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  • #46
    Originally posted by mel
    Interesting comments, would it help if employees were offered some sort of vouchers by employers to shop for health insurance? Would this empower the employee?
    Aggregating the buying power of large employers leads to premium discounts. That is why only a few programs are offered. Disaggregating the buying power by issuing vouchers would likely lead to loss of said discounts and unethical behavior by insurance companies who seek to prevent delivery of services and payment of claims.

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    • #47
      Originally posted by mel
      Interesting comments, would it help if employees were offered some sort of vouchers by employers to shop for health insurance? Would this empower the employee?
      What would "empower" employees would be to pay them the money they have earned instead of spending it for them. Vouchers would be an unfair restriction on employees to spend their money as they choose.

      The notion of "empowerment" implies weakness or perhaps inabilty to choose for oneself. I don't see people as lacking in power because the insurance companies and employers have confiscated part of their wages and usurped their freedom of choice. I see them as being swindled by insurance companies and employers seeking to maximize profits.
      God made man upright, then he learned to count...

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      • #48
        Originally posted by Kursk
        Aggregating the buying power of large employers leads to premium discounts. That is why only a few programs are offered. Disaggregating the buying power by issuing vouchers would likely lead to loss of said discounts and unethical behavior by insurance companies who seek to prevent delivery of services and payment of claims.
        If everyone was free to purchase his own health care the same as he buys anything else, there would be no "aggregating" by employers, which is how the present system locks employees into whatever plan the insurance company and employer agree upon. If employees were free to purchase their own health care as individuals, insurance companies would have to market to the public at large, just like Wal-Mart does. That would lead to free-market competition and discounts galore. Insurance companies that behaved unethically or delivered poor service would dry up and blow away.
        God made man upright, then he learned to count...

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        • #49
          Discounts to patients with known angina, early cancer, risk factors? I imagine there would be a scramble for those healthy patients unlikely to get sick. I imagine they would avoid the potentially sick like the plague. But that would be a free market, you're right. And it would be fairer -why should the well subsidize the sick?

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          • #50
            Originally posted by Kursk
            Discounts to patients with known angina, early cancer, risk factors? I imagine there would be a scramble for those healthy patients unlikely to get sick. I imagine they would avoid the potentially sick like the plague. But that would be a free market, you're right. And it would be fairer -why should the well subsidize the sick?
            Well, we are in a quasi-free market actually. The health care sector has been distorted. One aspect of the distortion is the arrangements between insurance companies and employers that attach insurance to employment. That makes employees captives of both the employers and the insurance companies.

            Perhaps the greatest distortion is the fact that so-called "health insurance" is not just indemnity insurance to pay for unexpected, large losses. It has become mostly pre-payment for routine services. Having a third party pay for routine services means that the purveyor of the services must be accountable to the third party instead of the recipient of the services. From that fact comes all the burdens of paperwork, credentialling, pre-authorization, and other interference that we suffer under today. It is also in large part responsible for the high cost of health care, because these parasites suck a huge amount of money in profits.

            Insurance companies already avoid sick people or dump them whenever possible. As far as the well subsidizing the sick, what goes on nowadays is that the well mostly subsidize the insurance companies.
            God made man upright, then he learned to count...

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            • #51
              Uncle Sam Wants You to E-prescribe!

              Warning: Read this after you remove the breakables about 2 arm-lengths away.

              MGMA's E-prescribing comments
              Issue: Regulatory Impact Analysis (70 Fed Reg6268)

              We invite public comment on our expectations for prescriber participation.



              Response:

              To implement voluntary electronic prescribing in the Medicare program successfully, HHS must be fully aware of the future Medicare environment. By law, electronic prescribing must be in place by April 1, 2009. At the same time, CMS actuaries predict approximately five percent reductions each year in Medicare reimbursements to physicians from 2006-2011.Concurrent with these cuts, the costs to care for patients are likely to continue growing at a pace that exceeds inflation. The result is that by 2014, after eight years of reductions, physicians will be paid about 40 percent less than in 2005, while practice costs will have increased significantly . Finally, although matching grants have been authorized to help the adoption of electronic prescribing, funds have not yet been appropriated.



              In this financial environment, it will be extremely difficult for physicians to allocate the resources necessary to invest in new technology unless it provides an irrefutable, tangible benefit to their patients and practice. To this end, careful and deliberative standards development is critical to widespread adoption and achievement of e-prescribing’s promise of improved efficiency, patient safety and health care quality. MGMA believes that e-prescribing offers significant financial and other benefit potential to providers. However, this observation may not appear compelling to many providers in the financial environment between now and 2011.MGMA recommends that CMS fund the development, analysis and educational documentation making the financial case for providers to implement HIT.
              Last edited by Kursk; 09-05-2005, 11:55 AM.

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