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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