Health Insurance Isn’t the Problem

The will to change and fear of failure is

Introduction

Normally we talk about healthcare and health insurance in the United States but today is a little different. Today we are going to explore why things are the way they are in US healthcare, why we pay double what everyone else does and then ask the question “why are we not doing anything about it?”

The Problem

In our article “Commonwealth Fund: The U.S. Health Care System Is an International Embarrassment” we detailed that the United States spends 17.8% of the Gross Domestic Product (GDP) on healthcare, about twice as much as the OECD average. Further, health spending per person in the U.S. was nearly two times higher than in the closest country, Germany, and four times higher than in South Korea. In the U.S., that includes spending for people in public programs like Medicaid, the Children’s Health Insurance Program, Medicare, and military plans; spending by those with private employer-sponsored coverage or other private insurance; and out-of-pocket health spending.

That is not the worst of it, however. The outcomes for that exorbitant amount of spending are worse as well

• Health care spending, both per person and as a share of GDP, continues to be far higher in the United States than in other high-income countries. Yet the U.S. is the only country that doesn’t have universal health coverage.

• The U.S. has the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, the highest maternal and infant mortality, and among the highest suicide rates.

• The U.S. has the highest rate of people with multiple chronic conditions and an obesity rate nearly twice the OECD average.

• Americans see physicians less often than people in most other countries and have among the lowest rate of practicing physicians and hospital beds per 1,000 population.

• Screening rates for breast and colorectal cancer and vaccination for flu in the U.S. are among the highest, but COVID-19 vaccination trails many nations.

The Solution

These problems all boil down to two root cause categories:

• Money

• Patient Education

If we bring down the cost of health insurance and educate the patient on behavior that causes and exacerbates chronic disease then we would be at par or better in outcomes and significantly less expensive than criminally expensive universal health coverage.

This is exactly what we have done. You can read the entire plan here, and actually see the solution in action here, but discussing the details of that is beyond the scope of this article. Go read the articles. I’ll be here waiting when you get back. The point is that this is demonstrably a solved problem, so why aren’t we implementing it?

What’s the Holdup?

In a word, we think the problem is inertia. The ‘fear of missing out’ has not overcome the ‘pain of a failing healthcare system.’ We see Germany doing fine with their Bismarck, a government controlled healthcare system, but fear is having to pay more than half again the taxes we pay now to get it. We see the UK with their taxes about the same as ours, but they are just about bankrupt with their system, shutting down facilities and skyrocketing wait times with their Beveridge system. We see Canada with their Nationalized Health Insurance, roughly equivalent to Bernie Sander’s Medicare for All, in the same boiling pot with the UK shutting down facilities and unable to hire practitioners for what they have to pay. The linked articles were gleaned from a 30 second internet search, there are literally hundreds of thousands of them, these were at the top

Clearly something has to be done, and we have shown you above and for the past decade, how to solve this problem. We think that it is kind of like being a prostitute. You know you are getting screwed, but you don’t have a viable choice, so as long as the corpulent, middle management, unimaginative, loser health insurance company leader John isn’t too rough and leaves the money on the nightstand it is just easier to succumb.

Except that we just gave you the solution. We started detailing and building the solution in 2009, and it has been done for years. There is a better way. There is a way to not only mitigate the Commonwealth Fund’s two problems, cost and patient education, but to completely solve the cost problem by controlling expenditures, waste and graft at every stage from your wallet to the practitioner's bank account. That includes eliminating everything your insurance company does that isn’t ‘pay for your healthcare’ and automating the rest. We are in the process of doing the same thing for your hospitals and practices, so the only manual processes will be the actual practice of medicine and sweeping floors.

Sure, But That Didn’t Identify the Holdup

I blame you. Every one of you sitting out there reading this and not telling everyone you know, calling your congressman, even throwing money at this solution, has just decided that it is easier to succumb and just get screwed. You are waiting for the government to finally do something that doesn’t further wreck the system. Everything they have ever done to healthcare has hurt, but maybe this time is different. A smart person, Albert Einstein said "We cannot solve our problems with the same thinking we used when we created them." You know that the government can’t solve this. Out of 8 billion people in the world there are two outcomes to government controlled healthcare: bankruptcy or insanely high taxes.

