Where did the money go? Insurance companies keep about 33% Healthcare By The Numbers

Where did the money go? Insurance companies keep about 33%… 

Healthcare By The Numbers

Where did the money go? What is the American public buying when it pays for its health insurance and is it a good value? If the public knew that their insurance company kept as much as 33% of what they spent how would they react? While there is nothing wrong with making a profit, there is also no issue with insisting that money provide a good value. On his weekly podcast, Dr. Steven Goldstein describes in detail where all that money goes. The Houston Healthcare Initiative podcast can be heard on : Apple Podcasts, LibSyn, Spotify, Radio.Com, Listen Notes, iHeart Radio, Podcast Addict, Podbay, Backtracks, Player FM, Stitcher, and SoundCloud.

Where Does That Money Go?

Most people and their families who have health insurance, have it through their employer. The business pays for some if not most of the premiums and the employees pay deductible and out of pocket costs. But where does all that money really go? Does the public purchase more benefits or receive a better value as a result of what they were charged for that insurance?

Hospitalization Charges & Costs

When Paying for Healthcare?
Is what the public paying for healthcare and health insurance a good value?

Dr. Goldstein told his listeners, that in 2018 the average cost of hospitalization was about $10,000.00. The average charge for hospitalization with private insurance was about $20,000.00, thus the amount charged was double the cost. “Now let’s multiply that same number by a sample of the population, Dr. Goldstein proposed. “The average number of hospitalizations per year was about 9 for every 100 people. So, for those nine, the amount the insurance company collected was $180,000.00.” But there was more to healthcare payments than simple hospitalization. “People often go to the doctor and have what are classified as outpatient charges. Those are charged at about $500.00 a year, per person,” he said.

Add Drug Costs

The drug costs across the population were estimated at $1200.00 each. “We can reasonably assume that drug costs are higher for the over 65 population,” Dr. Goldstein said. “Now, for people under 65 years of age the expense estimate is less. So, the amount paid overall by the population of 100 people is about $500.00 each. The total for 100 people at $500.00 each is another $50,000.00.”

Factor Insurance Into The Equation

To get to the ultimate amount of money spent and where it all ends up, the cost of insurance factors in. “Say someone has a $50,000.00 deductible along with discounts they receive from the Preferred Provider Organization (PPO), we can figure a $20K discount for our 100 people,” He said. “Or charges to them all of $30,000.00.”

It is here the distinction between price and costs reveal an interesting outcome. Insurance will generally pay two thirds of the cost with the other, remaining third paid by the individual in the form of co-payments and applied deductions. “If we add these costs together, we find the total charges for 100 people = $300,000.00,” Dr. Goldstein declared. So where does the other one third go?  “The very cheapest Blue Cross policy for a 31-year-old male living in zip code 77096 (the Houston are) was $257/month or $3084/year, said Dr. Goldstein. “The cost for 100 people would be $308,000.00 annually but would have a $7400.00 deductible.”

For someone age 50, the cost was $4000.00 annually. The high deductible means that outpatient care is not paid for and that the insurance only pays for the reinsurance and hospitalization costs of $200K. So, who benefits the most from these expenditures?

No surprise, it’s the insurance company. “The gross profit for them is at least $100K. That is income per 100 patients of at least $300K less claims of $200K.” Is this a good value for the public? It’s a fair question and good way to think about healthcare costs.

A study in ‘Health Affairs’ co-authored by a Princeton University health economist, found that Americans use the same amount of health care as residents of other nations. They just pay more for them. U.S. hospital prices are 60% higher than those in Europe. Government efforts to reform health care and cut costs raised them instead. “Our system is broken and needs to be overhauled,” Dr. Goldstein said. “Efforts at reform, that we have talked about before on the podcast, are a waste of time and effort when the overall system for providing and charging for healthcare is so fundamentally broken.”

About Dr. Steven Goldstein and the Houston Healthcare Initiative

The Houston Healthcare Initiative (HHI) was founded by respected, Houston neurologist Dr. Steven Goldstein. Like many Americans, Dr. Goldstein is concerned about the state of the U.S healthcare system and the sorry state of the public’s health. The Houston Healthcare Initiative web site is an aggregator of news, healthcare pricing information, and resources for those who want to help drive reform for the healthcare industry. HHI’s emphasis for reform is on free market innovation and personal responsibility. Learn even more here at https://houstonhealthcareinitiative.org/about-us/.

