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View Diary: This is why we must pull their coverage (293 comments)

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  •  If you have this system (1+ / 0-)
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    (which I hope we can eliminate; as nyceve pointed out, the insurance companies are on notice) what we need is the ability for small employers and individuals, self-employed or otherwise, to be able to buy into groups that provide the kinds of discounts that large employers have.

    What has happened in most cases under Republican rule, however, is that when these kinds of programs have been proposed, part of the goal has been to eliminate local/state mandates for certain kinds of coverage. So, what you do get at that point is, well, just junk insurance. No one wins with that.

    What we need is some leadership and courage in our so-called 'leaders.'

    Civil marriage is a civil right.

    by stitchmd on Thu Mar 06, 2008 at 06:31:48 AM PST

    [ Parent ]

    •  Companies (0+ / 0-)

      might just consider buying hospital care for their employees at the local hospital.

      A company might buy say $100,000 worth of care based on Medicare rates from the local hospital for say $115,000. This might be done on a monthly payment plan of $5,000 a month over 23 months.

      You could access the care reserve under the same conditions as Medicare, but with a $500 ER deductible. The hospital would also act as a gatekeeper.

      A company might also withhold $20 from each weekly pay check and place it in an employee/hospital joint checking account. The money would belong to the employee. The hospital would have the checkbook. The hospital would just take the amount of the Medicare level co-pays from the account. The company human resources department could allow the employee to access any excess over $2,000 in minimum amounts of at least $500.

      For drugs, the government might let people making less than $20,000 a year (after potentially buying drugs) buy into Medicare Part D.

      For paying doctors, the company might get a company crafted interest rate limited credit card system for its employees with a $2,000 credit limit.

      The company credit card might have a legal access notice like:

      The recipient of funds via this card agree to limit total charges to the Medicare amount*1.15 (adjusted upward by the CPI from the January 1st, 2008 amount if provided on an outpatient basis) (or less as required by law or as contracted). Use for anything other than Medicare scope Part B services (or Part A services at out of care reserve hospitals) or non-addictive prescription drugs shall be considered theft.

      [It would not have a visible number, so it could only be used by physically swiping it.]

      The local chamber of commerce might also get local doctors to give calendar year discount prices to the employees and owners of chamber members based on popular billing codes.

      At the end of the year, the company would take up to 10% of the profits and pay down or off the credit cards as it sees fit.

      A company or any authorized third party could at any time the care reserve is below a linear drawdown place employee care reserve drawdowns on the employee's credit card up to $1,000 per care reserve drawdown and add the amount to the care reserve.

      It's really about as easy as Medicare for the providers.

      A hospital clerk debits the care reserve account ledger by the Medicare amount, enters the patient's name, and then writes the check for the patient's co-pay drawn on the patient's plan bank account. The checking account would overdraft to the charge card. Every month, a care reserve account statement would be sent to the company.

      The doctor's office puts the Medicare limiting charge on their card reader, swipes the card through, and has the employee sign the charge slip.

      •  Great idea (0+ / 0-)

        that's largely how Kaiser (as an example) got started, and why we have capitated care still.

        But like a lot of things, what works in theory has broken down in practice.

        Civil marriage is a civil right.

        by stitchmd on Thu Mar 06, 2008 at 07:29:12 AM PST

        [ Parent ]

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