Health-Care Situation in the US - A Possible Solution

  • Many millions of Americans rarely use medical facilities or doctors. They should be rewarded for their considerate attitude regarding that limited resource. A method might be able to do just that, and far more.

  • But EVERY person pays in large Premiums for Health Insurance coverage. Few people seem to have thought through WHERE their Insurance Premium money goes to! It primarily goes to two purposes. One is to supply the $80 million dollar per year Salary of a lot of the Executives of the giant Insurance Companies. Personally, if I thought they were hands-on people who were actually DOING SOMETHING on a daily basis, maybe they could be seen as deserving such obscene Salaries, but the reality seems to be that they only actually make one or two major decisions PER YEAR (where they have subordinates do all the actual work). When such giant Corporations claim to be Non-Profit organizations, I have even less tolerance for the Executives receiving such enormous Annual Salaries. ONE million dollars per year? I guess I could swallow that, although even then I have some doubts whether they actually EARNED even that! The other place where YOUR insurance Premium payments go is to a very small number of patients which use up millions of dollars in exotic treatment. It is well documented that patients in the last six months of life often are the focus of many millions of dollars AUTOMATICALLY spent, to allegedly extend their mortal life. Such patients are commonly in comas or under such extreme pain medication that they seem to not really be aware of their environment anyway. Shouldn't someone have ASKED the patient whether (someone else, including YOU) should have to spend millions for such apparently minimal accomplishment? Of course, the fact that it is NOT THEIR MONEY, I suppose they would want billions spent on themselves! But what I am trying to point out here is that thousands of generally healthy people constantly make Insurance Premium payments which effectively is like flushing the money down a toilet, as it will never be used FOR THEM. A single person who has advanced AIDS can consume the Premiums of many thousands of OTHER Premium payers. An interesting detail is that it is relatively rare that the person with the AIDS has rarely paid in much or any Insurance Premiums anyway!

  • Imagine a PRIVATE, MEMBERS ONLY group of exactly 10,000 American families. The participants would have to QUALIFY in two distinct ways for possible membership in a specific group. Their entire family expenditures for medical situations, including insurance, for the previous five years must be examined and confirmed as accurate.

  • The Premium rate that each Member would pay would then be based on the total of the entire group per year.

  • There would be NO millions of dollars going to a bunch of Executives. And, with reasonable selectivity regarding accepting the member families, relatively few might have lifestyles which might involve AIDS or other behavior patterns of certain portions of human society. You might see that such a SELECTIVE and SIMILAR group of Members might have minimal Medical expenses. Since THEIR Insurance Premiums would be EXCLUSIVELY calculated by the running balance of THEIR Insurance Account, once they have collectively built up an adequate amount, THEIR Insurance Premiums might drop to near zero.

  • This situation is exactly what National Medical Insurance programs are fearful of. They NEED and EXPECT thousands of healthy people to be sending in payments, in order to have the money to pay for the extreme expenses of a small number of patients.

  • The suggestion here is simply to enable thousands of SEPARATE groups each effectively have their own tiny Insurance Company. In general, many such groups of generally healthy people should NEVER need any government money at all! Their own Premiums into their own Account would generally be sufficient to cover all of the medical expenses of all of the members of all of their families! It should therefore be rare that their Account would need any help at all from the Federal Government regarding covering all of their Medical costs.

  • The government would endow a Fund for this group with an initial one million, and the Premiums of the Members would therefore maintain the balance in that Fund at the desired amount.

  • The government would also provide a $400 income tax reduction for every family that was a Member of any such group.

  • For the minimal health care families discussed above, their ANNUAL Premiums might be less than that $400, so by minimal usage of the Health Care system, they would actually MAKE MONEY in the process, along with having the coverage they desire for their families.

Each American could select among a wide variety of such very specific groups to try to apply to. There would be two primary issues which would determine acceptance to a specific group. The first is the AVERAGE TOTAL HEALTH-CARE COSTS for that family, including all medical insurance, over the previous five calendar years. The second is the size of the Deductible.

Consider different situations:

This presentation was first placed on the Internet in January 2009.

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Carl W. Johnson, Theoretical Physicist, Physics Degree from Univ of Chicago