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You are on the right track as a physician who is speaking out about the broken state of American health care. But I am puzzled by your apparent statist solutions. Government, whether local, state or federal is not the answer and I would submit are 1/2 of the problem of American health care. The answer is to restore the physician/patient relationship directly. Consumers should pay physicians directly for their services just as clients pay attorneys directly for their services. For catastrophic illness or emergency care, a catastrophic policy could be maintained much like a term-life insurance policy. 3rd-party payers should be eliminated as should Medicare. One group which has some experience regarding my post is the AAPS - American Association of Physicians and Surgeons.

What are your thoughts about a system where in one could buy and sell their HSA money in an open market voucher system, much like EBay's auction system. If you are young and healthy and don't want to send your $4000/year in premiums to an insurance company. Instead you buy a really high deductable HSA, to the tune of $20,000 or more, to really get the essence of catastrophic insurance.

I envisioned a corporate healthcare voucher system where in a set amount of health care dollars would be given to employees, in voucher form, to be used for health care costs in any way they choose. The employer would not provide insurance, they would provide vouchers. Say $4000/year. These vouchers would carry a 5 year life span, at which point they would expire.
In this system, I imagine the buying and selling of these vouchers in the open market, an ebay type system. If my unused vouchers will expire, and I have $10,000 built up, I can put them up for auction to the highest bidder. Of course, they will go dimes on the dollar. Instead of my $20,000 in premiums over 5 years going to an insurance company, it would be paid to me by my employer as a voucher. I can then choose to use it or sell it at auction.

It would be up to the patient/ employee to buy their own HD insurance plan. It could potentially cheapen the cost of insurance and remove a massive amount of first dollar health care from the insurance companies coffers, and into actual health care service.

Just some thoughts.

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