The goal of the Houston Healthcare Initiative is to be a catalyst for change in the way Americans receive and pay for medical treatment. To cause change the site aggregates information, tools, and targets for the reform of the healthcare industry with an emphasis on free market innovation and personal responsibility. Visit online at www.houstonhealthcareinitiative.org.

Healthcare by the Numbers

Where Does the Money Go When Paying for Healthcare; Prices, Costs, and Value…

Healthcare by the Numbers

March 23, 2021 – On the latest edition of the Houston Healthcare Initiative podcast, Houston based neurologist and the founder of the Houston Healthcare Initiative Dr. Steven Goldstein, describes the numbers and dollars associated with health insurance and hospitalization costs. This to inform us all where the money that individuals and employers contribute goes and who really profits most.

Dr. Seven Franklin
Where does your money go when paying for health insurance?

The answers are surprising when it comes to cost, price, and the ultimate value those with health insurance derive from the premiums they and their employers all pay. Ultimately, did the public purchase more benefits or receive a better value as a result of what they were charged? “There is nothing wrong with making a profit, but most people will want to know what they bought and was it worth it,” Dr. Goldstein told his listeners.

Additionally, Dr. Goldstein describes the profits hospitals and health insurance companies accrue, what percentage of their payments actually go to help pay for their healthcare and how much the insurance companies keep. All this to help the public decide if this money was well spent or if it could be better managed.

Where To Listen

The Houston Healthcare Initiative podcast can be heard on: Apple Podcasts, LibSyn, Spotify, Radio.Com, Listen Notes, iHeart Radio, Podcast Addict, Podbay, Backtracks, Player FM, Stitcher, and SoundCloud.

About the Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

Did The Covid-19 Pandemic Cost You Your Job and Health Insurance?

In a time when so many lost their jobs because of the Covid-19 Pandemic….

Job & Health Insurance Loss Come and Go Together; How To Find Affordable Coverage

March 2, 2021 — In December 2020, 66% of Americans who answered a survey said they fear they won’t be able to afford health care this year. Of the 41% of respondents who are very or moderately concerned about health-care costs, 53% are parents with children. The amount of people who were and remain unemployed because of the Covid-19 pandemic remains high. Since most individuals get their health insurance with their jobs, those same folks are also in need of medical coverage.

On his regular podcast, Houston based neurologist and founder of the Houston Healthcare Initiative Dr. Steven Goldstein has immediate and affordable medical insurance solutions for those who need coverage. To hear the podcast visit: Apple Podcasts, Radio.com, iHeartRadio, SoundCloud, and the Houston Healthcare Initiative web site. Job & Health Insurance Loss Come and Go Together.

Use the Obama Care National Marketplace

People who lost their jobs due to the pandemic have the burden of finding work and paying for healthcare. As most people’s healthcare is tied to their jobs. “There are alternatives for people who lost both their jobs and accompanying health insurance,” Dr. Goldstein told his audience. “The key for those people to get covered is to act quickly.”

One reason for this is that job loss qualifies Americans for a special enrollment period in the health insurance marketplace regulated by the U.S. government, but it only lasts 60 days. “Normally the enrollment period for this is in the month of November, but job loss allows an exception. Just remember the 60-day deadline,” Dr. Goldstein said.

Private Health Insurance

Private health insurance will sometimes offer more flexibility than standard coverage. For example, short-term policies lasting up to one year are available in many states. There are differences between health insurance and private health insurance. People buy private health insurance many times because their place of employment does not offer it. In the case of people who lost their employer provided health insurance, purchasing it like this is an option. Private health insurance is often an option for those who work part time, are self-employed, or own a small business.

Health Co-Ops

Health insurance co-ops are private health insurance plans that serve a small group of people and are owned and operated by the members of that group. The health co-operative or co-op is a member owned not for profit corporation. They are run democratically by the members.

The real benefit of health insurance co-ops are they are significantly cheaper than regular health insurance. “The monthly fees are called membership fees, not premiums, Dr. Goldstein said. “The average cost of a co-op membership is about $40 to $90. To put that into perspective, regular COBRA insurance premiums can cost as much as $650 per month.”

Job loss is unnerving enough at any time. Losing health coverage during a pandemic makes that level of anxiety even higher. Because no one wants to be without medical insurance when a previously unseen virus is spreading.  It could make you or a loved one sick at the worst possible time. Fortunately there are reasons to be optimistic about getting health insurance that is affordable and obtainable if action is taken sooner than later.

