Healthcare Reform or Deform?

An Open Letter

To All Government Officials (and privite individuals) Concerned with Healthcare Reform: Federal, State & Local, Healthcare Professionals

Almost everybody agrees that Americans Healthcare "System?" needs reform, (for a whole lot of reasons which need not be enumerated -- again! -- here.  Even "best system" -- of what ever "kind" -- can be improved, so our healthcare system, which does indeed provide some of the best healthcare in the world, perhaps indeed most Americans, it still can be improved.

So the question is not should Healthcare in the United Stated, be changed, or improved, that questions are "how, and of what kinds of changes, are appropriate and will result in real improvements, over the short-term, the medium term and the long term.

It would seem common sense, therefore, to study both where our existing healthcare system is at its best and at its worst, to sew how its best can be increased and expanded, and its worst, reduced and eliminated.  This clearly involves a historical retrospective to make sure that we don't repeat our "mistake" AND how we can learn form the past.  As George Santiayna may be paraphrased, "If we don't study our past to profit from it, we will repeat our mistakes in the future."  This applies to hour healthcare system. 

One of the most egregious failures that ALL our "politicians" and healthcare providers has been their utter failure to "report" what I think is a "fact" that once upon a time in the  United State all of the so-called "Blue Cross and Blue Shield" "providers" were at one time "non-profits" run by either "doctors" and/or "doctors and their patients" as "healthcare cooperatives!" 

And, additionally there were, and still are, a very large number of "patients" served by "physician-run patient participating" healthcare non-profits" -- like Kaiser Permanente -- even though through the years all of the "non-profit" BlueCross/BlueShield "cooperatives" have gradually converted into profit-making institutions -- often accompanied by much kicking and screeming of their "customers" -- as conversion aided and abetted by state, and perhaps federal, legislators -- promising better and less expensive health care, (often by way of the shibboleth of "competition") -- much the same as a more recent generation of legislators approved the "deregulation" of the "energy industry utilities" because "competition" would result in lower utility costs, (as Enron "competition" provided?) in Southern California, and Constitution is providing in the MidAtlantic States?  [Thus again proving the clairvoyance of Mark Twain/Will Rogers, that "American has the best legislators and money can buy?"] 

, that a number of large "Mutual" "Assurance" companies were once customer-owned, "cooperatives" that converted into conventional for-profit insurance companies -- yes. a few still are like "Mass Mutual" -- though some may have "converted" while still retaining the "mutual" vestige of their one cooperative states.

What is all this about?

Well, for starters,
  • Aren't the proposed "exchanges" nearly exactly what the BC/BS once were? How will they differ and be the same?  [More...]
  • Over the last 40 years or so how has the percent spent for actual medical drifted up or down?  [More...]
  • How has executive compensation drifted up or down?  [More...]
  • Over the last 40 years, how has the percentages of administrative overhead cost changed, i.e. not "provider payments". [More...]
  • How much are "they" spending on "sale",  e.g. salesperson commissions and salaries, exclusive of marketing, [More...]
  • How much have "they" spent on "marketing", e.g. TV, radio, print media, etc, [More...]
  • From both a macroeconomic and microeconomic point of view:
    • How have "patients" benefited, or not, from each of the above, or
    • What number and % of "prior conditions" waved in group policies, similar to identical conditions used to deny coverage in individual policies, and
    • What are the actual "costs" to the industry of these "patients" in group health plans, such that "society" can
    • Project these same costs to people now denied insurance because of their "prior conditions" and
    • Require of the healthcare industries the numbers (and percents) of such
    •  applications submitted and denied