Quote:I didn't watch the debate so I can't comment on it directly.


I think the biggest problem is that most people don't understand the concept of insurance vs. healthcare. Insurance is supposed to be there to cover an unexpected or catastrophic event. It wasn't meant to cover routine doctor visits, birth control, etc. That's why people used to buy health insurance and why employers used to offer it as part of a benefits package along with life insurance, long/short term disability, etc.


It wasn't until the 1970's that HMO's (Health Maintenance Organizations) came along that provided routine care at a fixed price for customers that was pre-negotiated with health care providers. The way it works is that health care providers would offer a service for a less amount if paid by the HMO in return for driving more patients to them. Essentially HMO's are doing what people can and should be doing for themselves. Here's an example of how the system works.


Say a health care provider offers a routine physical in his office for say $100 (just to keep the math simple). If you walk into the office with "no coverage" and paid out-of-pocket it would cost you $100 for the physical. Now say the HMO and the health care provider make a deal that a physical would cost $80 if the patient was a member of the HMO. In return, the HMO added the provider to their "network list", so the provider is assuming that he will see more patients that belong to the HMO.


The HMO would turn around and charge the patient say $10 per month as a premium. They would also tell the patient that a physical exam would only cost them $20 and they are able to get one physical annually.


People will look at this and think "I only have to pay $20 for a physical rather than $100. That's a good deal". What they don't realize is, they are paying the exact same amount for their physical PLUS paying the HMO for the "service". The provider still gets his $100 = ($80 from the HMO + $20 from the patient). He also benefits from getting more patients.


The HMO on the other hand makes money two ways. The first way is that they are gambling that the patient, especially a younger one will not use the "benefit" and get the annual physical. If they don't then they just made $120 annually on that one patient (remember the premium that is charged).


The second way that they make money is even more simple. Remember the premium that the patient pays? $10 per month for a year = $120. If the patient actually uses the service and gets a physical, the HMO only has to pay $80 out of that $120 that it's getting so they still made $40 on that patient.


This is a very simple and crude example of what "healthcare" has become and how the industry makes the money that they do. HMO's have pretty much "merged" with health insurance companies that will provide "$5 office visits" along with coverage for a catastrophic event.


The way to fix it is to allow individuals to buy insurance to cover a catastrophic event, and allow them to save money on their own tax free to pay for their "health maintenance". One of the biggest flaws of Obamacare is making certain types of "coverage" mandatory even if a person will never use that type of service. A good example is birth control. Another example is "women specific needs" such as mammograms or pap smears.