1.     Third-party payments introduce unavoidable temptation to “rig” the system.

2.     No discipline/no incentives by any party within the current system.

3.     No monitors as to cause and effect (flaws in the system).

It is a haphazard system run amok.

EMPLOYEE RELATED:

1.     Develop health savings account.

2.     Employee must share cost to share problem.

3.     Each insured is given a health “ranking” of controllable criteria (such as smoking, overweight, addictions, etc.).

4.     Adopt a complete (database) health history–make records available to authorized medical personnel.

5.     Adopt cost of insurance benefits to health ranking earned by the patient.

DOCTORS :

1.     Public disclosure of primary treatment cost

2.     Invoice patients directly (include cost details without a code) plus service charges (representing operating costs or other hidden costs, i.e. welfare contributions) and in a common format.

3.     Prompt billings (30 days), under the standardized detail format. Collect from client and insurance company with a stated ratio of payment allocation.

4.     In private, issue health profile to patient and recommendations to improve.

5.     Patients should be encouraged with incentives to better their health. They should not be rewarded for acting stupid and expect the cost to be paid by others.

6.     Cure tort problems (i.e. frivolous malpractice suits).

HOSPITALS:

1.     Board of Directors need independence and should have representation by the parties contributing most of the cost.

2.     Adopt uniform billing allowances chargeable for routine redundant practices (probably need antitrust waiver because hospitals would have to discuss the allowances among themselves). Issue public reports in an adopted common format.

3.     Monitor and profile of performance at State level.

4.     Adopt computer storage and records on file per patient.

5.     Cure tort and shakedown practices (i.e. attorneys threatening hospitals over dubious claims with full intention of settling out of court).

INSURANCE:

1.     Adopt uniform billing allowances (need antitrust waiver—see above).

2.     Adopt computer health file per client.

3.     Encourage antitrust enforcement against illegal practices within the health care system.

4.     All premiums and costs by insured categories should be a matter of public record.

CORPORATIONS:

1.     As with all investors, companies with employee benefits deserve representation on hospital and insurance boards to an extent relative to their underwriting of hospital costs and investors.

2.     Companies should promote incentives for employees and encourage better health habits.

3.     Companies with health benefits should rightfully assume responsibility for monitoring health insurance related to doctor and hospital billing practices and systems.

4.     Health insurance has taken on a socialist approach. We are on a dead end path. Streamline for better structure, management, etc. and incentives all through the delivery system.