Some thoughts on healthcare reform

Not an easy topic to find solutions to.  Billions at stake, lives at stake.  Others have done a good job debating the pros and cons of the current law as it makes its way through the courts, so I will not rehash those, but will just add a few ideas.

Many have an unease in advocating for a single payer system and for some good reasons, the current system Medicare does not pay well for the doctors, and creates many limitations for the patient.  I am interested in the Swiss system where as I understand it, insurance is purchased by the individual (and thus not tied to employment), you can purchase a variety of plans to suit your needs and lifestyle, and the companies while private cannot make a profit.  It is the middleman without the exorbitant middleman pay.  Here are some examples of middleman profit and non-profit in insurance companies in America: (numbers from Wikipedia)

Aetna  net profit 1.28 Billion for fiscal year 2009

Cigna operating income 1.3 Billion for fiscal year 2009

United net profit 3.82 Billion for fiscal year 2009

Regence Blue Cross/Blue Shield is Nonprofit (a favored insurance among many doctors in my area due to higher pay rates)

Premera Blue Cross is Nonprofit (another liked insurance due to paying doctors quickly) (Premera did try to go for profit but was rejected by Washington state insurance commission.)

I would love to go into further detail about how insurance contracts work, how much docs get paid, ect, however it is against the terms of my insurance contracts to discuss these details.  It is also against the terms of my contracts to change my fee on a need basis other than a 25% time of service deduction.  (I did go into it a few years back with some members of congress, that were quite astounded to hear how it all worked... or in our case does not work)

So far in the end I would propose a Swiss style system. Private companies not allowed to make a profit but can still pay CEOs their 6 figure salaries.  States that want to, can put out their own plan as they do now...  in Washington it is Lifewise a subsidary of Premera.  This gives the control at the state level where currently states have the right to control healthcare law.   I see the role of the federal government as two fold: help provide states with funds to build and run hospitals and emergency services, and to offer tax deductions for those purchasing health plans.  Health plans would all be bought by individuals and would not be tied to employer however, and employer can pay an employee more to buy more insurance if they so choose.  Brings alot more competition and free market into the system and does not tie you to a job you hate.

I like the idea of catastrophic plans for young healthy folks tied to a health savings account (HSA).  This is a plan that only covers big medical emergencies and 1 annual visit per year, but allows you to put away tax free several thousands of dollars and rolls over from year to year.  These HSAs can be used for over the medications, over the counter meds, supplements, massages, acupuncture, chiropractors, ect... Many things that conventional plans may not cover.  This is the type of plan I currently have.

Comments, questions?