Sunday, July 9, 2017

Patrick Schubert's Take on Health Care (Reflections)

I found this detailed, lengthy account on how to deal with the health care concerns in the United States.

Patrick Schubert

Patrick Schubert brings some welcome insight to the discussion, and I wanted to share his thoughts with you:


When discussing Health care you must first address it as what it is, Insurance…

Defining terms is crucial. I could not agree more. There are too many people who think that having a piece of paper that says "insurance" on it guarantees health care. Not so.

Insurance in general, regardless of type or derivative of it, is a shining example to us all, everyday of why government, as we know it does not work.  It also exposes how the government works against everyone of us by providing the Insurance market a tilted system.

Interesting. 

We have lost our understanding of what our government is supposed to look like and how it is supposed to operate.  Government has one right, the right to exist, as a necessary evil for the management of the People’s business.  It has 3 duties. Preserve the Union and its Laws. Protect the People, Union and their standing in the World.   Defend the People, the Union and her precious Freedoms from all enemies foreign or domestic.  Any right or duty the Government has picked up since the inception of the Constitution, has infringed on something belonging to the People.  Sometimes they partner with others to infringe on Rights they don’t dare touch themselves.

Now you're talking. I agree. The Constitution outlines clearly enumerated powers. There is no reason for the federal government to get involved in the healthcare or insurance industries--and I do not care how hard progressives try to spin the preamble to suggest otherwise.

When such a misunderstanding of duties like this happens and continues to happen we end up exactly where we are now.  The People running frantically to manage a maze of laws, rules, penalties or intentionally placed hurdles or outright blatantly ignored conditions of disgusting proportions just to find their Freedoms.  It is the physics of Government versus People that drove the Forefathers to give us the Constitution we have had for the last 230+ years.

I would add that all of this government micromanaging has hurt our health care system and stringently limited our access to quality health care. This is the message I have been sending at length to single-payer and Obamacare supporters over and over again.



OK, back to the purpose of this writing.  Insurance, like government, is a necessary evil.  Most states require it for your car.  Every bank requires it for your home.  You can not open and operate a business without numerous type of policies in place.  The conditions of our World in 2017 require Health, Disability, Life Insurances and depending on your way of life you may require other types of specialized insurances.  In many of these situations insurances are a prudent and a responsible choice.

The problems come like a herd of stampeding of cattle when you need to use it.  When your home floods and you find out your home insurance doesn’t cover that.  Nor does it cover Hurricanes, Tornadoes and a myriad of other Acts of God.  When they do cover your loss, they attempt to pay you pennies on your dollars.  Usually it requires specialized skilled professionals and attorneys to defend your loss costing you from 10% to 33% per professional.  In most cases non-attorney professionals charge flat fees upfront.

Insurance as a necessary evil .... hmm. I am glad for insurance, since it ensures that if I get into an accident, whether my fault or someone else's, that I will be prepared to continue driving or get a new car. Insurance companies have to be judged based on the service they provide. Insurance companies with a reputation of nickel-and-diming their customers will go out of business. 

It's about competition, efficiency, and accountability.

Still, the problem with insurance companies trying to get away with providing as little as possible to cover your claim--that does happen, and that is an issue which has to be confronted.

Still, I would say that my car insurance is pretty good. I do not have to go to court, and much of the time I get exactly what I need and more to cover losses incurred by someone else's negligence or malfeasance.

Health care is a more precious need than driving a car, too. I get that concern. What can be done so that in matters relating to our health care,

When these losses are in matters of Disability and health issues, there is an evil undertone to our current laws that not only allows the system to abuse its users, the users insurance companies are contractually obligated to protect, but allows the insurance companies an unfettered right to push you until you either reach the end of their golden road or you remove yourself from the process.  They don’t care how that happens, as long as you’re no longer their responsibility.  If you are severely injured but choose to go back to work risking more injury simply because your rent is due, kids need clothes and food or you just got sick and tired of fighting a system designed for a no-win situation they could care less, in fact they are probably banking on life forcing you back to work long before they give you any real help.  Even if you win, you’re still going to lose. 

