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To: Vermont Lt
Insurance ain’t paying for them.

That's true. So what is the solution and how does it get resolved?

Nobody wants govt. funded health care.......

40 posted on 04/10/2026 2:31:32 PM PDT by Hot Tabasco
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To: Hot Tabasco

The denial problem stems from the way health and auto insurance is typically sold - with fixed dollar premiums.

It incentivizes the insurance company to fight for every dollar, which can head directly to its bottom line.

Insureds as a group should if practical bear all of the financial risk, so insurance companies don’t profit from jerking insureds and providers around.

Insurance should have an issue fee [~$100], a potentially refundable issue margin reserve charge [~$100], a monthly profit allocation [~$20], and an offer premium.

As the months go by, a $520/month health insurance offer premium would typically be adjusted by a higher-than-expected payout charge, or a lower-than-expected payout credit.

For January, you might pay $740.
For February, you might pay $540.
For March, you might pay $540.
For April, you might pay $532.
For May, you might pay $545.
....
For December, you might pay $557.

For healthcare insurance, when healthcare claims have almost all been settled, in say May of the following year, you might get a refund of the remaining issue margin reserve charge in the amount of perhaps $56.

For auto insurance, the refund of the remaining issue margin reserve charge might take years to arrive.


42 posted on 04/10/2026 2:46:56 PM PDT by Brian Griffin
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To: Hot Tabasco

For health care, bring on market force:
1. Break most hospitals into two highly competitive entities.
2. Convert other hospitals into real estate leasing entities with competing surgical suites and nursing wings.
3. Separate out drug coverage so hospital systems can run care coverage systems and cut out insurance company overhead and meddlers.
4. Create interstate drug plans that don’t have to pay what the drugmaker wants for every drug. To qualify for exchange listing and federal subsidies, they would have to most (~80% or more) in all important types (large volume recombinant, small volume recombinant, breakthroughs under patent, etc.). Group and exchange plans to offer time-limited vouchers at plan set amounts for out-of-formulary drugs. Voucher plans would have variable premiums. Plans without minimums (or vouchers) could be vended directly to individuals and families.
5. These plans would be all the doctors prescribe for formulary drugs with co-pays equal to manufacturing cost.
6. Reform medical education, breaking down medicine and dentistry into simpler chunks and start it in the first year of college.


43 posted on 04/10/2026 2:52:01 PM PDT by Brian Griffin
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