Saturday, May 18, 2013

The Other Side of Healthcare sidesteps all the Social Security and Medicare debates because we recommend that everyone's basic needs be taken care of and accounted for. Part of the problem in fact is that these are special programs for favored sub-populations rather than general programs to care for all the people. They are discriminatory by design and therefore are fundamentally broken. That explains why they keep failing and why we have to keep fixing them.

There will be no need for Social Security and Medicare in's vision of the future because everyone will get those benefits anyway. There will be no "work age" or "retirement age" because people will be encouraged and led to do what they can do no matter what their age. It seems likely that mental inactivity and physical inactivity lead to premature aging and death anyway, so we want to discourage the whole concept of retirement in the sense that people become inactive "lotus-eaters" when they retire.

With regard to healthcare alone, we can remove a lot of waste from the system by the use of exclusive currencies. Neither Medicare nor health insurance will be necessary any longer because everyone will be taken care of. By one mechanism or another, everyone will have enough internal money to pay for their healthcare.

In's view, health insurance – any health insurance – is poorly structured. For comparison, auto insurance is about accidents, but health insurance is about certainties. Individuals may or may not have auto accidents, and the accidents may be more or less severe. There is a lot of chance involved.

In contrast, it is certain that the health of every individual will decline over time, ending in death. Therefore "health insurance" is not really insurance, it is an attempt to pre-pay for the certainty of ever poorer health with age. This distorts the healthcare market because pay and fulfillment do not occur at the same time. That is the basic problem with the American healthcare market. Healthcare providers know how much is already "saved up" to pay them, so they have a negotiating advantage at the time of delivery. They charge enough to use up the "savings" and then charge a little more. Thus no matter how much we save for healthcare, we will always have to spend more than we save. This is the reason why healthcare costs keep going up.

Instead wants the people themselves to pay for their healthcare at the time of delivery. They will have enough money because their healthcare will be paid for in an internal currency. Even so, people will be more careful about what they buy when the money comes out of their account. It is money that they might otherwise spend on something else.

Under the system, doctors and hospitals will once again be directly responsible to their patients. Furthermore, they will not have to waste time dealing with insurance bureaucracies.

Another important element is time for the people to take a greater role in managing their own healtcare costs. This is related to what we already suggested in Life on The Other Side, that the people would be given more time to participate in the political process. Regarding healthcare, the people would be given time and help to deal with the healthcare market. The help is as important as the time, because many people will need help to decode their healthcare bills.

Finally, the poor will not have to compete directly with the rich for healthcare because they will be in different markets. The rich can fend for themselves in the external, international markets. Government agents for the internal markets will also buy healthcare resources in the international markets, but in very large quantities and with collective purchasing power. They will be able to provide the most healthcare possible for the internal markets and at the lowest price.

Healthcare providers themselves will have to deal with the restrictions of exclusive currencies. They need to understand that from the start. Let us take the case of doctors, for example. Right now there are government programs to pay for medical educations in return for promises to practice in underserved areas. These programs do not work very well because it is hard to enforce the promises and the doctors are paid in international dollars.

These programs would be easier to enforce if doctors were paid only in an internal currency. Their ability to bypass the system would be reduced because they could not move their internal money into any other market. Exclusive multiple currencies prevents it.

In their favor, however, and somewhat in compensation, doctors would also graduate from medical school without enormous debts. Their educations would be paid for with an internal currency from their own educational funds. Provision for physician training would be part of the mandate of government agent buyers of healthcare resources. Internal-market medical schools would also be built and run, so it should be possible to train more doctors than the current system.

Internal-market hospitals would be funded the same way.

The buying power of almost an entire nation will be able to get much better deals for healthcare goods and services than we poor individuals, each working alone. Those savings will be passed on to us in the translation between the external currency and our internal currencies. The distribution of the internal currencies will be made in a way so that everyone has enough to pay for their own healthcare.

This is why we see the Affordable Care Act (the ACA, also known as ObamaCare) as doomed to failure from the start. (Note that we could only explain this after an introduction to our idea of The Other Side of Healthcare.) The provisions of the ACA will fail because they are chained by the single U.S. currency. The single currency makes the ACA a servant of the rich, not the poor, with new taxes that will make us poorer. Without collective purchasing power to get the best prices and without currency separation to pass the discounts on to the poor, the result will ultimately be less healthcare for the poor and ongoing exposure to business cycle extortion. The ACA sets up one giant hostage-taking organization (i.e., holding our healthcare hostage) that will be used to squeeze ever more money out of the government and the poor to the benefit of the rich.

It is time we understood that the concept of health insurance is fundamentally flawed. It distorts the healthcare market and encourages healthcare cost inflation. Instead we need multiple exclusive currencies and markets so that healthcare can be purchased in bulk for the many and the savings passed on to the poor through the distribution of internal currencies. Wasteful healthcare bureaucracies will no longer be needed. Those personnel can be transferred to new bureaucracies for large-scale healthcare purchasing and for helping the poor keep from being cheated on their healtcare bills (patient advocacy).

Doctors and hospitals will be directly responsible to their patients because those are the ones who will pay them. They will also be able to spend more time on healthcare because they will no longer serve giant bureaucracies.

This cannot happen without multiple exclusive currencies and markets because under one currency, the poor will always be competing directly with the rich for healthcare. It is time to "level the playing field" and make the rich compete against the collective poor.

The way capitalism should be.

Socialism for the socialists and capitalism for the capitalists.

TheOtherSideOfCapitalism (

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