Posted on 11/27/2025 4:59:05 AM PST by chiller
As families gather to celebrate Thanksgiving, many worry about the impossibly high cost of health insurance. Let’s play a game of What If? (It will be fun, I promise.)
What if healthcare dollars currently going to insurance companies were paid instead to the consumers themselves? Would good things result, or bad?
This “what if” exercise was prompted by President Trump’s offhand suggestion to give ACA subsidies “directly to the people...[instead of]...BIG, BAD insurance companies”? (Republicans are currently considering this idea but only for the ACA.)
Specifically, what if all the money called employer-sponsored health benefits that presently goes to insurance companies were paid instead directly to employees? What might happen?
(Excerpt) Read more at americanthinker.com ...
If politics is taboo today, personal health issues and costs will certainly be discussed.
...and spread it today.
The traditional British NHS system has capitation payments to local hospital systems called trusts.
Those trusts are physically very similar to hospital systems like Johns Hopkins in metropolitan Baltimore, iNova in Northern Virginia ana Partners in metro Boston.
The British NHS is falling apart because expensive drugs are financially bleeding out the system.
The article fails to mention the marriage penalty this imposes, also. When one spouse covers the whole family (this is almost always the way it goes) the other spouse simply doesn’t “get” health care coverage from their company. So they don’t get that ‘withheld’ wage even as health coverage. Just BOHICA. Some companies give a small pay bump if your spouse covers you so they don’t have to, but it’s not most companies and when they do it’s a fraction of that now $25,000.
There is also a possibility of federal reinsurance wherein the federal government would pay for percentages of care and drugs, probably in the 60% to 85% range.
My family member gets a $200 subsidy and pays $71. Income: $30k
I had a landlady who worked for Sprint in the early 1990s. She was given a benefit options book and she picked out the benefits she wanted from her financial allotment.
I forget the numbers, but say if she had an $8K allotment, single health care might have been $3,500, dental $800, disability $300, $100K life insurance $200, and 401-K match $3,200.
Knock on wood, I remained pretty healthy so far and now reaching Medicare, so I’m ignorant regarding much of this, but this caught my attention.
I’m counting on any of you with better experiences to vet the idea.
The current subsidies are pretty generous although the policies are pretty weak. I would definitely reduce the subsidies.
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. Hospital system plans might charge an age-related fee if you lack a drug plan listed by the hospital system plan.
4. Create interstate drug plans that don’t have to cover 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 vouchers at plan set amounts for out-of-formulary drugs. Plans without minimums (or vouchers) could be vended directly to individuals and families.
5. These plans would be all the doctors (and AI) prescribe for formulary drugs with co-pays equal to manufacturing cost
6. Have drug patents limited by government sourced product revenue and overall domestic government health care spending and not by time [so drug companies have an incentive to minimize government health care funding]
7. Require Kirchoff patent collapse to a single entity upon FDA marketing approval of a covered entity
8. reform medical education, breaking down medicine and dentistry into simpler chunks and start it in the first year of college
9. replace most primary care doctoring with AI
(Insurers would pay human doctors to confirm AI diagnosis, orders for expensive tests[MRI, genetic], prescribe radiation imaging[CT, PET, X-ray]/treatment, and voucher/government co-pay drugs. Other human doctor care would be private pay.)
10. Radioisotope scans would be at international airport centers
Mrs. Unlucky will need $169,000 of care in 2026.
Putting $6K in an HSA for her won’t cover that $169,000.
Self-insurance HSAs are called houses.
There is a matter of fixed premiums.
Premiums really shouldn’t be fixed. They should be variable, because fixed premiums mean the insurance company has a dollar-for-dollar incentive to fight whenever it can (on debatable care items) or must (to prevent losing on a policy group or year).
Insurer profits should be limited to issue fees and valid claim timely payment incentives, subject to reductions if initial premiums have to be raised.
I think that’s a brilliant idea. When I drafted my original business plan for my company, I included that exact provision for prospective partners. That’s because we had several different partners with different personal and family needs at the time. So I simply assigned a dollar value of $X as an overhead cost for each partner and would let them each select what they wanted that $X to include. Options were medical coverage, a company-paid life insurance policy, travel expenses, home office expenses, reimbursement for education expenses, etc.
And if Mrs. Unlucky has been putting $6,000/year into an HSA for ten years before this, she can buy an insurance plan with a $25,000 annual deductible at a much lower cost.
What if, our taxes were lowered so that “checks” wouldn’t have to be sent to taxpayers to subsidize their healthcare?
This would simplify and reduce costs at the same time. It IS the key.
Online shopping has become easy-peasy and could easily translate to health needs, procedures. An internet search, a couple of calls to doctors, hospitals who suddenly WANT your business would not keep you on tele-hold forever.
1) this procedure √
2) this much $√
3) this Dr.√
Either you're good to go, or will search further. It is you who needs this procedure. It is you paying for it. You'll get it done the way you need.
Lower costs, lower taxes...all in due time.
Initially use the $4T in potential subsidies to establish sizable personal health accounts.
As years go by, contribute to it if healthy, perhaps with some employer assistance..or draw down from it, with additional catastrophic insurance to cover the biggies (which won’t be as big in a competitive market).
There will be no real health care cost containment without massive tort reform.
Practitioners’ and hospitals’ liability insurance are driving much of the health care cost increases.
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