This is a dovetail piece to Culture of Ineptitude.
We have, as a Nation, favored big business and large unions via restricting Nation-wide coverage to those businesses that have facilities and workers in all 50 States. Rep. Paul Ryan went over this and described how professional and industry associations with National membership (things like the American Restaurant Association or National Association of Barber Boards of America) could offer industry level pricing due to the membership being National in scope. This would allow small businesses to band together or use pre-existing industry organs to supply members with business health insurance that is standardized and accepts all entrants, just like Big Business.
The government mandate is stepping in-between small businesses getting treatment for their associations at a National level, and removing that mandate is a repeal of it by Congress to allow this to happen.
With that mandate gone the second set of groups with Nation-wide membership will also have the opportunity to do the same thing. Who are these groups?
In the blather we hear for reasons on Nationalizing or National control over health insurance the term 'pre-existing conditions' arises very, very often as a bugaboo. 'Denied coverage because of pre-existing conditions!' is how the howls go. Yet pre-existing conditions are defined risk pools with known ailments that have expected and normal courses throughout one's life. Here 'insurance' doesn't do so well, but a coordinated treatment plan system so that those WITH pre-existing conditions and KNOWN requirements for medications and procedures should be able to get price BREAKS because they can negotiate at a National level.
How would they do that?
Through the current voluntary patient advocacy organizations.
You know those: American Heart Association, American Lung Association, American Cancer Society, American Diabetes Association, Lupus Foundation...
Heard of those?
Their voluntary membership is:
2) Targets pre-existing conditions,
3) Covers the demographic risk pool of an entire disease.
Health 'insurance' doesn't really cover this, but known treatment types combined with risk analysis then garners known and expected outcomes and needs for future goods and services. These organizations have the power of their pre-existing conditions behind them and can negotiate the lowest possible cost for medications used by their members for their diseases and even give a good idea of how the overall course of medications is going, over time. This becomes not only a patient treatment system (where the patient cost for the coverage may be higher than normal, but the cost for medication and treatments far lower due to the shared, known risk pool) but an industrial feedback system to let the industry know how its work in new medications, devices and treatments is actually doing. Statistical demographic data is a gold mine that can be held by the PATIENTS to get the best PRICING from industry so as to get a lower COST due to KNOWN NEEDS.
Any set of laws that prevents American Citizens from banding together via voluntary medical organizations from getting tailor-made coverage for their conditions is nuts. Yet that is exactly what we have.
Even better is that these organizations can work with their patient community via donations or special fees so as to EXPAND this coverage to the poor. Make that a tax-deductible donation and you will see the sufferers of conditions helping the poor to get good treatment because they know exactly, and particularly, what it means to have that disease.
Further than that is these groups could easily cooperate between themselves to offer co-coverage for people with multiple pre-existing conditions so that they get the best coverage, treatment plans and price breaks possible for their multiple conditions.
No one can be excluded from pre-existing condition pools for having a pre-existing condition. They are set up to address those, in particular, and may even do things like offer price break incentives to those secondary complications that can be put off by living healthier lives and managing your condition better than you have. That is because these organizations are currently health information and teaching organizations who have a purpose in letting their members know of the best way to treat conditions, what you get by doing so and who to contact to GET such help in forming a healthier set of living conditions for your condition.
At this point the piecemeal removal of regulations that restrict competition gains far, far more rewards than does new regulations further restricting competition. Even if only a few million, say 3 or 4 get covered by small businesses, that is 3-4 million FEWER of the 'uninsured' to worry about. And if those who band together on a Nation-wide basis with pre-existing conditions can start to pick up those generally able to afford any insurance but have been refused general health insurance, then that is more millions to stop worrying about and a charitable system can help to address the poor with those conditions via known organizations designed to offer the best medical coverage and help for that condition.
The final thing the patient run associations can get, and it is the one place where there is absolute interest that cannot be gotten with today's system or any future government run system: spontaneous remissions of diseases for known pre-existing conditions.
These are the rarest of the rare, and hard to find in the general population for health care but extremely easy for those with such conditions as they are the ones who will have signed up for those plans. An agreement whereby if you have a spontaneous remission you get health care coverage FOR FREE so that you can be studied to find out HOW your body did this would begin to offer keys to unlock the most persistent and difficult to understand conditions on the planet. After 20 years there is a small chance of actual remission for Type I diabetes, as an example, and there have been reported cases of AIDS not only going into remission but individuals having no evidence of it after suffering from it for many years. How the immune system can stop attacking the body (as is the case with Type I diabetes and possibly MS and Lupus) or suddenly find the way to get rid of one of the most pernicious and adaptable of viruses (AIDS) may hold valuable keys to the entire understanding of our immune systems as a whole. Yet we currently scatter those keys and cover them up, because there is no concerted effort by PATIENTS to have these people agree to step forward in case their body contains the lottery winner of genetics for that disease.
Any government that could do that, on that basis, I would not want to live under as it would be so omnipresent as to stifle liberty and it would be controlling my life.
I would gladly do it for my fellow sufferers if my body pulled up the lucky winner. I've been through a medical trial for one of my conditions and came out far worse for wear, though not because of the test medications, strangely enough. I am far more interested in assuring the long-term health of my fellow citizens than in 'insuring' it.
Insurance means that, sooner or later, you come up with snake eyes.
Assurance means you get the best fighting chance to lead a healthy, long lasting life that is full of capability and attempts to put the secondary problems of a condition further and further into the future via better care and treatment.
And don't forget price breaks for good personal care of your disease!
Seeing long term test results that demonstrate good personal management and understanding of your own pre-existing conditions should be rewarded.