So if you are the holdup, stop it. You have the power and the mandate to fix this yourself. You have been told and then shown proof of this system working. It works. Call the neighbors and wake the kids. Shout it from the rooftops. This system will cut half from the cost of health insurance immediately, It will cut your personal health insurance bill in half. Over time with the health and wellness system that incentivizes healthy living, we can cut another 25% of the total cost of health insurance by getting us down to the OECD mortality rate for behavior-based, avoidable chronic disease. For those of you that don’t want to be incentivized, fine, you don't have to be, you can pay more and subsidize those that do eat healthy and get up and move around for half an hour every day.

Once More for the Cheap Seats

The reason this isn’t solved is because you all are too scared to change anything. If you’re scared, buy a dog. If you’re very scared, buy a big dog. Do your own analysis of the risk. What could go wrong? We only need about 5000 lives to make this model profitable. If you find that this isn’t a viable solution, I am absolutely positive that the big, greedy, dumb, paper pushing, spreadsheet emailing, claim denying, payment delaying, authorization seeking health insurance companies will be happy to continue fleecing you. They will waste or just keep more than half of every dollar you pay them. So after we try this system, they are still there and still willing to steal your hard earned cash. But what if we are right? 75% off the cost of healthcare in the US makes us about half of what they pay in South Korea, and we get to keep the US style healthcare with the best of everything: the best doctors, the best equipment, the best facilities. Oh and for those of you that say “I get my health insurance at work,” If you cut your insurance bill by half, your boss makes more money, and you can get an instant raise. That money is coming out of your pocket one way or the other. I know that some, or even most of you, do not understand that you always pay for health insurance, but you do. If the boss didn’t have to pay for half your insurance he can split the difference with you and you both make money.

Conclusions

I don’t care what you do. I am effectively retired and want for nothing. I am frustrated by detailing and actually spending the seconds of my life building this solution to solve the problem and then being ignored by you all, standing around with cold, wet toes because you can’t commit to jump in and sink or swim, even when there is a pack of greedy, hungry wolves (corpulent, middle managers, insurance executives?) running down the dock you are standing on.

My friend Peter Cranstone brought your individual reticence to my attention by saying (I’m paraphrasing)

“ I think you have something amazing - but I don't count. Your current approach and narrative is not working…you’ve built yourself an automobile while everyone is asking for a faster horse.”

Peter is right. I would add that the people want a faster horse that doesn’t defecate in the streets and doesn't need to be fed if you aren’t using him, but I digress. Message him and ask. How do I educate you all to not only understand the streamlining and automation inherent in our system, but also to start a grassroots movement? What do I have to say to get you up off your back and tell the corpulent middle managers that run insurance companies to get out of your house and never touch you again?

I am always available to show off the system and the third article previously linked actually has video of the system in action. I know it is complicated. I know it is hard to understand. I am telling you that it works and we can explain it to you so that you know it works too.

If you don’t agree with me, tell me why. Use small words, I am not bright. Either I will convince you or you will convince me. If I convince you, you can go proselytize and help save the world with me. If you convince me, I will stop proselytizing and you won’t have to hear from me again.
Either way it is a win for everyone.

So this healthcare crisis is your fault. You have been presented with a viable, working solution a decade and a half ago, and have quite literally argued against its utility, or ignored it altogether. If you don’t repost this article, tell everyone you know about it and call your government officials and demand this system be put in place, you only have yourselves to blame.

We have built a comprehensive health information system to keep the patient healthy and on the right track with the ability to incentivize healthy living. This system includes the automation of the health insurance industry completely. We have designed and are currently building the ERP style PM system. Implementing this system should be fairly simple and will completely revolutionize the way healthcare is paid for, saving countless lives. We have shown a way to use this system to make the best healthcare system in the world also the most efficacious and the most affordable.

If you liked what you read contact us here, on our site, SentiaHealth.com, our parent company SentiaSystems.com, or send us an email to info@sentiasystems.com or info@sentiahealth.com.

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Read on our site:
https://sentiahealth.com/WebLog/Details/3096

Or on our parent’s site:
https://sentiasystems.com/WebLog/Details/13045