revolves around two

> > > distinctly differing viewpoints. On one side we have

> > > the call for a

> > > government takeover of the present system, with new

> > > insurance

> > > mandates, continued insurance management and

> > > regulation, and higher

> > > taxes. On the other side we have the call for an end

> > > to government

> > > regulation, an opening up of the free market, and

> > > the end of the

> > > insurance industry's undue authority and oppressive

> > > control over

> > > healthcare processes, without any new taxes.

> > >

> > > Is there a way to bring the two sides together?

> > >

> > > Let's look at some numbers:

> > >

> > > Estimated population of the United States is 300

> > > million.

> > >

> > > Estimated direct government contribution to

> > > healthcare spending in

> > > 840 billion dollars.

> > >

> > > That is about $2,800 a year per person.

> > >

> > > Is there a way to spend that money more efficiently?

> > >

> > > Here is my proposal:

> > >

> > > Individually owned Medisave accounts for all United

> > > States citizens

> > > from birth.

> > > With no added taxes from the government, the $2,800

> > > can be used to

> > > purchase a catastrophic high deductible insurance

> > > policy that would

> > > also cover the first $500-1,000 per year of

> > > preventive coverage for

> > > well exams, Pap smears, childhood vaccines, etc.

> > > These Medisave accounts would be individually owned

> > > and controlled

> > > and could be managed by banks or other brokerage

> > > service centers. To

> > > cover the costs of the deductible, patients and

> > > employers could

> > > voluntarily contribute to the accounts. For the

> > > unemployed, there

> > > could be more charity care and other tax deductible

> > > accounts set up.

> > > Means testing would also be on the table for those

> > > truly in need. Any

> > > money remaining in the Medisave accounts at the end

> > > of the year would

> > > roll over for the following year.

> > > Hopefully money would be saved in these accounts to

> > > fully cover any

> > > future year deductible. Family members can use a

> > > portion of their

> > > excess Medisave dollars for other family members or

> > > for charity to

> > > others in need.

> > >

> > > The Medisave accounts would be paid for by the same

> > > taxes present

> > > today. However these monies would need to be

> > > separated from the

> > > government's general fund to avoid having any of the

> > > funds spent on

> > > other programs. With the accounts controlled by

> > > individuals, it would

> > > bring an end to government lobbyists and special

> > > interests.

> > >

> > > Tort reform would also need to be enacted to lower

> > > the costs of

> > > defensive medicine. A fair system is beyond the

> > > scope of this article.

> > >

> > > Lets look at the positives of this plan:

> > >

> > > 1) Lowers employer costs greatly. Employees could

> > > get more in salary

> > > as a result. Also insurance is fully portable, and

> > > not dependent on

> > > employment, only upon citizenship. Non-citizens can

> > > buy into the plan

> > > at much lower costs than today's insurance premiums.

> > > 2) Ends Medicare and Medicaid and all the government

> > > regulations and

> > > price controls and replaces them with individually

> > > controlled and

> > > owned policies.

> > > 3) No price controls. The free market would set the

> > > costs.

> > > Competition would open up and be fierce to increase

> > > innovation and

> > > decrease costs. Look at all the mini-clinics opening

> > > up as lower cost

> > > alternatives as an example of true free market

> > > competition.

> > > 4) Citizens can opt out of the plan, but what would

> > > be the advantage?

> > > 5) If individuals want to buy a Medigap policy for

> > > their deductibles,

> > > they may buy one on the open market.

> > > 6) Insurance companies would stay in business but

> > > would have to

> > > change they way they operate. They would no longer

> > > be in the business

> > > of healthcare, but back solely in the business of

> > > insurance.

> > >

> > > This proposal would cover every United States

> > > Citizen and be funded

> > > by the government in the form of Medisave

> > > withholding deductions from

> > > paychecks. This would replace the Medicare

> > > withholding. The

> > > percentage needed can be calculated by a group of

> > > budget economists.

> > > It would be budget neutral as no new funds would be

> > > needed.

> > >

> > > Medicare and Medicaid would end along with the

> > > regulations. Patients

> > > would have open access to any doctor or health care

> > > provider they

> > > choose in the free market. Payment would be direct

> > > from their

> > > Medisave accounts at the time of service or as

> > > agreed upon between

> > > patient and the doctor or provider. There would be

> > > no third party

> > > involved to increase costs or intrude upon the

> > > doctor-patient

> > > relationship. And most importantly, those with

> > > medical expertise and

> > > genuine interest in our patients' health will once

> > > again have

> > > absolute control.

> > >

> >

>

June 14, 2008

I too am actually rooting for the pay cut. I do not think CMS has the time needed to implement a pay cut at this point anyway, so the impact will be felt, even if it is just temporary.

I look at the current health care payment system that has come to control the availability of health care services as the Titanic. Trying to offer everyone a chance at a third party payor (ie making sure everyone in the United States has access to health insurance, not to health care) is akin to putting the Titanic on the same course with the same hull and the same decision makers at the helm, but adding several million more passengers on the boat. THE THING IS STILL GOING TO SINK!!!!

Physicians are the only players in this group with true power, but we consistently fool ourselves into thinking we are powerless. WHY DO WE BELEIVE THAT USING THE TITANIC IS A GOOD IDEA???

