Leon wrote:
"dpb" wrote in message ...
Leon wrote:

They might; then again they may not. Most likely the selection criteria
were made when you were enrolled in the group. What if you had been 70+
and in need of serious heart care when first applied? Think you'd still
have been accepted?

It would really be a waste of time to simply speculate how something would
work with out actually getting the details.

Given that comment, there would be no screening necessary, remember you do
actually pay for treatment. The cost would be less than "normal" because
there would be no losses caused by non-payment, slow to pay, or reduction of
item costs by an insurance company.

I'd wager it's the latter--every one of those groups I've ever seen have
very selective membership criteria.
Have you seen them all?
Of course not--but I've seen enough to have a pretty good understanding of
their business model.

It does not sound that way to me.

Well, it does to me...

But what you're describing above is at least somewhat different than
what I was speaking of if indeed they will accept anybody.

There was quite an at length article in Forbes or somewhere similar a
while back that went into the practice of which I was speaking at quite
some length and detail. It certainly is true that many of the specialty
private surgical centers, heart centers, etc., are quite selective in
their accepted cases.

It's quite selective, not universal.

Why would that be, you are obligated to pay for any and all procedures.
They are not selling or operating like an insurance company.

No, they're controlling risk to an even higher degree than most insurers
in the practices/groups of which I was speaking (see above).

simply charging what they consider a fair and profitable amount less the
huge cut that the insurance company gets.

The "huge cut" the insurance company gets is that other part of the high
risk pool in large part as well.

....

The fact remains, the costs are inflated to make up for Insurance loss
costs.

What we have now is not working and is soon to break down, lets not crap on
new ideas. Can't never could do anything.

I'm not sure I've seen much in any really new ideas, unfortunately,
particularly those that would actually help across the full spectrum of
both abilities to pay and access to services.

The one thing I'm pretty sure of is that the inclusion of large segments
of currently under- or uninsured without a commensurate inclusion into
the payment pool by some means is going to be another federal welfare
program that will not be able to be funded w/o massive deficits or taxes
of one form or another.

One specific place where I think it's gone badly wrong to date is that
far too many young, relatively healthy working folks are opting entirely
out of having any insurance at all in order to have more toys so they're
not helping in the spreading the cost and are dead weights when the
occasional one does have a serious disease or accident. It would also
help many self-employed if it were required that carriers accept them as
a part of an equivalent-age/work-type pool rather than only as
individuals. That would put many older that currently aren't but would
like to be back into the system.

--