The tail always wags the dog, however. For years now hospitals and clinics set themselves up to please the least cooperative insurance plans, Medicare and Medicaid, because most of their patients have those plans.
Any new plans would have to be able to get all the medical infrastructure (doctors, clinics, hospitals, etc) to buy in. Even if they buy in they are stuck still dealing with ALL the same crap that we are sick of! We want RID of it, we do not want to have to support all that and a secondary system too.
I say repeal completely.
Here are things to start with however:
(1) A Free Market requires feedback from PRICES. And yet no one knows how much ANYTHING costs in medicine until after the bills are done going around. And they price they charge is rarely the price that gets paid.
It is not even legal to post online a list of medical prices corresponding to CPT® codes (the list of 5 digit code numbers that the AMA “owns” that show what medical service was purchased. The AMA will sue you for a LOT unless you PAY them A LOT based on your web server’s traffic, etc. Why is there no advertising of prices in medicine except for “cosmetic” procedures?
We need a NATIONAL OPENSOURCE COPYRIGHT-FREE medical procedure code system, 5 digits also, so existing software does not have to be changed, that everyone can use to list and advertise prices without getting sued by the AMA. Maybe the AMA in the name of national interest will donate the CPT system and make it copyright free? (Nah — they make more money selling those codes than they do from their members dues.)
(2) It should be illegal to charge different people different prices for the same service. There is typically a “charge master” type price that is ridiculously high, and then there is a different price for virtually every insurance plan that will be accepted, and they vary a LOT. No one knows what things cost. No the patient, not the staff, not the doctor except maybe private doctors only on the things they charge for. You cannot even find out in advance, accurately, what something costs. “You have to buy it to find out how much it costs!” That does not work!
So also make it illegal to charge differently. Same price to any person, no matter how it is paid. An exception can be made for welfare-like plans, possibly even Medicare, to give discounts, but otherwise, no matter if you pay cash or an insurance company pays, the charges are the same for all people and all plans. Period.
This allows people to KNOW WHAT THINGS COST. Then the free market can kick in better, people will buy things that are worth it and avoid the garbage.
Encourage STATES to pass this. Illegal for the feds to do it. Develop model laws for states. States that do not use them will not reap the benefits, their loss.
(3) SPLIT insurance plan fees into a PREVENTIVE/WELL-CARE portion (”part P”), and an ILLNESS/INJURY portion (”part I”). No one has to buy the preventive portion “part P.” It’s an add-on people can buy extra, or else they just pay their own way, because it is all predictable expense for a certain age and sex. It dose not need to be insured. No rules for it, no arguments about free birth control, screening for depression, etc. You want that stuff, you pay for it.
The “part I” is the “taking care of the sick” part. That’s insurance.
That’s all the time I have to type right now. (1) and (2) are very important. Prices have to be KNOWN TO PATIENTS and really to their doctors also for a free market to work best, and we need all the benefit that we can get from that free market because it is much smarter that the Gruberized Bureaucracy.
By the way preventive care prices will drop like a rock if not subsidized. Welfare type plans could still receive those services with their subsidies but it would still be “most favored nation status” where the welfare plans get to pay the low prices that result from a free market for preventive care.
I think we have high premium & high deductible,because every one lump into one insurance pool. Not like previous the system without the exchange,high risk pool,pre-existing pool are rated separately based on your health.