Health Insurance

This morning reports of John McCain's health insurance reform ideas were all over the news. The idea of an open market seems capitalistic, and fitting for a democratic nation, at first glance. Open market on the professions, human condition careers and their supports. What a novel idea, I would like to explore that concept a little bit further. Lets examine the idea from the perspective of the insurance company, health care providers, and the patient using the who, what, when, where, how and why format.

Health Care Insurance Companies:
Who: Insurance companies present and those to be formed dealing with health care payment.
What: Health insurance will take money from members and purchase the care responses based on the member's level of membership.
When: This could take years to implement.
Where: United States, nation wide, not regionally.
Why: Uninsured patients are draining our medical cookie jar. Uninsured patients include people in the country illegally.
How: U.S. Government would give employer's health insurance payments directly to the health insurance company designated by the patient. Employers would no longer be the health insurance provider for employees. Patients would be independent consumers mining available health insurance providers for the most protection for the dollar. This would put pressure on the insurance companies to keep costs of memberships low.

Health Care Providers:
Who: Facility owners, facility supporters and direct care providers such as doctors, nurses, dentists, psychiatrists and others.
What: Dollars would come from Health Care Insurance Companies instead of the many money streams currently in place, including the Federal Government. Facilities would be directly beholden to the insurance companies.
When: This could take years to develop a system and put it in place.
Where: All of the United States as one.
Why: To standardize the quality and quantity of care and payment for that care as a patient driven and insurance company centered model.
How: This is a good question. How would the providers and the support system function under the patient driven model?

The Patient:
Who: The patient would decide on the insurance plan right for him/her and the family. Insurance companies, which would still strive to realize the maximum profit possible, would probably structure a multiple level care program approach.
What: The patient would decided on the plan based on their need and ability to pay for the extras. I would imagine the tiered membership would begin with the basics for check-ups and proactive items paid for, but radical procedures would not be paid for under the plans, without additional payment. Insurance companies have the data to study which ailments are common and which are uncommon and would structure a membership accordingly.
When: This is any one's guess.
Where: Everyone, no matter the geography or environment, would have a certain number of dollars to spend from the U.S. Government for health care insurance. I wonder how long a rural clinic and hospital would remain open and operational if there were not the people around who would maintain the facility. Would this lead to dis entitlement? Something to ponder.
Why: People, under this system, would drive the market. A market driven health insurance system partially or totally paid for by the government's direct pay of premiums to the insurance company. Did I get this right?
How: People would be able to decide which health insurance company would receive their health insurance dollars. Employers would no longer take part in the health welfare of employees, that responsibility would fall to the employee. For example, a farmer, who never did work for an employer, who never received government subsidy for employee health care, is going to be responsible for providing his/her own health care. How is this a change for those who are the bravest of our workforce? Are we going to expect the patient to know actuarally what they can expect to need care for? Are we going to expect the patient to know the language well enough to know what they are purchasing is what they will need?

I have some nagging questions. Will this lead to health care providers cow towing to insurance companies? Will such a system curtail research? Will this system turn insurance companies loose to know and manage everything? How will this help those who have no money to pay for insurance or are geographically or functionally distant from services?