US Healthcare Spending

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  • commented 2017-09-05 04:05:45 -0600
    Sorry, this is in reference to a talk by Robert Messeman this evening, 4 September 2017.
    One infers that the ~$700$B health insurance industry will accept buyouts without respect to the disruption in the separation of half a million or so employees from their paychecks and daily structure. An enormous disincentive to cooperate is inevitable, speaking very mildly.

    Rather, the task will only be achieved when incentives coincide, not conflict.

    Ergo we need a New Dispensation such that the insurance companies honor the rubric of “we compete, therefore we have a reason to exist” so dear to the hearts and minds of the people involved. What is needed is new rules, new understandings of the purpose of insurance companies, that connect their success to positive outcomes.

    Also, the incentives must connect the full and free acceptance of every single applicant to whichever company the applicant chooses.

    How an insurance company learns to embrace the million dollar a month rare patient as enthusiastically as it does someone whom they will likely not have to treat for the next twenty years, excluding the odd rash or hiccup, is a challenge, but when I have the time I will outline one.

    Simply begin with the thought of insurance companies forbidden to spend more than a tiny percent of their budget in advertising (caveat, the advertising industry will rain down its displeasure) and that the tort industry will have only one opponent, the United States Attorney General, when suing for malpractice awards, causing the entire ABA, whose members include most of the United States Congress, also adept at expressing its displeasure in a very persuasive manner, – - -

    Presuming that these challenges can be overcome, proceed to design a system which uses the power of a single SOURCE of funds yet with 330 million SOURCES of access to those funds, in such a way that the more clients the company has, the better its outcomes will be.

    Tilt the financial rewards toward better outcomes; Yankee ingenuity will find ways the insurers will incent their clients to live healthier.

    Insurers with more clients will make more money. The primary thing affecting the bottom line will be drawing people to your company via greater client satisfaction with their outcomes.

    Those employed today as “denier of first resort” a.k.a. the front line personnel, the ones who accept or deny each claim as it arrivers, will instead find their job description changed to “facilitator of first resort.”

    Answers coming; I’ve misspent too much of the evening to do this subject justice.

    Joel Hinrichs

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