Insurance as a necessary evil: I have to still consider what to think about that one. What can be done about this problem? I agree with restoring a close relationship between patient and doctor. In order to accomplish that, however, men and women would have to cover the costs of whatever needs they sought from their medical professional.

Perhaps treating health insurance more like car insurance, where it kicks in only for catastrophic needs would be the way to go.

These behaviors do not happen because the laws allow it.  They exist because the laws intentionally do not address these issues.  Insurance companies own our Representatives and because of that, we pay the price while the politicians and insurance companies make trillions annually.  Government’s job is to protect us from these companies but instead they stack the deck against us.  Only when enough people get outraged will they plug a hole in a law and they won’t plug all of them.  Each occurrence will require the same massive outrage.  The insurance companies know every hole in the laws, they exploit them daily.  Our officials know they exist also.

Laws are becoming a major impediment to the proper use and disbursement of funds. Government regulation has created more problems, rather than simply ensuring that contracts are enforced. What has made it so easy for insurance companies not to comply with their contractual obligations? That's the million dollar question. 

The ACA had nothing to do with insuring you.  What it did do was swell the ranks of Medical Unions and give you the appearance that you were getting something.  Sure insurance companies had to enroll you if you had a pre-existing condition.  Did it require the insurance companies to cover that condition or did they not address that?  Most insurance companies had a 1 to 3 year wait for pre-existing condition coverage pre-ACA.  

100 years ago, 200 years ago men and women of all backgrounds had pre-existing conditions. How did they deal with these issues? I don't recall all of these people clamoring in the streets for the government to step in and save them. What the United States had before was working pretty well. I do agree that the more regulatory burdens that have stepped in, that the problems have not been solved.

Guess what, most still do.  The only way to get coverage for a pre-existing condition is to go on Medicare or Medicaid via the ACA.  The ACA was designed to ingrain the American psyche with the notion that healthcare should be free.  Research “The 2nd Bill of Rights” for evidentiary data.  We can debate back and forth over the design of free healthcare and other entitlements as weapons against American financial security but it surely is a weapon against political peace in America today.  Another benefit of the ACA. 

I could not agree more. This perverse notion that health care should be for everyone at "the government's expense" is a perverse power play. That is all wrong.

There will be no healthcare solutions until the insurance companies and their friends in Washington resume their seats at their assigned chairs.  Insurance companies must be held to the standards of contract law.

YES!

Those contracts must be uniformly fair and not include the current menagerie of intentional misrepresentation that can vary in the industry today.  They must also meet a strong representative of the people who will ensure they are not left to trample their customers in sacrifice of their bottom line. 

Milton Friedman outlined in "Capitalism and Freedom" that the government should serve as an umpire to provide and protect equal treatment under the law. I would add that market forces would do an even better job. Allowing men and women to purchase health insurance across state lines would allow for more choice and competition. Insurance companies in any one state who fail to deliver on their promises will get a bad rap, and other insurance companies will get the business.



Indeed, the insurance companies are very much trying to work and slant the system in their favor. To be pro free market does not mean pro-business. Consider this passage in Adam Smith's "The Wealth of Nations":

“People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices."

Government should be the arbitrator in matters between insurance versus the People, not the hand on the back pushing those companies ahead of us.  Government should set the guidelines and keep its hands off our care.  When the insurance companies overstep, our representatives should not be a copy service sending notes of how angry we are.  It needs the tools to check Insurance and help us become whole again.

I agree. The government has been making life too easy for insurance companies at the expense of consumers. Car insurance companies must compete on-line, through social media, on TV for customers. But just as Adam Smith announced, insurance companies have found a way to meet together with the government's blessing and raise prices against consumers.

