This was my first post on my other blog titled, New Health Care for America. I am republishing this here because this is a different audience. It is intended to start discussion.

To start my blog about fixing health care I thought I would start with just making some comments that in my heart of hearts I believe to be true. These are random thoughts but my thoughts. Anyone who wants to add to them feel free to jump in.

Most Americans want everyone to have access to health care.

Providers of care, generally care. They want to do good.

Our chaotic pricing of health care is caused by our financing model. Everyone has a deal, and everyone is trying to push the cost onto someone else.

Our health care financing system is the cause of escalating health care cost. Fix health care financing and you will reduce health care costs. The insurance industry thinks it is the other way around. I disagree.

We will never fix the system until the incentives are properly aligned. Providers of care need to be rewarded for keeping people healthy and being efficient.

Employers don’t want to be in the health insurance business. Most would get out if they could.

Employers are blocking access to higher quality and more affordable health care. I will write about this one. 

I can lower my own costs easier than my employer.

Health insurance should not be tied to a job.

I want all my health care information in one spot.

Artificial Intelligence can possibly save my life. However, it can’t work if my data is scattered all around. 

I want my doctor to have all my health care information so he/she can properly advise me.

I don’t want my employer to be involved in my health care. 

I want my doctor to be incented to keep me healthy.

I am never going to understand how the whole system works so it better be easy or I need someone to guide me through.

On second thought, it should be so easy nobody would need a guide. 

When people have health issues, they don’t want to be worrying about how to navigate the system.

Low cost care, like office visits and tests, should not be insurance. Insurance is designed to protect oneself from an unanticipated event that could cause long term financial harm.

Health Spending Accounts are a good idea.

If the government wants everyone to buy insurance, then it should be with pre-tax dollars for all.

Everyone in the system thinks the other guy is ripping them off. Health insurers blame the providers and the providers blame the insurers. The brokers blame everyone. People should look in the mirror. 

The whole country can run on 10 health insurance options.

Revision – after talking to some people, I think we only need 5

Fee for service needs to go away.

Price transparency is a feel good, bad idea. It won’t fix anything. Which is why fee for service needs to go away.

Health insurance should not be a 1-year term policy. You insurance people know what I mean.

Health insurance should be a whole-life policy.

As long as we have rules that let people game the system, they will.

Employers are dumping their bad risks into the individual market if they can. This is one of the games.

The government is the biggest driver of escalating costs through tax policies.

Most health care dollars pay Americans. If we reduce costs 20%, who is losing?
I think we can reduce administrative costs to around 5%-7% but not under the current system.

Everyone should watch Mark Bertolini’s presentation to the Mayo Clinic. He presents the future of health care.


  1. Hi Joe, I agree with most everything you said. It seems the carriers will bust the under 50 market for those that don’t qualify for level premium funding. Basically, thrusting those employers onto the individual platform and thus, ICHRA. Although I did read somewhere (NAHU?) that Biden administration isn’t a fan of this. Any thoughts? Always enjoy your blog posts.


  2. I think the ICHRA is consistent with ObamaCare so I think Biden will either support it or try to move even farther towards the individual market. In the short term it is up to the States to start and try to shore up the individual markets. In MA the individual rates are very competitive. In FL, not so much. I still think group is very broken and even having to do level funded is simply trying to “beat the system.” I sold $100 million of level-funded in the early 90’s and know that it will run its course.


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