Originally
posted by
Pontius Pirate:
yeah, yeah, i know the patients are better off but you need to tradeoff the needs of the patients and the shareholders
Anti-trust regulations. These regulations might need to be updated in the wake of moving insurance out of most of healthcare, but then you might just create incentives for doctors to move their practices closer to home because they no longer have to be part of a big company to have patients. They also no longer need the backing of pencil pushers that come with large organizations because the paperwork is a lot less when the patients pay on their own. Some of these areas unprofitable to corporations because they can make more money somewhere else may well provide enough business for a one doctor office.
A lot of healthcare is predictable and can be budgeted for when insurance companies are taken out of the equation. The best value proposition on health insurance is catastrophic care policies because you can't predict this and you can't budget for it, but it also has a low risk of occurring. Why should anyone come between the customer and the provider for needs that can be predicted. That just adds another body that has to be paid, whether it's the government or a health insurance company.
One American company's employees are scrambling for cover after Obamacare, because that company had some time ago decided that it was cheaper for them to just pay the entire cost of a catastrophic care insurance plan for their employees and put $1000 (or whatever it was) a year into a health savings account for their employees to pay for their predictable costs. The employees owned that health savings money and it always rolled over. They could use it to pay for doctors visits, against their catastrophic care deductible, prescriptions, etc. Over the years, some employees had accumulated $10,000+ in their accounts because they carefully monitored their costs with doctors and got discounts because their "insurance" consisted of swiping a payment card. Some employees could literally have a catastrophic health event and not pay a single dollar out of their personal money (their HSA could pay for the entirety of the deductible). This experiment in business recruitment and retention/healthcare has now been killed because of Obamacare.
Perhaps the best solution for the VA and everyone else is to re-privatize predictable healthcare to the customer and the provider (and NO ONE coming between them). Sure, for the VA, they may have to set payments for predictable care and their would be additional health problems that fall under "predictable", but that just means less to leave to the remaining VA health system.