Ask HN: Is It Possible for Non-Profit Single Payer Health Insurance?

1 point

9 years ago

LTDR; Is a single payer ran privately possible where private non-profit handles all billing/pharmacy/network management, and hospital that patient 'belongs to' gets bulk of money to divy to primary care physician and others who provide services to the patient. Completely cutting out insurance companies, sales agents, etc from the process?

I read today about Direct primary care - no insurance model, and thought it could be better...source : http://www.businessinsider.com/direct-primary-care-a-no-insurance-healthcare-model-2017-3?r=US&IR=T

I'd like insight on if the community here thinks it's possible, and if anyone wants to help get it started? Hospitals become the insurance provider and receive bulk of money. 85%. Patients would pay on a sliding scale based on income something like 4% if < 4k/monthly income, 6% if > to start. Of that money the hospital gets 85%, the patient can choose ANY doctor in the system. The hospital will pay said Doctor a % monthly, there are no copays, hospital pays other secondary medical like OB/GYN as needed.

Prescriptions would be negotiated at bulk rates and we'd handle the pharmacy/mail order at cost plus s/h fees. If someone gets sick out of network or traveling - their host hospital pays for it.

To get an idea of the financials on this though...

University of utah for example saw 22k patients in a year. If we took an average of 200/month (meaning they earn about 5k/monthly) that would be 2,860,000 monthly insurance revenue for the hospital. We would handle all billing, so they could downsize all their 'billing' related staff which could save millions. This doesn't include health customers who don't need to visit hospital at all or at most once or twice a year for minor things like vaccines.

https://www.ahd.com/states/hospital_UT.html shows U of U hospital earning 2.9 million which seems low, not sure if that's per month or year as the page is a little vague on what that constitutes.