Healthcare in Transition Blog 2019-07-09T10:01:57+00:00

Dr. Brian Casull’s Blog


Healthcare is not a “system” in the United States. Rather it is like a game of baseball where your perceived and actual coverage is determined in large part by where you sit in the ballpark of healthcare.

basball park - where is your healthcare seat

Read my posts below to discover … learn … realize … understand what you can do about
American Healthcare in Transition.

  • common health care system finance models chart

Health Care System Choices: The Beveridge Model

And what are our healthcare “system” choices? There are four major models for health care systems: Beveridge National Health Service Model Bismarck Model National Health Insurance Model Out-of-Pocket Model. (1)(2) I will discuss them one at a time.  In this blog post, we will examine the Beveridge Model. The Beveridge Model: A single-payer national health service that was first developed by Sir William Beveridge in 1948. Examples: United Kingdom, Spain, New Zealand, Cuba. Relevance to the U.S.: similar to [...]

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Healthcare Dollars and Sense

In this blog I begin to discuss dollars and sense. “The legislative text (“Medicare for All” proposal) won’t include a financing plan. Opponents of a single-payer system say it would require major tax increases and cost more than $30 trillion in its first decade. Supporters say it would save money by reducing the expected pace of U.S. health-care spending. Funding options include a so-called wealth tax and increasing the marginal tax rate.” (1) If the critics indicate “major tax [...]

  • Brian Casull and his pet cockatoo, Poppy

How I Would Approach Healthcare Reform

I support physician leadership, even when considering a one-party payor system. The broadest division among one-party payor system advocates is how the delivery of care is organized. The Democrats have revealed their “Medicare for All” proposal. According to the Wall Street Journal. Here are the salient features. Under the Medicare for All Act of 2019, the federal government would pay for the following[1]: Health coverage for all Americans to include items such as premiums, copays and deductibles (see [...]

  • Consider another healthcare model

Healthcare in 2020: What Should Be Done?

To reiterate a previous blog post, we know Health Care is an important national topic. Also, a federal judge ruling that the ACA is unconstitutional has set the stage for its continued importance. The ACA is still in place until 2019 when the mandate to have insurance goes away, thanks to the 2017 Tax Bill. Appeals have begun. The Supreme Court will become involved. Health Care will continue to be a hot topic in the 2020 Presidential Election. So what [...]

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Cost is Key to Whether You Can Provide Adequate Health Care Coverage For You And/Or Your Family

In our previous blog, I discussed the concept of Health Care Park and Tectonic Plates. COST being a major one of those results of an angry lithosphere. I left you with a question. IS COST A VIABLE CONCEPT FOR THE INFORMED CONSUMER OF HEALTHCARE?  I believe it is. But, don’t just take my word for it. Here is a discussion which will I believe will prove my point. COST becomes the chief determinant of whether you can provide adequate [...]

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Where You Live Determines Your Healthcare Cost

Last week we talked about variability. And even that variability is variable. Say what????  At the end of the day the final variable is location. Where you live determines cost -- not how sick you are. Whatever the market can bear in our FOR-PROFIT HEALTHCARE INSURANCE MODEL. And that variable variability is augmented, aided and abetted by our old friend THE THIRD PARTY. And there's a third party —the insurance company —who pays for the service, but they don't [...]

What Influences Access to Healthcare? Cost!

In last week's blog I talked about ROI (Return on Investment). Health outcomes (mortality, morbidity-how sick you are, life expectancy, healthcare status, functional limitations, etc.) are strongly impacted by your access to healthcare. And what influences ACCESS TO HEALTHCARE?  Healthcare expenditures. COST! And WOMEN HEALTHCARE CONSUMERS are impacted more often by cost than their MALE counterparts. The primary driver of COST is VARIABILITY. There's the FIRST PARTY— the provider — who [...]

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Healthcare 2020 and Out of Pocket Costs

In my previous blog I talked about the three obvious and prominent components of our FOR-PROFIT HEALTHCARE INSURANCE MODEL. And no, it is not a free ride for the healthcare consumer. We have OUT-OF-POCKET COST. We have the privileged of paying premiums, deductibles, co-pays, coinsurance or other fees out of pocket in order to play on one of the six teams.  That process, in reality, looks something like this. In essence these six teams funnel their payment process through [...]

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Introducing the Current Model of Healthcare

Today, I would like to introduce the current model of healthcare. It is the FOR-PROFIT HEALTHCARE INSURANCE MODEL.  That model has three prominent components and one behind the scenes.  Let me introduce those players under a little different name. THE FIRST PARTY The FIRST PARTY is the PROVIDER OF HEALTHCARE. Under federal regulations, a "health care provider" is defined as: a doctor of medicine or osteopathy, podiatrist, dentist, chiropractor, clinical psychologist, optometrist, nurse practitioner, nurse-midwife, or a clinical social [...]

  • border wall map between usa & mexico

Do We Need a Border Wall From a Healthcare Perspective?

Poppy tweets about healthcare 2020 ... where are we headed? The results of the 2018 mid-term elections solidified Health Care as an important topic. The recent federal judge ruling that the ACA is unconstitutional set the stage for its continued importance. The ACA is still in place until 2019 when the mandate to have insurance goes away thanks to the 2017 Tax Bill. Appeals have begun. The Supreme Court will become involved. Health Care will continue to be of [...]

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