Betty Boop: TRUMP CARE — Simplicity with Honesty?

06 Family, 07 Health, 09 Justice, 11 Society, Civil Society, Commerce, Ethics, Government

A citizen offers this commentary.

TRUMPCARE – A Simple Replacement for Obamacare!

The “HOOKS”!

The idiom – “get your HOOKS into someone” means “having influence, control, or possession over another person”!

The “Hooks” that health insurance companies utilize  to brainwash people into thinking they need expensive health insurance are the FEAR of having to pay artificially “Inflated” and “Catastrophic” healthcare claims!

TRUMPCARE removes the HOOKS!

  1. DISCOUNTED FEE SCHEDULE – instead of being charged artificially “inflated” Medical & Rx pricessimply remove one HOOK by allowing every US citizen (under age 65) to utilize the existing Medicare Participating Provider Network and pay Medical & Rx claims upfront based upon the Medicare DISCOUNTED FEE SCHEDULE pricing which is approx. $.10 – $.60 cents on a dollar. (There is NO cost to the US Govt. or US citizens to offer and receive Discounted Fee Schedule pricing. Also, individuals would save $3000 – $10,000 in Obamacare premiums and $5500 -$7000 in Deductibles annually – which could be used to self-insure future Medical & Rx claims! Providers benefit by being paid their fee schedule upfront, from paperwork reductions, and tort reform!)
  2. CATASTROPHIC COVERAGE – the US Govt. would remove the other HOOK by providing every US Citizens (under age 65) with FREE CATASTROPHIC COVERAGE after incurring $20,000 in DISCOUNTED FEE SCHEDULE claims during a calendar year. This coverage would be purchased by the US Govt. from one or multiple Stop-Loss Insurance Carriers competing nationwide. The claims for the CATASTROPHIC COVERAGE and the DISCOUNTED FEE SCHEDULE components of TRUMPCARE would be coordinated. (The probability of and individual, under age 65, incurring greater than $20,000 in annual claims at Medicare Discounted Fee Schedule pricing is very low and should be reflected Stop-Loss Insurance premiums paid by the US Govt.)
  3.  OPTIONAL FEE SCHEDULE SUPPLEMENTS – US Citizens and Employers (for employees) would also have the option of purchasing standardized individual and group OPTIONAL FEE SCHEDULE SUPPLEMENTS, from Health Insurance Companies in the Private Marketplace, to reduce their individual  DISCOUNTED FEE SCHEDULE exposure from $20,000 to as little as $1,000 annually. Regional Health Insurance Carriers would also be allowed to utilize the existing national Medicare Participating Provider Network and DISCOUNTED FEE SCHEDULE pricing – thus enabling them to compete nationally!  Claims covered by the OPTIONAL FEE SCHEDULE SUPPLEMENTS would be coordinated with the CATASTROPHIC COVERAGE and DISCOUNTED FEE SCHEDULE components of TRUMPCARE. (Ex. Plan A – Discounted Fee Schedule Coverage from $1000-$20,000, Plan B from $2,000 – $20,000, Plan C from $3000-$20,000 etc, Optional Fee Schedule Supplements will cost US Citizens less than Traditional Health Insurance Plans because health insurance companies will no longer be covering the Catastrophic claims – now covered by the US Govt. via Stop-loss insurance. Additionally, there will now be real nationwide price competition among regiional health insurance companies!)

* The Discounted Fee Schedule and Catastrophic Coverage components of TRUMPCARE will now enable Employers to have multiple options for providing Group Health Insurance for their employees! Employers could simply offer a group OPTIONAL FEE SCHEDULE SUPPLMENT plan to employees – available from one of many health insurance companies competing nationwide. Other options available to Employers would include self-funding employee Medical & Rx claims or contributing to Employee HSA’s – giving Employees the option of  either self-funding their own Medical & Rx claims or purchasing an individual OPTIONAL FEE SCHEDULE SUPPLEMENT tailored to meet their specific needs! TRUMPCARE is a Health Insurance Industry “DISRUPTOR” – Employers and Individuals will no longer be held “hostage” by exponential health insurance rate increases!

  1. SUBSIDIES – OPTIONAL FEE SCHEDULE SUPPLEMENT plans may be subsidized by the US Govt. for Low Income and Disabled US Citizens (under age 65) not currently receiving Medicare or Medicaid. Providers would also be allowed tax deductions to write-off unpaid claims based upon DISCOUNTED FEE SCHEDULE pricing.
  2. MEDICAL MANAGEMENT – Catastrophic Claims Utilization Management, Medical Utilization & Pricing Management, Rx Utilization & Pricing Management, Provider Regulation Reductions, Tort Reform, Health and Wellness Incentives, Upfront Price Transparency, etc. would be implemented within TRUMPCARE to control and reverse rising healthcare costs.

THE TRUTH ABOUT OBAMACARE!

Obamacare was a BIG LIE, BIG STEAL and designed to FAIL from its inception!

It should have taken only a few dozen pages to include benefits covering Pre-existing Conditions, Maternity Coverage, Preventative Children and Adult Wellness, Unlimited Maximums, Dependent Coverage to age 26, etc.

So, why did Obamacare (ACA Legislation) contain approximately 20,000 pages that no one has ever thoroughly read?

The truth is that the 20,000 pages were written by the Insurance Industry to CONTROL and REGULATE Medical Providers & Employers, RESTRICT healthcare,  generate PROFITS for BIG MED and BIG PHARMA, impose hidden TAXES, and ultimately FAIL with the purpose of HERDING the masses into Government Controlled National Healthcare.  Listen – Dr. Dave Janda – a member of the Presidential Health Care Committee from President Reagan through President Obama – until he spoke out against Obamacare and was consequently targeted by the IRS!

