Rich & Others
 
Public awareness is often critical to this discussion and is part of the
reason insurance companies are so successful in maintaining the status quo. 
 
EVERY MINNESOTA RESIDENT is guaranteed the right to purchase insurance
coverage, regardless of their prior health under MCHA.  Those that can not
afford it can be covered under medical assistance.  Employers do not have to
stay in a group plan to protect someone in the group who has health
problems.  This is one of the most misunderstood assumption most employers
and employees have. WE HAVE NEVER FOUND A GROUP RATE OR COLA RATE THAT IS
LESS THAN MCHA.
 
A single payer system is "not" insurance it is used to set prices which is
what most people really are asking for.  The cost to process Medicare, the
model most use is estimated at 3 percent.  Yet Medicare contracts to
private, for profit, companies for the administration of it.  This would
tend to reinforce the argument that no government business can do it for
less.  People assume single payer and government insurance for all are one
in the same but that is not correct.  Their are many private, single payer
systems in place now and some that also do it for  3 % or less so the issue
is not single payer but price negotiation, price regulation or price
controls.  Part of the problem we have now is driven by Medicare as non
profit hospitals are forced to accept Medicare payments at less than the
cost of the services which then results in cost shifting to the rest of
their customers which include the 1/3 of the uninsured or self insured as I
prefer to call them.
 
This is what I think should be done and would meet the needs of the 98 % of
the population.
 
All medical expenses as currently classified as deductible should be able
paid by people out of pocket until they reach the 7.5% which is currently
exempted under the tax code.  Every individual or their employer is they
elect would pay $1.50 per the age of the person per month into a public pool
of dollars. For a family of four ages 38, 35, 12 and 10 total 95 x $1.50 =
$142.50 month or $1,710.00 year.  Once the 7.5% is spent 100% of anything
over that it is reimbursed dollar for dollar from the pool.  The 7.5 %
applies to those over 65 but the $1.50 is absorbed by the pool.  ALL
INSURANCE WOULD BE ELIMINATED. Government price controls "could be" used or
price enforced under the existing Robinson-Patman law.  
 
I welcome others to run the numbers
 
Paul Double

 -----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf
Of Rich PFlughoeft
Sent: Friday, October 24, 2003 12:44 AM

I've been asked who should pay for health insurance if it's not the
employer. Dwayne and Phil both are convinced it should be a government run
single payer system. Their arguments are convincing to me. I would support
such a system. However, I'm not convinced that you can bring such a system
to reality. In my opinion, Americans (for good or bad) are loath to put the
federal government in charge of aspects of their day to day life. Imagine
for a moment, you call the IRS for a health insurance question. I know it's
not a fair analogy, but it is the way some people think (again, this is my
opinion).
 
While I'm breaking the rule that says you should never write a letter like
this late at night (I'm never as clever and witty as I think I am) I'm going
to give it a shot.
 
Assuming Dwayne and Phil are unsuccessful at bringing about a move to a
national health care system I would propose the following:
1) Think only in terms of the State of Minnesota
2) Think in terms of making Insurance Companies play by rules that would
'mimic the rules we would use in a single payer system'.
 
What does this mean?
 
Well, besides the evil profit motive of insurance companies (sarcasm
intended since I'm sensitive to the word profit being equated with evil)
there are a few things that strike me as reasonable reasons that health
insurance premiums vary significantly from person to person or business to
business.
 
1) Pools and Cherry Picking: If you're a small employer with one or two
employees with significant health issues, your premiums are going to be
different from employers who have huge numbers of employees and 'on average'
aren't as high a risk factor. Throw in the fact that self-insured people who
have little in the way of 'health issues' are able to get insurance much
more easily (or less expensively) than an individual who is seeking
insurance but has a history of health problems. 
 
2) Many healthy people are not in the insurance pools. I would suspect this
happens because of two primary reasons.
   2a) I'm young and healthy and I have better things to spend my money on.
                                 -or-
   2b) I'm wealthy enough that I don't need insurance.
 
 
How would I 'regulate' insurance companies to deal with this?
1) First and foremost, I would eliminate the issue of 'which pool are you
in'?. If I was King for a day and could decree only one absolute law, it
would be that insurance companies had to look at Minnesota as one and only
one pool. If you are a resident of Minnesota, you are a member of that pool.
Add to that the requirement that you could NOT be denied insurance because
of a pre-existing condition. If you live in Minnesota, you can get insurance
and it doesn't matter where you work or what your health history is.
 
2)This is going to be the part that will kill my plan but, .... treat health
insurance in the same way we treat auto insurance. If you have an auto, you
are required by law to have insurance. In my opinion, if you have a 'body
and you're alive' you should be required to have health insurance. This will
keep all the people that think they can stay out of the equation while they
are young and healthy (or wealthy enough to avoid insurance) from diluting
the pool of healthy individuals.
 
 
Please note that neither of the above points preclude insurance being
provided by your employer. While I'd rather not pretend that it makes sense
for me to be an integral part of the health care system, at least level the
playing field.
 
Oh, if it isn't already obvious, the state of Minnesota would have to play a
role in providing the health insurance premiums for those who could not
afford them. And, the state of Minnesota may have to address the 'Minimum
Wage Laws' if we expect people to buy their own insurance. Of coarse, if
people would prefer, we can continue to require businesses to provide this
benefit. I'm expecting then that the day will come where I'll be required to
buy my employees their groceries. 
 
So much for my late night dissertations. Good night all.
 
Rich Pflughoeft
 
 

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