How? By shutting them out of choosing products from other markets. They have colluded to limit choice and drive down supply, while demand has remained level or increased, thus raising prices. This racket has to be broken up.

Government repeatedly attempts to solve problems but from here on the street it looks like no considerations are given to the possibilities of what can go right or wrong in any scenario they attempt to “help” with.  Every politician says they want a market driven solution but they gerrymander the market every time they get an opportunity.  They promise you everything and deliver nothing.  When their reigns of control are yanked, its our neck that breaks, not the insurance companies.  That’s now how any of this is supposed to work.

"Gerrymandering" the market will end when I can purchase a health insurance plan anywhere I want to. We don't need the government making promises. Rather, we need the government to stop prevent all sorts of different companies from making their own promises.

Tort reform is necessary.  When insurance companies push people to court they should be held responsible for all the expenses of that process they chose over meeting their contractual obligations.  When they are forced to pay you for your loss or care you should not have to give a large portion away for winning.  This will end the “I guess this is where you sue us” mentality too many insurance companies have today.  They know the judicial system, a product of our government, will protect them before us so why wouldn’t they want to go to court on every issue?

Tort reform is necessary. One of the biggest roadblocks to this reform is the trial lawyer associations, since they make big money off of repeated lawsuits. Just like the insurance companies, lawyer associations are colluding to ensure that business remains active and growing, all while the rest of us pay the price. This dynamic could be changing, however, with a limitation on legal actions, or an acceptable consequence. The state has a right to regulate legal actions, since these are government institutions. I would suggest that the losing party in a lawsuit must pay the attorney's fees for the winner. Such reforms would discourage frivolous lawsuits. Capping damages to the clear costs would be good, too.

We do need lawyers, but we do not need a legal culture in which men and women routinely run to court to exact revenge on others.

Any American Citizen who wishes to have insurance should have an opportunity to get the policy that best suits their needs.  In today’s climate, a person who lives in a low population density state has most likely never heard of an HMO insurance plan.  Currently under ACA standards, these plans are Cadillac plans and taxable. 

They are too big and too expensive. Insurance companies jumped into the whole plot to force people to pay for Cadillac plans, since they would cash in big time.

Many think the idea of a HSA (Health Savings Account) as a great insurance against bad potentials.  The ACA took away the employer contribution to those plans.  Many employers who offer HSA based plans pay much less for those plans because the plans generally help people be more vigilant about their regular care issues which has been known to improve your overall health.  More than 25% of this country has no access to these plans.  Buying across state lines can and will offer these policies to everyone, regardless of location.

I am so glad that Patrick is talking about Health Savings Accounts. Let's encourage people to save for their future. Let's welcome individual citizens taking responsibility for their lives and actions. Providing incentives for working people and other income brackets to take care of themselves is a welcome decision.

Of course, the power differential pushed by Obama and progressives has never been about providing health care. It's been about gaining more power over the populace. All of this is wrong.

Coverage pools are one of the most misleading things ever introduced to any industry.  They give insurance companies the ability to micro manage their costs and profits and show unprofitable numbers while as a whole the company is thriving.  One insurance pool, all 50 states per company.  Less than 20% of the coverable people in this nation ranks as a high risk patient.  If a company is splitting the nation into 10 pools they are structuring those pools not to provide you better coverage but to provide themselves better profits.

High risk pools should be open to competition just like any other aspect of health care or health insurance.

Healthcare can not be a Right, it is a service.

Thank you so much for stating this so plainly, Patrick.!

Thank you again! It is so simple, and yet conservatives, free market advocates, and pro-individual Republicans are not getting this point across.

Check out what Rand Paul explained at the Veterans Affairs Committee hearing in 2014:


Of course, Sanders spun this discussion to make Dr. Paul look foolish, but Paul's point about enslaving practitioners is valid.

