Fight corruption with it's evil-evil-twin: Anti-Evil. Like a Positron.

in #medical4 years ago

Medical provision in America is already socialized, and is non-equitable in its distribution, due to third party gatekeepers dictating (under impenetrable secrecy) who gets what and how much will be reimbursed, if reimbursed at all.

Health Insurance is simply an Option Contract:
a financial contract expiring monthly (when premiums are due) that enables the buyer to purchase:
unknown medical goods and services
at undisclosed prices
provided by non-obligated third party providers (hopefully willing and available)
at some future date.

Sellers of this so-called "insurance" are not medical providers, they are finance companies which MONETIZE THE PROMISED FUTURE PERFORMANCE OF NON-CONTRACTUALLY OBLIGATED THIRD PARTIES (doctors and nurses).

If you want medical care, by law, you need a licensed doctor and/or a nurse.
These care providers are forced to jump through Gordian-knot-ish hoops to get reimbursements from Third Party Payment system.

Buyers of (hoped-for) medical care pay Third Party for a finance contract to purchase something that the Third Party cannot provide and cannot guarantee provision of...AND no prices are disclosed (you didn't think there would be no co-pays, did you? No denied claims? No Out-Of-Network Provider BIG surprise bills?).

Sellers of medical care (docs and nurses) hope a Third Party finance company will reimburse them for services rendered, AFTER sellers have spent significant up-front time and money to pre-approve txt's (no-guarantee of payment) and billing-coding (required, but again no guarantee of payment) and risk Rac Audits (Google it).

This is a corrupted system, where Buyers and Sellers of a critically needed service (medicine) are kept apart from one another by a tortured law designed to benefit only the Third Party Gatekeeper.

Solution? Of Course:
GPO (group purchasing organizations) formed by patients willing to pay cash for services from licensed medical professionals at disclosed prices.
You know how much actual healthcare a human can purchase for the reimbursement rates to actual health care providers? No, how could you know, that information isn't allowed to be disseminated.
It is a lot.
Buyers and Sellers could share an enormous chunk of the Medical Transaction Cost Savings by eliminating the Third Party Gatekeeper.

Why GPO? Because GPO enjoys a unique Congressional protected status of safe harbor exemption from Federal Anti-Kickback Laws. GPOs are blamed by many medical professionals for the intractable high cost of pharmaceuticals and the commonly occurring shortages of hospital commodities like saline bags.
But here's the thing: doctors are afraid to post prices or advertise or do anything free-market (which would benefit both doctors and patients) because Anti-Kickback Law is the threat used to prevent them from doing so!

Hence the Positron reference: when corrupt incestuous Political Class actions create untenable circumstances for non-corrupt-non-Political-class humans, the victimized humans must look for novel self-defense mechanisms.
Appealing to the mercy or honor of malignant narcissists is never a winning strategy.

'Positron' strategy, in the arena of trying to survive the American Healthcare Finance Industry, involves buyers (patients) and sellers (docs&nurses) using the same mechanism (GPO) that bad guys use to enrich themselves at the expense of patients and healthcare professionals, but instead using it for the power of community good rather than narrow insider evil.

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