My Healthcare Plan

On July 26th of this year after pondering healthcare for some time I produced the following tweet:

My healthcare plan: Preventive Care--everybody, Core Care--insurables, Expected Care--not easily insured, Elder Care--quality of life at end

Here is a post explaining in detail the plan, which is tiered:

1. Preventive Care--the value of free preventive care for everyone is one of the least debated critical elements to a solid healthcare plan. The tweet notes that everyone is included.

2. Core Care--Health insurance companies get a lot of heat for trying to only insure healthy people when from their perspective that makes sense for profit, which is a huge issue which has created a lot of pain and misery.

This plan suggests that you can turn a negative around and see healthcare companies as being adept at figuring out people who are likely, or "expected" to get ill at some point, so that they can get help NOW, while allowing health insurers to still be for profit when it comes to the healthy, who would make up the Core Care tier.

So they are the insurables--those who are currently in healthcare plans now. For them, little would change except preventive care would now be guaranteed free.

3. Expected Care--Here those selected out as likely to become ill or who are currently ill who no longer are easily insurable under normal plans are now in a government paid for plan that is third-party administered by the health insurers.

So everyone gets the same health insurers, but those who are part of the Expected Care tier are third-party administered and the government pays for their care.

They pay premiums to the federal government, not the health insurer. If you're in Expected Care you get a bill from the federal government, not the health insurer.

Health insurance companies are then rewarded for figuring out which people are likely to get sick later and properly placing them in Expected Care because the government pays, and we're all benefited as they can get proper care as soon as possible. The health insurers now become part of the first line of defense for detecting those who need help!

But whether you're in Core Care or Expected Care you carry the same insurer's card and the only difference is with payment: If you are Core Care and get ill, your insurer pays. If you are Expected Care and get ill, the government pays.

4. Elder Care--Is the final tier handling issues specific to the elderly with an emphasis on quality of life at end. It is also a government paid tier.

-------------------------------

One critical feature of this healthcare plan is that it rewards health insurance companies for being businesses by putting their strengths to public good. For instance, an obese smoker with a history of hypertension in his family might find himself put in Expected Care, which could be a wake-up call in and of itself. But it also means he is at risk, and healthcare workers can focus on the specifics of that risk simply by noting into which tier he has been placed by the experts who need to get it right to survive.

If healthcare companies do a great job, then their profits come from the healthy--by them remaining healthy. Those with underlying conditions are not discriminated against, and have the same health insurance carriers, who for them are third-party administrators, with payment for claims coming from the government.

Some might still worry about discrimination against those ill or likely to get ill, but it has a built in protection.

To understand the beauty of this plan imagine healthcare insurers put all the people who are sick or likely to get sick into Core Care, and all the people who are healthy into Expected Care, then what happens?

They pay to their coverage limits at a much higher rate, while the government pays at a much lower rate as its Expected Care population remains healthier than expected, so there is a natural check-and-balance built into the system, rewarding for-profit companies for proper selection and punishing them financially for getting it wrong.

And that is the expansion of the 140 characters from the original tweet. It is exactly 140 characters as I needed every character I could use to get an entire healthcare plan in there.


James Harris

RealNetworks against the MPAA

Link above goes to: Geek.com

Quote from the Source:

Real says Hollywood is a cartel, trying to kill DMCA Fair Use
May. 18, 2009 (8:11 am) By: Rick Hodgin

The ongoing legal battle between a group of Hollywood movie studios and RealNetworks stepped up a notch. RealNetworks filed a countersuit against the DVD Copy Control Association (CCA) and all major movie movie studios claiming abusive use of power....

The story here is amazing as it's hard to comprehend exactly why there is such a battle in this area, and I like the article I'm linking to, as it puzzles over the same issue and ultimately offers some conspiracy theories.

I know, I know, people tend to dismiss conspiracies, but what if they DO exist?

I have a personal interest here myself as I produced an idea I call Digital Media Equipment Self-Encryption or DMESE for short, and introduced it on one of my other blogs near the end of January 2007.