The amount of information about this and other similar issues grows ever higher at the Houston Healthcare Initiative web site and its social media sites. To learn more about the Houston Healthcare Initiative go to www.houstonhealthcareinitiative.org.

Job & Health Insurance Loss Come and Go Together.

Hospital Price Transparency & The Creative Ways Hospitals Find To Avoid Posting Their Prices For The Public

Lacking transparency
Lacking transparency for hospitals and healthcare.

Some of the most creative writing in business lately are the ‘reasons’ why hospitals and other healthcare providers are not able to post their prices, as the law requires. Respected Houston based neurologist and founder of the Houston Healthcare Initiative, Dr. Steven Goldstein, understands the letter and intent of the new rules on price transparency for healthcare providers and hospitals. Specifically, all the new rules that call for these medical suppliers to essentially post their price list. What the spirit of these new rules intended and what is happening in practice are not quite the same. To hear all of his insights tune to the Houston Healthcare Initiative podcast on SoundCloud, Apple Podcasts, Radio.Com,LibSyn, Spotify, Podcast Addict, iHeartRadio, Stitcher, Backtracks, Podbay, Podbean, and other places where podcasts are syndicated.

Claiming They Do Not Know

The big idea here was to make all of the prices, different rates, payer specific costs charged by insurance companies all more available and more transparent to patients. Sounds easy enough. But, according to the healthcare industry, procedures and services are often not as cut and dried as placing a price tag on a service and charging your insurance. According to them, some procedures can affect patients differently, causing them to have different levels of care and other needs that all have different prices.

Many healthcare providers also cannot say upfront what exactly the price will be, because doctors do not know the extent of the services until they begin offering care. “Hospitals do not want to be pinned down on prices other than to say, ‘it depends’ which is not much of an explanation,” Dr. Goldstein told his audience. “Some hospitals only posted price estimates, uploaded files in difficult to use formats, or promised to release information only after someone enters their insurance information. In New York City, a published investigation found only a handful of hospitals in that city complying while the rest were less than upfront.”

More Reasons To Not Comply

There are other reasons cited for non-compliance. Like the American Hospital Association claim that staff who would help with compliance are stretched thin because of the Covid-19 pandemic. “But the bottom line is that price competition only works if those involved are really competing, Dr. Goldstein said. “Without price disclosure, competition remains very elusive.”

Price Transparency Background

As of January 1, 2021, hospitals are required to make prices, those payer-negotiated rates for their services, available online in a readable format. In late 2020, the Department of Health and Human Services issued the final rules on price transparency for healthcare providers. Prior to the release of these new rules, health insurance companies, and healthcare providers like hospitals negotiated prices for all the things they do for patients and did not make any of this information public. What this arrangement meant was that patients did not know what they would pay for treatment, tests, surgery, drugs and everything else until after they were treated and received the bill. “There is a lot of potential benefit for the American public when or if these rules are fully adopted and made more available for the public,” Dr. Goldstein said.

About The Houston Healthcare Initiative

The Houston Healthcare Initiative (HHI) is a member owned, non-profit medical co-op. Led by Houston based neurologist Dr. Steven Goldstein, the HHI will replace traditional health insurance for qualified individuals and families and provide incentives for members to adopt healthier lifestyle habits. HHI will provide affordable medical coverage through a combination of negotiated rates, low monthly payments, personal accountability and lifestyle incentives. The medical co-op promises to save qualifying individuals and families money on health insurance. At the same time, HHI will help uphold quality care by asking members to bear some responsibility and individual accountability for maintaining their personal health.

 

Hospital Price Transparency Podcast

Hospital Price Transparency Podcast

How Some Hospitals Are Balking At These New Rules And One That Is Not

This week respected Houston based neurologist Dr. Steven Goldstein will discuss the price’s patients are charged by doctors and hospitals. Specifically, on the new rules about healthcare price transparency. Specifically, on the new rules about healthcare and price transparency. What needed to change on disclosing prices and is anything different as a result? Of course, there are ways that the hospitals are playing around with the information. But there is one shining example of what looks like full compliance.

How Haven Failed at Repairing America’s Healthcare System

How Haven Failed at Repairing America’s Healthcare System. The reason that healthcare and associated costs for medical treatment are so high is the way pricing is established, managed care. Making healthcare more affordable and accessible was what Haven was supposed to do.  Its failure to address how prices are kept artificially high via managed care was among its biggest failures.

