Thanks, and again a great read!

Great writing!

However, I’d like to know if the following has been measured against inflation since 1970? …can it be found in the PRI’s study?

According to the Pacific Research Institute, since 1970, the per-patient costs of all healthcare apart from Medicare and Medicaid have risen from $364 to $7,119, while Medicare’s per-patient costs have risen from $368 to $9,634.”

“…I guess I do approach this as if I were president…”

(*ROFLMAO*)

I’ll “see” your presidential “bid” and “RAISE” you…

(*GRIN*) (*DRUM ROLL*)

I – William R. Barker, Legend In My Own Mind – approach these matters placing myself in the role of… umm… a godlike, all knowing, all seeing, all wise Being always ready, willing, and able to give… umm… “THE” answer.

(*WINK*)

* Hey, Sinz… for your peace of mind… if that “hole in the Ozone” ever gets too big… no doubt my ever expanding ego will fill it in!

(*ROFLMAO*)

L&W. It’s ALWAYS great chatting with you!

** Hey… Midcon… where’s Midcon been…??? (Brutus…??? You around, Brutus…???) (Franco…???)

BILL

I understand the WHO dilemma. I haven’t totally figured that however I guess I do approach this as if I were president…which I admonished someone about once here on NM.

If Kaiser and Cleveland do exist are effective and are supported by the market, why don’t more exisit? I don’t know exactly, but I do know, often times people need a swift kick in the @ss to change what they’ve been doing.

I know our proposals are not much different.

http://online.wsj.com/article/SB10001424052970203706604574376981533298534.html

How many different articles about the failures of EXISTING federal “health care” initiatives do we need to be exposed to?

(*SHRUG*)

BILL

Try browsing “Obama’s Big Idea: Bankrupt Medicare Faster.”

BILL

“Primary care, as I have described it above, is provided by community-based HMOs which hire the doctors, not unlike Kaiser Permanente.”

Ahh… yeeesss… BUT… Kaiser Permanente EXISTS!

(*GRIN*) (Do you see my point….???)

WHO is it “providing” the “community-based HMOs…???” (*GRIN*) That’s the question! And even if you give me an off-the-cuff answer… that answer would be just that – simple words – not actual ACTION by a real “organization” willing and able to provide these “community-based HMOs.

In other words… what you’re giving me is a mixture of speculation and ultimately mandate. (*SHRUG*) If no one – no private organization – steps up to the plate… well… then we’re left with GOVERNMENT.

(*SHRUG*)

Again, L&W… I oppose government owned/run healthcare.

(But I do like your use of the word “paradigm” in your first paragraph, second sentence!) (*WINK*)

“Kaiser is not all that different from Cleveland Clinic…”

Like Kaiser… Cleveland Clinic… er… EXISTS. (*SHRUG*) (See where I’m coming from…???)

“As I pointed out, if you wanted to hire a primary care physician to serve the needs of you and 1999 of your neighbors, the cost of the salary is $6.25 per person per month. … I know this isn’t what YOU want, but I am certain if I tried to sell this, I would have a lot of people who would much rather pay $6.25 per month and never have to be concerned about access or cost, than the alternative.”

It’s not so much a question of “what I want” as it is this simple reality, namely…

L&W. “You” are doing nothing. (*SHRUG*) By that I mean unless you’re about to reveal a big surprise to us all, you’re not some multi-billionaire with the resources to put his plan into actual action on the “testing” level in the real world.

Again, L&W, with respect, like the libs you’re quick to say what “others” should be creating and what “others” should be spending their money on… and that’s ALWAYS an easy call. (*SMILE*)

Now you might respond that I’m doing the same thing, demanding people pay (*LOOK OF SHOCK*) for their OWN health general health care out of pocket… but my call is in line with societal norms for pretty much EVERYTHING we need – food, shelter, clothing…

(*SHRUG*)

“I would add, that this has a very dramatic impact on the cost of the insurance for specialty and facility care. The two biggest impacts are on administration and insurance costs. Relative to administration, by doing a paperless primary care model, more than 80% of the claims/admin/paperwork is eliminated than a comprehensive insurance plan. Admin costs are further restricted, because the claim payment is based on a scheduled fee, versus fee-for-service. I don’t want to get bogged down in this area, but by eliminating primary care claims, and administering a fee scheduled plan, administrative costs can be reduced to 6% from 20%. This alone can fully counteract the inflationary part of the cost of care.”

(*GRIN*)

L&W. Let me leave you with something hopefully more palatable than my constant “nitpicking” on your plan.

How’bout this… we institute “The Barker Plan” and then you start pounding the pavement looking for investors to start up “Live and Win Clinics, Inc.” and I’m sure Americans will flock to you.

(*WINK*)

No. Seriously! I’m NOT being a wiseass. I’m being serious. Just as under my plan Americans would be free (and be WISE) to utilize “groups” such as as Kaiser and Cleveland, so too would it make sense for them to spend THEIR money utilizing YOUR ideal facility.

L&W. When you think about it… our two “plans” are more complimentary than in conflict.

(*WINK*)

BILL

Bill, I do appologize. I have been in theoretic mode for so long on this issue. I am eager to run my proposal around the block. But theory has to meet reality…

Kaiser is not all that different from Cleveland Clinic and other well regarded, low cost, high quality operations.

And of course, in my paradigm, specialty and facility care is private where insurance plans, similar to medicare supplements (highly regulated, uniform specific plans from A-F).

As I pointed out, if you wanted to hire a primary care physician to serve the needs of you and 1999 of your neighbors, the cost of the salary is $6.25 per person per month.

I know this isn’t what YOU want, but I am certain if I tried to sell this, I would have a lot of people who would much rather pay $6.25 per month and never have to be concerned about access or cost, than the alternative.

I would add, that this has a very dramatic impact on the cost of the insurance for specialty and facility care. The two biggest impacts are on administration and insurance costs. Relative to administration, by doing a paperless primary care model, more than 80% of the claims/admin/paperwork is eliminated than a comprehensive insurance plan. Admin costs are further restricted, because the claim payment is based on a scheduled fee, versus fee-for-service. I don’t want to get bogged down in this area, but by eliminating primary care claims, and administering a fee scheduled plan, administrative costs can be reduced to 6% from 20%. This alone can fully counteract the inflationary part of the cost of care.