RoR: Forum

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Saturday, July 29, 2017 - 12:33pm

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Thanks! I read the interview. The history is interesting, of course, but I do not see any way to change such a massive system. On the other hand, when you consider these other alteratives, you might be able to arrange something for yourself. Every now and then, you read about a doctor who refuses to accept insurance and only bills directly.

Working on behalf first of our mother and then his wife, my brother, who is more of a business manager than I ever would be, was intrigued by all of the complex billing involved in a hospital stay. The one perspective I bring is from the viewpoint of physical security: everyone wears a lot of badges; and everyone wears scrubs; anyone can be anything. In terms of this topic, it just reflects the fact that you, the patient, have no idea who is treating you, or treating you which part or procedure.

From the article interview, I did not know that there is no billing for a general office visit, for a consultation. It explains at least one of the unnecessary procedures that I got in an office: they have to have something to bill for.

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Sunday, July 30, 2017 - 6:06am

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The history is interesting, of course, but I do not see any way to change such a massive system.

I believe that a change in the tax system bring about significant change. Make insurance premiums paid by an employer taxable income to the employee just like wages are. (Roberts and Chapin say employer-provided medical insurance is a tax break to the employer, but I don't regard it as any more a tax break to the employer than paying wages. The tax break is not taxing the employee.) This would get many employees to think about getting insurance on their own and considering the cost. If they got insurance on their own, that would expand the individual insurance market (under age 65), where there is low demand due to employer-provided insurance. Or the employee could otherwise participate in some sort of private market arrangement with a physician or medical care group.

Of course, allowing a tax-deduction or partial tax credit for any premium paid by the individual would increase the incentive to go the individual or private market.

P.S. Making premiums paid by the employer non-deductible would be far less effective. It would not affect non-profits or government.

(Edited by Merlin Jetton on 7/30, 8:55am)