The lessons available from this epic ‘bellyflop’ are the subject of the latest Houston Healthcare Initiative podcast, hosted by respected Houston based neurologist Dr. Steven Goldstein. The Houston Healthcare Initiative podcast can be heard on: SoundCloud, Radio.com, Spotify, ListenNotes, iHeartRadio, Podcast Addict, Stitcher, BackTracks,PlayerFM, and the Houston Healthcare Initiative web site.

Resource Rich but Still A Bust

Haven was a joint venture between Amazon, Berkshire Hathaway and JPMorgan-Chase. Its purpose was to use the leverage of its tens of thousands of employees and its expertise in technology to improve the healthcare system.

Managed Care Keeps Prices High

Haven Failed to Fix Healthcare
How Haven Failed at Repairing America’s Healthcare System. Haven was a $100 million bellyflop of a failure, as represented here.

Haven worked at the edges of what really made medicine expensive and avoided the fundamental challenge of the managed care model. “We need a system that enables hospital systems to profit from the improved health of the population rather than the amount of ‘sick care’ delivered,” Dr. Goldstein told his podcast audience. “Innovative ideas need to focus first on improving health. The only way for this to happen is for hospital systems to profit from this outcome.”

How?

One example of how to accomplish this, is for hospitals to offer Medicare pricing to patients without insurance at Medicare rates. In return for the discounted prices, patients would pay the hospital a monthly fee. They would also pay a monthly fee into a savings account in order to pay the hospital bill. In this scenario, the hospital would collect the monthly fee even if no patients were admitted to hospital. If patients were kept well, the need for hospitalizations would decrease. “In this environment, the innovative ideas of Haven would have found a much warmer reception,” Dr. Goldstein said.

No Reason for Change or New Ideas

Haven also failed to understand why the medical business was not interested in new, innovative ways to provide and charge for medicine. The reasons were simple. Insurance companies and providers make lots of money from the current way of doing things,” Dr. Goldstein said. “There are few enticements for them to change and why should they when money is pouring in and there is no pressure to do things differently.”

Thanks, But No

Would the ‘industry’ be open to creative ideas and problem solving when it comes to pricing, service delivery or an emphasis on making the public healthy and not just treating illness? “Probably not,” Dr. Goldstein reported. “The current system of managed care frowns on innovation. It controls innovation by only paying for services that have codes. It likes to use words like usual and customary. Medicine lags behind the tech world by approximately 25 years. So no, in a change averse industry I would not look for any creative approaches to take place except over long periods of time.”

About Dr. Steven Goldstein and the Houston Healthcare Initiative

The Houston Healthcare Initiative (HHI) was founded by respected, Houston neurologist Dr. Steven Goldstein. Like many Americans, Dr. Goldstein is concerned about the state of the U.S healthcare system and the sorry state of the public’s health. The Houston Healthcare Initiative web site is an aggregator of news, healthcare pricing information, and resources for those who want to help drive reform for the healthcare industry. HHI’s emphasis for reform is on free market innovation and personal responsibility.

The goal of the Houston Healthcare Initiative is to be a catalyst for change in the way Americans receive and pay for medical treatment. To cause change the site aggregates information, tools, and targets for the reform of the healthcare industry with an emphasis on free market innovation and personal responsibility.

With Haven in the rearview mirror… Failures to Reform U.S. Healthcare System Are Because the System Is the Problem

Haven Failure
In spite of the high tech ability and deep pockets of the joint venture partners, Haven went out of business on January 31, 2021.

Big fail. Haven, a joint venture between Amazon, JPMorgan-Chase, and Berkshire Hathaway, booted the chance to reform their collective employee health insurance, in part, by not working on the correct challenge, according to respected neurologist Dr. Steven Goldstein.  Dr. Goldstein hosts the Houston Healthcare Initiative podcast with a focus on reforming the highest priced healthcare system in the world. Haven is the most recent, but likely not the last, story of corporate good intentions not delivering what was hoped. So, what’s the right challenge?

The System Is the Problem

“Our current healthcare system is focused on treating sick people, not preventing illness,” Dr. Goldstein told his audience, and he gave an example. “The more people there are in hospital beds, the more money is made by the hospitals, doctors and everyone else involved in patient care.” The U.S. healthcare industry is a volume-based scheme of reimbursement for getting paid. Better patient health is not part of the current equation.

