Health assurance has failed because it underwrites basic certainties, slightly than risks. What risk is there that an typical working adult will crave medical comment in a 12 month span? Probably 50%; maybe better. Thus, a third festivity guarantor gambling against the attendant expenses must be able to charge an inflated “top” for his promise to pay the bet if he loses. The amount of his payment does not matter as extensive as his margin, the difference between the premium and the payment ( and the XX% risk-factor), is carefully maintained.

for the reason that the need for some medical attention by a “fee for service” provider is high, the insured risk is not really a risk at all, but an eventual certainty. Over a 5 year period, the insurer/guarantor/bettor will almost definitely be telephonlyd upon to pay. And, since the bettor does not barter or receive the services, he is mostly excluded delight in the base transaction. Attempts to introduce himself into the purchase and provision of the services skews the focus of the underlying relationship away from the conamounter and toward the guarantor, usually without consideration of the medical necessity or efficacy of the services required, and more importantly to him, toward the cost/return on investment calculations vital to his sensation.

Health care insurance fails because it does not insure against a “risk.” Working Americans do not benefit by dissipateing their health care dollars underwriting the insurers betting system. They could be better served, and their money more carefully spent, if they controlled the purchase of medical services. Insurers are necessary for those medical expenses that truly are risks; accidents, catastrophic and chronic illness, and the results of activities voluntarily engaged in by the consumer (e.g., skydiving, bullfighting, smoking).

If an average working American arranged aside the “premium” dollars he spent each month, tax free, to spend as needed at market-driven rates, he would have a willingly available pool of funds with which to make his choices, much like pre-qualifying for a mortgage or pre-approval for a car loan. But, what about immediate needs before he has amassed the “pool”, and the danger of the unexpected emergency?

A lump sum payment, likened to the employers share of his health insurance premium, would before long establish the necessary pool of funds available to employees, per capita, or upon any system the company and employee agree upon. The employers incentive would furthermore be a reduction of his tax liability for any contributions and maintenance costs pertinent to the creation, funding and administration of the fund.

Unexpected expenses could be insured against with individual policies, similar in terms to the “Accidental Death and Dismemberment” coverage so inexpensively available that no one takes its costs seriously – or the risks! Which is why such coverage reflects true “insurance” and affordable leverage of risk by groups of people and groups, depending upon the nature of the risk covered.

Imagine health care insurance being as cheap as “air travel” or “trip” insurance. Imagine the “Doc-in-a-Box” vying with the branch hospital of the local Community Hospital, or the dentists office offering “employee discounts” to “Smith Toyotas” employees and preferred buyers. This is market-driven health care. Not a no-frills industry, but a competitive marketplace in which special, expensive services are readily available to those who need them, with collective pools of consumer-controlled, and specially risk-underwritten, dollars set aside for such eventualities.

Average workers with average needs and expenses will control their health care with their own money. Extraordinary expenses would be spent for with employer-contributed funds and insurance. (Careful employers will make “extraordinary expense” coverage a part of the pool contribution duty)

How Many Americans Have Private Health Care Insurance

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Filed under: Health Insurance

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