We ended the practice of people being forced into providing services free of cost over 150 years ago.  The people who provide our healthcare are well trained professionals who deserve to be compensated for their work, which is usually a thankless job.  America is a compassionate country.  If a person is unable to work due to medical reasons they should be cared for in a fair and equitable system that does not teat them differently based on whether they have Blue Cross & Blue Shield or Medicare.  Those who do not wish to work should not receive free care.

YES! No free medicare, not welfare-medicine. NONE!

Tax breaks always sound great but they are nothing more than an appeasement scam government has used to get us to comply with their desires for decades.  If you get a 10% tax credit and are paying $15,000 a year for insurance you will not pay taxes on $1,500 of your income.  This will save you probably $150 or less a year. 

Let the market determine the costs of insuring people. 

Yes!

Let the people decide which coverages are best for them.  Stop trying to fix things and let the market correct itself.   When the buying restrictions are removed hundreds of thousands of companies will go into a competition mode.  Plans will get cheaper, coverages will get better and the companies that drag their customers through the current legal and financial mine fields will cease to exist.

That's what I am talking about!

Standardization of documentation is a must.  Every insurance company has a different sets of paperwork for every part of their process.  Healthcare costs will never reduce without removing the massive effort in every doctor’s office, clinic or hospital on paperwork alone.  Addressing this can reduce the need for specialists who do nothing more than paperwork.  Most offices and hospitals run like well oiled machines by the scenes.  Freeing them from the mass of paperwork can allow more effort to creativity to improve these systems even more while saving billions.

Competition in a wider marketplace will force different insurance companies to get rid of all their p paperwork issues. These reforms must depend on the individual insurance companies who want to control costs while increasing the number of clients.
.
Common Sense must be applied going forward.  When a young adult decides they do not want health coverage, they should be required to sign a document that says they accept all responsibilities for all care they may require in the future.  When you leave a job due to a disability, your insurance must persist or there will be no care for your condition.  You’ll never return to work.  When you pay for coverages, you get what you pay for and the care you need.  We must finally draw a line on fraud in the medical industry.  Make the current maximum penalties for fraud the new minimums and prosecute all who defraud aggressively.

"You get what you pay for" describes the experience for Canadians in their single-payer system. They get lousy care if any. The shortages, rationing, and waiting times are outrageous. No single-payer! No socialized medicine.


People need their prescriptions; Make it mandatory for employers, over a predetermined income level, to at least offer a prescription, dental, eye care and disability insurance package as a minimum. There should be a max 50% cost to the employee.  Most of these plans have very minimal costs and can protect workers in times of need.

No mandates, please. I disagree with this final point. Businesses, employers, companies must have the choice to decide what kind of benefits they offer--or do not offer. If an employee is concerned about the benefits package, then they need to ask for it. If they are that concerned about receiving something like that, then they can look for a job somewhere else.

Final Reflection

I am grateful for these extended remarks from Patrick Schubert.

We need to recognize that there are clear political conflicts which have prevented true competition and choice, and thus providing for quality healthcare and access.

The federal and state governments have been picking the winners and losers, specifically because of insurance companies lobbying Congress for rules which help them at the expense of everyone else. This Big Business-Big Government collusion must end.

I do agree with the Bernieacs on one point--there middle man is getting too much money and power, and it has to stop. After that, I emphatically disagree with their argument to allow the government to step in and provide "Medicare for all".

Insurance companies can play a role, and their capacity to pool risk and provide funding is worth seeking out. No one wants to be on the hook for a multi-thousand dollar medical operation for a crisis or a chaotic event.

How do we ensure that insurance companies provide good service? Ensure competition. Insurance companies are in the business of making money. We could limit their impact and scope by allowing for clear transparency and ensuring the insurance companies cover unexpected needs--just like car insurance.

Patrick Schubert's analysis is pretty incredible. I enjoyed the widespread scope of his comments on the health insurance/health care discussion. Let's hope that we get more people elected who will respect the will and needs of the voters, the clients who purchase health insurance and seek adequate health care.

No comments:

Post a Comment