More of the Same

The business system Haven tried to disrupt offers no tie to healthier outcomes for patients or incentives for those same people to take better care of themselves. “It’s just more of the same,” Dr. Goldstein said. “Haven failed at reforming their collective employee health insurance in part by not working on the correct challenge but instead ‘worked on the fringes’ of a non-competitive business.”

Worthy Goal but Poor Execution

At Haven, the published goal was improving healthcare services and lower costs for the three companies’ employees. With a heavy reliance on ‘big data’ and the ability to analyze patient information in big amounts, Haven promised to make primary care easier to access, prescription drugs more affordable and render insurance benefits easier to understand. While essentially getting nowhere but costing a lot of money to get there, Haven shut down without affecting the healthcare industry at all.

Healthcare as a Commodity?

The best way to ensure an adequate supply of anything at the lowest possible price is to permit the laws of supply and demand to work. “But as we also know, that is not what we have and not the way costs are assigned or managed by insurance companies, hospitals and pharmaceutical companies that assign prices,” Dr. Goldstein said.

Employee & Patient Voices Heard for a Change?

The public has little to say about how pricing is determined but could have a great deal to say with the right type of organization. The correct method available to everyone is via the non-profit, employee-owned healthcare cooperative.

The cooperative or ‘co-op’, can replace traditional health insurance for qualified individuals and families. Co-ops can also provide incentives for members to adopt healthier lifestyle habits. Financial incentives based on lifestyle would result in lower healthcare costs by decreasing utilization. Ownership of the cooperative would pass the savings from the cooperative to the employees. Co-ops can allow employees to remain members even if they leave the company. By transferring ownership of the cooperative to the employees, companies are no longer responsible for healthcare and can concentrate on their core business.

How Co-ops Work

Co-ops provide affordable medical coverage through a combination of negotiated rates, low monthly payments, personal accountability and lifestyle incentives. “By organizing their workers and families, businesses of any size can overcome this less than efficient way of doing things,” Dr. Goldstein said. “For example, financial incentives based on choices about diet and exercise will result in lower healthcare costs by decreasing utilization. The ownership of the cooperative will pass the savings from the cooperative to the employees. But there are other benefits that will make those employees healthier.”

About the Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

In The Global Covid-19 Pandemic Who Suffers Most?

In The Global Covid-19 Pandemic Who Suffers Most?

January 5, 2021 – In the midst of an ongoing and worsening global pandemic, there are those who are more likely to be sicker and die than others. This according to respected neurologist Dr. Steven Goldstein, founder of the Houston Healthcare Initiative. He told his regular podcast audience that the mortality rate from the Covid-19 infection was greater for patients with obesity, chronic lung disease, diabetes and hypertension and that the older a patient was, the greater the mortality.  “The Covid-19 pandemic teaches us that improving public health should be a priority in reforming healthcare,” Dr. Goldstein said. The Houston Healthcare Initiative podcast can be heard on Backtracks,SoundCloud, Libsyn, Listen Notes, iHeart Radio, Spotify, Stitcher, Apple Podcasts and the Houston Healthcare Initiative web site.

When things are uncertain
Americans remain in the midst of the Covid-19 pandemic. What can we learn from it and how can this influence our thinking when it comes to personal lifestyle choices and healthcare reform?

Mayo Clinic Data

According to the Mayo Clinic web site, risk of severe Covid-19 is highest based on age; older people are at higher risk than those who are younger. Other conditions include type 2 diabetes, severe obesity and serious heart diseases. The site states, “obesity and diabetes both reduce the efficiency of a person’s immune system. Diabetes increases the risk of infections in general. The risk of infections, including COVID-19, can be reduced by keeping blood sugar levels controlled and continuing your diabetes medications and insulin.”

What Individuals Can Control

Dr. Goldstein said that people can take control of their own health by leading a healthier lifestyle. “By this I mean maintaining a modicum of physical fitness and being compliant with medical treatment if you have a chronic illness like diabetes and hypertension,” Dr. Goldstein told his audience. These and other voluntary measures like quitting smoking, moderating alcohol consumption and eating sensibly will help prevent an infection of Covid-19 or keep one from being more serious.

Freedom & Responsibility

Dr. Goldstein believes that in the New Year, the congress should find a balance of individual freedom, responsibility and monetary incentives for a better, national outcome. “People should have the freedom to adopt any lifestyle they wish as long as they do not interfere with anyone else. But, along with that freedom comes the responsibility to pay for it,” Dr. Goldstein said.   He mentioned how the government frequently uses its power to promote lifestyle choices. “For example, they impose high taxes on cigarettes to discourage tobacco use. But it does not outlaw the use of cigarettes. If anyone wants to lower their healthcare costs, they can adopt a healthier lifestyle.”