:Thank you for your comments.Balance billing for Medicare is fine with me but only as an incremental step and still does not have a true free market.The Medisave would truly move us to cover the 6 points you mentioned,

while taking the bureaucracy and third party middlemen out of most of the equation.I am rooting for the Medicare pay cut and I hope that the other third parties follow suit. It may finally wake up our profession to drop

the third party payment scheme.But in a political election year, if we can come up with a plan to cover the uninsured and be budget neutral, and if it comes from our profession as opposed to the lawyers and politicians, we have a

chance to move change in the proper direction.Steve Horvitz, D.O.> > > > > Hi All.> > > > > > I am interested in some feedback. I wrote on my blog

> > > about a blend of > > > govt and free amrket healthcare system that would> > > maintain or return, > > > depending on how you look at it, control of> > > healthcare to individuals

> > > and doctors. My blog can be found at> > > http://doctorsh.blogspot.com/ > > > but I copied the text below.> > >

> > ------------------------------------------------------------> > > > > > Medisave: A Blend of Government funded healthcare in> > > a privately > > > controlled fund

> > > > > > > > > Much of today's debate about healthcare reform> > > revolves around two > > > distinctly differing viewpoints. On one side we have> > > the call for a

> > > government takeover of the present system, with new> > > insurance > > > mandates, continued insurance management and> > > regulation, and higher > > > taxes. On the other side we have the call for an end

> > > to government > > > regulation, an opening up of the free market, and> > > the end of the > > > insurance industry's undue authority and oppressive> > > control over

> > > healthcare processes, without any new taxes.> > > > > > Is there a way to bring the two sides together?> > > > > > Let's look at some numbers:> > >

> > > Estimated population of the United States is 300> > > million.> > > > > > Estimated direct government contribution to> > > healthcare spending in > > > 840 billion dollars.

> > > > > > That is about $2,800 a year per person.> > > > > > Is there a way to spend that money more efficiently?> > > > > > Here is my proposal:

> > > > > > Individually owned Medisave accounts for all United> > > States citizens > > > from birth.> > > With no added taxes from the government, the $2,800

> > > can be used to > > > purchase a catastrophic high deductible insurance> > > policy that would > > > also cover the first $500-1,000 per year of> > > preventive coverage for

> > > well exams, Pap smears, childhood vaccines, etc.> > > These Medisave accounts would be individually owned> > > and controlled > > > and could be managed by banks or other brokerage

> > > service centers. To > > > cover the costs of the deductible, patients and> > > employers could > > > voluntarily contribute to the accounts. For the> > > unemployed, there

> > > could be more charity care and other tax deductible> > > accounts set up. > > > Means testing would also be on the table for those> > > truly in need. Any > > > money remaining in the Medisave accounts at the end

> > > of the year would > > > roll over for the following year.> > > Hopefully money would be saved in these accounts to> > > fully cover any > > > future year deductible. Family members can use a

> > > portion of their > > > excess Medisave dollars for other family members or> > > for charity to > > > others in need.> > > > > > The Medisave accounts would be paid for by the same

> > > taxes present > > > today. However these monies would need to be> > > separated from the > > > government's general fund to avoid having any of the> > > funds spent on

> > > other programs. With the accounts controlled by> > > individuals, it would > > > bring an end to government lobbyists and special> > > interests.> > >

> > > Tort reform would also need to be enacted to lower> > > the costs of > > > defensive medicine. A fair system is beyond the> > > scope of this article.> > >

> > > Lets look at the positives of this plan:> > > > > > 1) Lowers employer costs greatly. Employees could> > > get more in salary > > > as a result. Also insurance is fully portable, and

> > > not dependent on > > > employment, only upon citizenship. Non-citizens can> > > buy into the plan > > > at much lower costs than today's insurance premiums.> > > 2) Ends Medicare and Medicaid and all the government

> > > regulations and > > > price controls and replaces them with individually> > > controlled and > > > owned policies.> > > 3) No price controls. The free market would set the

> > > costs. > > > Competition would open up and be fierce to increase> > > innovation and > > > decrease costs. Look at all the mini-clinics opening> > > up as lower cost

> > > alternatives as an example of true free market> > > competition.> > > 4) Citizens can opt out of the plan, but what would> > > be the advantage?> > > 5) If individuals want to buy a Medigap policy for

> > > their deductibles, > > > they may buy one on the open market.> > > 6) Insurance companies would stay in business but> > > would have to > > > change they way they operate. They would no longer

> > > be in the business > > > of healthcare, but back solely in the business of> > > insurance.> > > > > > This proposal would cover every United States> > > Citizen and be funded

> > > by the government in the form of Medisave> > > withholding deductions from > > > paychecks. This would replace the Medicare> > > withholding. The > > > percentage needed can be calculated by a group of

> > > budget economists. > > > It would be budget neutral as no new funds would be> > > needed.> > > > > > Medicare and Medicaid would end along with the> > > regulations. Patients

> > > would have open access to any doctor or health care> > > provider they > > > choose in the free market. Payment would be direct> > > from their > > > Medisave accounts at the time of service or as

> > > agreed upon between > > > patient and the doctor or provider. There would be> > > no third party > > > involved to increase costs or intrude upon the> > > doctor-patient

> > > relationship. And most importantly, those with> > > medical expertise and > > > genuine interest in our patients' health will once> > > again have > > > absolute control.

> > > > > >> >>

--

Durango, CO

June 14, 2008

I hit the send button before I finished my thoughts.

I personally believe that we as IMP's are on the right track and it involves smaller more personalized vessels with the goal, as Pam Wible puts it, of relentlessly pursuing the doctor patient relationship. That is what really matters. Primary care services provided in a manner that efficiently individualizes health needs of the citizens is the only hope for bringing costs under control.

But then here I go again preaching to the choir.

I would like for physicians to wake up and take back what is and should be the most important factor in the provision of health care--the physician patient relationship. As long as we truly believe that health insurance must be a part of this relationship, we and our patients will continue to suffer.

Just having a free flow thought moment.