I gave it away as open source and have since discussed it on that blog and on this one, including a post which addresses a concern I've seen mentioned in press reports about the ongoing court battle, which I called completing DMESE.

Now that post was back in early July 2007, and handles the issue by having the system ask for the DVD that was copied, again, after some period of time like 30 days to try and ensure that the DVD was purchased by the user and not borrowed.

So nearly two years ago I had a solution out on the web that answers the objection I've seen reported as the main plank of the case against RealNetworks with its copying software, which I should mention has a component that is shared with my DMESE which is that the copy is encrypted, which is where the "self-encryption" part of DMESE comes into the equation.

I'm not saying that RealNetworks used DMESE (as if they did they'd need to attribute the idea to me as that's what open source means, free, but say where you got it from) and it's a simple enough notion that I don't think that is an issue.

But consider a massive court battle costing millions of dollars and involving such massive use of resources for a problem I feel confident I solved, almost two years ago.

But would anyone pay?

I've been promoting this idea of actually paying for content, like a really good news article, after you read it, as only then do you know that it's worth paying for, and I think a natural issue with the idea is, would the average person pay?

And I think the simple answer is, no. But this idea is not for average people.

I call it Pay Back Value, and it's simply acting on the web like one would at a high end restaurant--you consume first, then you pay.

However, there are two types of people in the world: those who would pay without threat of punishment, and those who would run out of restaurants without paying all the time if there were no such threat.

The ease of distribution on the Internet means that you can market to the first set, and not worry as much about the second as unlike with a restaurant where the food has a higher reproduction cost, on the Internet, there is little cost in reproduction (production costs remain high!!!) so limited loss from the theft!

Electronic distribution and reproduction is cheap--buying, preparing and cooking food is not.

Still you can get a herd problem where even people who want to pay, feel stupid about paying if there is a perception that no one else is paying or that most are not, so the idea actually gives you the ability to identify people who deliberately steal value, and credit cards can help explain how it works.

You get a credit card, right? But what if you have no intention of ever paying?

When will the credit card company know?

Ans. When they send that first bill and you don't pay it.

What if you pay part of it, or pay for a while just to build up credit and then quit paying?

Isn't that reason for credit card companies to never issue credit cards?

What are they thinking!!!

Similarly to credit cards, you let people sign up for something that gives them content without them incurring upfront cost, on the expectation that they will pay for what they value, and if they don't pay, you find out after some time, like a couple of months.

Then you can stop giving them the content.

I like using the New York Times as an example, as last time I checked they have people sign up now to see articles on the Web, but you can see them for free with no ability to pay later.

Say they institute this concept. People can PBV--pay back value. Like there's a PBV button on the bottom of the page after the news article or column, you can hit that button and pay a dime or something, or if it didn't seem worth it to you, move on.

No payment, no penalty.

Hypothetically as I have no idea what the numbers would be (but psychologists should be interested!!!) they find that 20% of their users pay back more value than if they bought the physical paper and do this month after month, 40% pay back regularly--I know I said above the average would not pay but these are Times readers!!! I'm assuming a higher class of people--and 10% pay intermittently, while 30% do not pay at all.

At their discretion they can block members of the 30% who do not pay from their site, for instance, if someone is reading article after article, day after day, and giving nothing in return, they might simply cut that user off.

Also they can look at the content people across the board are clicking on and buying or not buying, and using regularly paying users as a benchmark for the real value of the paper--kind of a mark to market with content--get an accounting of their losses from theft of content without paying.

For the first time, they can get a real monetary number compiling losses, and have the ability to weed out people who will not pay, and they can reward that top 20% who regularly pay, so most importantly, they regain the ability to reward their best customers.

Quite simply, only then does the Times become a business again.

Free is not a business model.

I have no doubt that paying later will eventually dominate the Web as it's how we do most of our buying in the real world. We rarely if ever pay upfront without being able to thoroughly check for quality.

So the remarkable thing is that the Internet is backwards!!! It's not that the Internet was so advanced that money doesn't work any more.

It's that it's a laggard to how people actually do most of their buying in the real world.


James Harris