Obamacare put the Insurance Industry first – ahead of The People!  Keep in mind that HIGHER CLAIMS = HIGHER PREMIUMS = HIGHER PROFITS for Insurance Carriers!  Let’s presume that the State Insurance Departments allow carriers to set premiums to cover claims plus an additional 15% to cover their administration and profitability. If a carrier incurs $500 in claims – their premiums would be set to include $75 additional for administration and profitability. If a carrier incurs $1000 in claims their premium would be set to include $150 additional for administration and profitability. Exponentially rising health insurance premiums and profits have made Obamacare a huge success for the Insurance Industry but a huge failure for The People!

Check out the annual income statements of these “poor” Obamacare insurance carriers that always seem to find millions of dollars for lobbying and executive salaries & bonuses!  – See Aetna, and United Health

As if they weren’t already profitable enough – Hillary was planning on orchestrating another “BIG STEAL” by providing these very profitable health insurance carriers with additional subsidies, as a “parting gift”, before the HERDING began into Government Controlled National Healthcare!  * Note Aetna’s “financial engineering” the last few quarters – by simply inflating their Selling General and Administrative expenses by $800m – $1B their profits appear lower to “cry poor”!

PRESIDENT TRUMP DODGES A BULLET – Thank you Freedom Caucus!

President Trump was being set-up to fail by Paul Ryan and his Establishment Stooges. Luckily, Ryancare was DOA! Watch-  Dr. Dave Janda!

Just like Obamacare – Ryancare was also designed by the Insurance Industry and Establishment Stooges to orchestrate another BIG STEAL to benefit BIG MED and BIG PHARMA!

Ryancare would never reverse exponentially rising health insurance premiums (profits) for the Insurance Industry!

Under Obamacare and Ryancare – Regional health insurance carriers and Associations will never be able to compete “across state lines” without being able to utilize a nationwide Participating Provider Network and discounted Fee Schedule!

The largest Medicare Supplement Association is AARP. It is insured by United Health Care and utilizes the national Medicare Participating Provider Network and discounted Fee Schedule.

Currently, many smaller Regional Medicare Supplement Insurance Carriers, utilizing the same national Medicare Participating Provider Network and discounted Fee Schedule, are very competitive nationally and in many instances even more competitive than the much larger AARP insured by United Healthcare!

Health Savings Accounts help reduce the net health insurance cost to the insured via tax savings but will not lower Medical & Rx claims and consequently will not reduce exponentially rising health insurance premiums!

Anyone serious about reducing healthcare costs prefers paying a few dollars for inexpensive birth control pills and abortions rather than thousands of dollars for normal pregnancies and much more for pregnancies with complications!

TRUMPCARE is similar to Medicare!

Over the last 50+ years, when US Citizens reach 65 years old, they become eligible to receive medical insurance coverage under Medicare.

The US Govt. provides partial medical insurance benefits through Medicare Parts A, B, & D.  Medicare recipients also have the option of purchasing Medicare Supplement Insurance from Private Insurance Carriers to cover the “gaps” in Medicare Coverage (Medigap Insurance).  Medicare Participating Providers nationwide, including Pharmacies, have agreed to accept a discounted fee schedule (approx. $.10 – $.60 cents on a dollar) for covered claims from Medical Supplement Insurance Carriers and the US Govt.

Like Medicare – TRUMPCARE would also allow US Citizens (under age 65) and Insurance Carriers to utilize the national Medicare Participating Provider Network and discounted Fee Schedule.

By allowing the utilization of the national Medicare Participating Provider Network – Regional Health Insurance Carriers and Stop-Loss Insurance Carriers would now be able to compete nationwide – just like Medicare Supplement carriers!

TRUMPCARE could be efficiently implemented by utilizing the existing national Medicare infrastructure already in place!

TRUMPCARE – Winners and Losers!

US Govt. wins because the cost to the US Govt. for allowing US Citizens and Insurance Carriers to utilize its existing national Medicare Participating Provider Network with Discounted Fee Schedule is $0!

US Citizens win because their cost to “keep their doctor”, receive CATASTROPHIC COVERAGE, and utilize the existing national Medicare Participating Provider Network with Discounted Fee Schedule is $0!

Employers win because they can still purchase a standardized, group, OPTIONAL FEE SCHEDULE SUPPLMENT plan, available from one of many health insurance companies truly competing nationwide!  Other Employer options include self-funding employee Medical & Rx claims and Employers making HSA contributions to employees – giving employees the option to self-fund their own Medical & Rx claims or to purchase an individual OPTIONAL FEE SCHEDULE SUPPLEMENT tailored to their specific needs. TRUMPCARE is a Health Insurance Industry “DISRUPTOR” and the days of Employers and Individuals being held “hostage” by exponential health insurance rate increases are over!

Medicare Participating Providers win because they are already accepting a discounted fee schedule and would now be paid a portion of their Medical & Rx fees upfront!  They will also benefit from reduced Regulations and Tort Reform included within the MEDICAL MANAGEMENT component of TRUMPCARE!

BIG MED & BIG PHARMA lose because they would not be able to profit within the DISCOUNTED FEE SCHEDULE component of TRUMPCARE.  They would also experience reduced profits within the OPTIONAL FEE SCHEDULE SUPPLEMENT and CATASTROPHIC components of TRUMPCARE because of real nationwide competition. They may also lose business and profits competing against Employers that choose to self-fund employee claims or make HSA contributions to employees who wish to self-fund their own medical and Rx claims!

See Especially:

Karl Denninger with Greg Hunter: Fixing Health Care Permanently — Cuts Cost by 75% & Almost Balances the Federal Budget

See Also: