Posted in Access to healthcare, advance-pricing, Affordable Care Act (ObamaCare), Consumer-Driven Health Care, CPT billing, Direct-Pay Medicine, Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, Government Regulations, Health Insurance, Health Savings Accounts (HSA's), Healthcare financing, Individual Mandate, Individual Market, Individual ObamaCare Market, Individual Underwriting Standards, Insurance subsidies, Large group insurance market, Medicaid, medical inflation, Medical Practice Models, Patient Choice, Policy Issues, Portable Insurance, Pre-existing Conditions, Private Exchanges, Quality, Subsidies, Tax Policy, Uncategorized

A Path Towards a Viable Interstate Health Insurance Market | Robert Nelson, MD | Pulse | LinkedIn

Alternatives to our current over-priced and dysfunctional health insurance market are often biased, and thus limited, by our current operational and regulatory structure. These structures are so entrenched in our healthcare psyche that it makes it difficult sometimes to set these aside in our minds while entertaining how another approach might work.

If we view all alternative plans to replace the Affordable Care Act from the vantage point of “what is”, then there is little room for anything other than attempts at further regulating the problems away. If one presupposes that the current regulatory framework remains unchanged, indeed the same framework has served to suppress the very market we wish create, then of course that market will not be created.

The dilemma facing alternative healthcare plans being considered to replace the ACA is particularly evident when it comes to the issue of selling health insurance across state lines. A brief on this subject published by the American Academy of Actuaries in February of 2017 speaks to the the main challenges facing the advent of a viable interstate market for the sale of health insurance.

Source: A Path Towards a Viable Interstate Health Insurance Market | Robert Nelson, MD | Pulse | LinkedIn

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Consumer-Driven Health Care, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relations, Doctor-Patient Relationship, Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, Free-Market, Health Insurance, Independent Physicians, Medical Costs, medical inflation, Medical Practice Models, out-of-pocket costs, outcomes, Patient Choice, Patient-centered Care, Policy Issues, Price Tansparency, primary care, Self-Insured Companies, Self-Insured Plans, Telemedicine Trends, The Quadruple Aim, The Triple Aim, third-party payments, Uncategorized

Three Reasons Why Employers Should Care about Direct Primary Care | Samir Qamar | LinkedIn

Featured Image -- 24171.“Insurance is not necessary for all healthcare.”

2.“Not all healthcare is expensive.”

3.”Employers can use Direct Primary Care to lower healthcare costs.”

Healthcare is the only field where insurance is not only used for rare events, but also common and frequent events. However, “insurance is not necessary for all healthcare”.

To reduce frequency of claims, a large segment of medical care has to be affordable to render insurance unnecessary. Thankfully, “not all healthcare is expensive.”This is where Direct Primary Care makes its grand entrance.

Direct Primary Care takes this majority of healthcare, and caps the cost into an affordable, manageable, flat monthly fee, typically less than $90 per month. As a result, insurance use (and cost) is minimized to rare occurrences.“Employers can use Direct Primary Care to lower healthcare costs.”

Source: Three Reasons Why Employers Should Care about Direct Primary Care | Samir Qamar | LinkedIn

Posted in Access to healthcare, Deductibles, Economic Issues, Employer-Sponsored Health Plans, Free-Market, Health Insurance, Individual Underwriting Standards, Medical Costs, Patient Choice, Policy Issues, Pre-existing Conditions, Uncategorized

Rational Health Insurance | Health Policy Blog | NCPA.org

Health-InsuranceAfter hail damages the roof of your house, your homeowner’s insurance is supposed to pay for the repairs. But there is no requirement that you continue paying premiums while your roof is being repaired. And if you switch to a new insurer, the new insurer doesn’t pay for damages incurred while the previous insurance was in force. These same principles apply to auto collision insurance and every other form of casualty insurance.

If you get sick, your insurer won’t keep paying medical bills unless you keep paying premiums. If you are unable to switch plans (because your new pre-existing condition causes you to be rejected or face exorbitant premiums), you are stuck in a continuing relationship with your existing insurer — regardless of the quality of service or the premiums charged. If you are able to switch plans, the new insurer has to start paying your medical bills, even though the illness (and all the premiums paid up to that point) occurred while you were on some other plan. This is why the new insurer doesn’t really want you and has no incentive to treat you well after you arrive.

To make matters worse, healthy people always have an incentive to leave a plan after some of its members get sick. The reason: the new plan formed by healthy people can charge much lower premiums. Meanwhile, premiums in the original plan (which now has only sick people) must rise to ever higher levels to keep paying the medical bills.

In a very real sense, health insurance isn’t insurance at all. It’s the artificial product of unwise tax and regulatory policies. But fret not. There is an ingenious solution to all this.

via Rational Health Insurance | Health Policy Blog | NCPA.org.