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Tuesday, October 25, 2016

Problems and solutions to affordable healthcare

Where are the candidates on this important issue? Clinton has done her homework; Trump has not.

Sarah Kliff at Vox presents a cogent description for which problems and solutions can be readily identified? The headline remains: 'Health care costs are out of control and on the rise.'

According to the Kliff story, the reason is that insurers underestimated the number of very sick people who were without insurance. When they signed into the system, that created a financial burden that the actuaries did not anticipate.

Here is an important question, why are insurers taking risks about an audience they didn't research to understand? President Obama and his tram have argued that private company insurers should not be in business to outguess the health of its audience. Rather, their profit should come from the profit made on services provided. The services provided by insurance companies is administration and not healthcare.

Remove the risk from the equation to lower costs, should be the aim.

Knowing the wellness of the population is a fact from which healthcare providers can plan and on which they can focus their professional services.

Public policy can address part of the problem. For instance, too many Americans eat improperly and in excess. They fail to get proper exercise. Part of the plan to reduce cost is to focus on prevention.

Solving the problem requires addressing the associated business models and to distinguish between administrative costs and professional healthcare delivery costs.

Read her full report.

"Obamacare's double-digit rate hike explained in 400 wordsUpdated by Sarah Kliff Oct 24, 2016, 5:35p

Obamacare premiums are on track to rise faster than ever before in 2017.
The Obama administration released data Monday showing that premiums for midlevel plans will rise, on average, 22 percent between 2016 and 2017. 
Yes, that is a huge increase. Last year premiums went up by 7.5 percent. 
Premiums are rising on the Obamacare marketplaces largely because the people who signed up for coverage were sicker than the insurance companies expected. This led some health insurers (like Aetna and UnitedHealth) to leave the marketplace. The insurance companies that stayed behind realized they’d have to charge higher premiums to cover their members’ medical bills."

Image from Vox article


  1. This comment has been removed by the author.

  2. The question is how much administration is essential, and how much healthcare capacity is required. Second, is profit incentive needed by both administrative service providers and health care professionals and their institutions? The business model needs to reward efficient and accurate administration while providing sufficient incentive to health care professionals. Another way to eliminate excessive cost is to reduce the risk for all involved. Eliminate business models that reward corporations for gambling with healthcare. Eliminate excessive liability for doctors, hospitals, and nurses who provide health care. Hold everyone accountable for performance.

  3. Added in response to a FB reader: My point is that we must change the business model from the customer perspective. We don't need or want capitalists gambling and gaming our healthcare. We need service provide for administration. We need healthcare professionals and their associated institutions to care for patients. As you note, insurance companies (capitalists) have made a business game from this where they truly don't belong. Remove them and you have eliminated extra costs.