Healthcare Premiums to Rise According to Obama Advisor - page 3
"With the Presidential election one week away, it's worth reviewing how Obamacare will impact the residents of key swing states. In Wisconsin, as elsewhere, Obamacare will drive up the cost of... Read More
Nov 9, '12 by SC_RNDude, BSN, RNQuote from MunoRNThere will still be insurance, but it will be for emergency care and catastrophic situations, like the heart surgery. It won't be tied to your work, and you'll be able to choose from any insurance company. All things that make it more affordable, much like home our auto insurance.HSA's and FSA's are great for predictable costs and as a stop-gap in high deductable plans, but they don't work as free-standing insurance coverage.What you're suggesting is instead of large insurance pools, with broadly shared risk, we instead make every insurance pool for one person only. The problem with this is that this account has to cover a wide range of possibilities; Someone may need open heart surgery and a rehab stay, which means they'll need $120,000 in their account. I've had patients who hit the $1 million mark. Are you really going to put $1 million in everybody's HSA? Since most people won't need that much, that would seem likely to waste huge amounts of money in accounts where it won't be needed. In which case it would make more sense to just pay those costs as they arise out of a larger account, which just brings us back where we're at currently; insurance.I agree with you for the most part on competition, although it's not quite the same as other business sectors. There are over 200 restaurants in my area that compete for my business when I go out, yet there's only one hospital (which also owns the only lab group, only imaging, and 90% of the Primary Physicians).What you seem to be suggesting is that insurers be taken out of the decision equation, which is actually done successfully in many countries that we refer to as having "socialized" medicine. Much of "socialized" medicine still has for profit care delivery and even for-profit insurers, they just can't improve their profit by denying services, they have to pay for whatever the Physician and Patient decide is best.
Nov 9, '12 by MunoRNThen that's the same system we have now, HSA's have been around since 2003. The main problem is that it's not the things covered by HSA's that are hurting us financially, it's the big ticket items; it's the patient who doesn't get their DM treated and ends up on chronic dialysis with a stroke living in a Nursing Home, it's the 20% 30-day CHF admission rate, it's the 2 month hospital stay for 450lb MI patient, etc.
Nov 9, '12 by SC_RNDude, BSN, RNQuote from MunoRNNo, it's not even close to being the same. Right now, most of your money goes to the insurance company, and most of your employers contribution goes to the insurance company. Then, some people put some more into a HSA, if they can afford it.Then that's the same system we have now, HSA's have been around since 2003. The main problem is that it's not the things covered by HSA's that are hurting us financially, it's the big ticket items; it's the patient who doesn't get their DM treated and ends up on chronic dialysis with a stroke living in a Nursing Home, it's the 20% 30-day CHF admission rate, it's the 2 month hospital stay for 450lb MI patient, etc.
What I am describing would be a system in which all that money goes into a HSA instead. From the HSA is where your most of your healthcare bills will be paid from. Also from the HSA you would buy the "catastrophic" type of insurance for emergencies and things like a cancer dx, etc.
I discussed this in more detail in a couple of posts on this page in another thread.
Health Care Law vs Patient Outcomes