POPPY THE COCKATOO TWEETS HEALTHCARE:
“Hi. I am Poppy and I am a Cockatoo. My human has asked me to introduce the subject.”
The Big Picture
Today, the for-profit health insurance model drives american healthcare in transition (non-profits make money, they just don’t share it with stockholders). This model is broken!
What does the model look like? It is a three- party system.
There’s one party — the provider who provides the service
- Have their own master list of charges for different services
- Different from provider to provider
There’s a second party — the patient, who receives the service.
- In the three party system the patient is no longer the primary decision maker
And there’s a third party —the insurance company, or whoever pays for the service.
- Will not pay those listed charges
- Negotiates for lower prices with each hospital and doctor on every plan.
- Negotiated prices even can vary within an insurance company depending on which plan a patient has.
This model is much like a baseball park
Where you sit is dependent upon the seats you can afford to purchase (or have purchased for you as the case might be)
- The seat is determined by the type of healthcare insurance you have (or don’t have)
- The amount of actual healthcare coverage you enjoy and the amount of money you pay for healthcare is related to where you sit in that ballpark.
Important issue: Tectonic Plates!
“And make no mistake about it, there be earthquakes here!”
Added to the preferred hierarchy of seating arrangements is the X-factor.
- Out-of-your-control occurrences
- These are the tectonic plates
- Caprice ebbing and flowing (the ground moving under our feet) = earthquakes
- Which disrupt American Healthcare and keeps it in ‘transition.’
Losing the Benefits of Medicare and Medicaid
- Seeing the Doctor of Your Choice
- Health Care Costs
- -Medical Devices
- -Patient Compliance
- -Prescription Drugs (Pharmacy)
- The ACA Marketplace
- -Pre-existing Conditions
- -Coverage Mandates
- -Benefit Coverage
- Hospitalization versus Observation
- Mental Illness
- Coverage Denial