About the Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

Photo Caption: Americans remain in the midst of the Covid-19 pandemic. What can we learn from it and how can this influence our thinking when it comes to personal lifestyle choices and healthcare reform?

The Case for Healthcare Reform in Unsettled Times

Unsettled Healthcare
2021 starts with healthcare no less unsettled than it ended in 2020.

Healthcare reform in unsettled times. That times are troubled was never truer than in 2020 and 2021 will start out that way. But in an unsettled time with so much of the nation’s attention turned to medical care, could it be the time to really push healthcare reform and what might that reform look like? Americans remain in the midst of the Covid-19 pandemic. What can we learn from it and how can this influence our thinking when it comes to healthcare reform? Or is it all too big for any of us to do anything meaningful? Here to share his insight with us is respected neurologist and founder of the Houston Healthcare Initiative, Dr. Steven Goldstein.

For These Uncertain Times What Type of Health Insurance Is Best?

In wake of the election which insurance is best?
Three in ten uninsured adults in 2019 went without needed medical care due to cost. 

In wake of the 2020 election outcome…

For These Uncertain Times What Type of Health Insurance Is Best?

November 24, 2020 – According to Dr. Steven Goldstein, founder of the Houston Healthcare Initiative, “with the current system we have, I would buy a policy that has a high deductible,” he told his podcast audience. “This is sometimes known as ‘catastrophic’ health coverage. Then I would pay cash for my health expenses.”

That times are unsettled was never truer than in 2020. With the U.S. House and the presidential election settled, the majority of the senate remains undecided and will stay that way until the two runoff elections for both Georgia senate seats on January 5, 2021. The implications for the U.S. healthcare system are many. What can or should Americans do in the near term? Listen to “The Houston Healthcare Initiative Podcast to find out. The Houston Healthcare Initiative podcast can be heard on SoundCloudGoogle PlayLibsyn FeedStitcheriHeartRadioSpotify, and the Houston Healthcare Initiative web site.

Cash & Catastrophic Coverage

According to Dr. Goldstein, cash payments are accepted for most if not all medical charges and prescription drugs. Do not try to get the ‘insured’ rate to put against your deductible. Paying cash is much less desirable with the insured rate. “Most people will never reach their deductible amount anyway,” he said. “This arrangement is the best value for people under the current system. So, while at the doctors’ office show them your insurance card but tell them you are paying cash.”

Return of the Mandate?

Most Americans get their health insurance through their employer. The Affordable Care Act, also known as Obama Care, made more choices for insurance available and penalized people who did not purchase health insurance. While not ideal, it was a way to get more people covered by private insurance than before. Plus, it offered subsidies for those who could not afford insurance.  But at the same time, it was the mandate and accompanying monetary penalty that seemed to make the policy so unpopular with many. “The overall insurance industry and its approach to paying for healthcare are very flawed in fundamental ways,” Dr. Goldstein told his listeners. “We can spend time and money to make a bad system work better and that is probably what will happen in the near term.”

Likely Short-Term Changes

Some near-term changes are likely to be mandates for private firms and their employees to provide for and buy health insurance. The cost of care for uninsured workers is often passed along to the insured through taxes and other mechanisms. There are employed people now who go without health insurance and keep the part of their pay that would go to health insurance. One economic rationale for employer mandates is that the cost of care for uninsured workers is often passed along to the insured through taxes and other mechanisms. Mandates are, in part, an attempt to eliminate those who opt out of available coverage.

American Attitudes About Caring for Each Other

Generally, Americans have decided that we will treat sick and injured people who do not have insurance, but that treatment is not free. “So, we have all these schemes for the uninsured, or others to make people buy insurance,” Dr. Goldstein said. “While caring for the sick and injured is laudable, paying for it is another matter, like with the Obama Care mandate.”

Three in ten uninsured adults in 2019 went without needed medical care due to cost. Studies repeatedly demonstrate that uninsured people are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases. Not having insurance is generally a financial issue and one that leads to unhealthier people. “With the catastrophic coverage, patients are able to be seen as many practices will not see anyone without insurance,” Dr. Goldstein said. “Paying cash for services and not applying them to the deductible will both save money and result in a healthier population.”

About Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.