What if we, as a nation, had an adjustable healthcare program? It would be structured like a PBM but put short, you would only pay for what you use, and all plans would cover health, prescription, dental and eye costs. Say John Doe has hypertension and is far sighted. There's really nothing else wrong with him. He's 45 years old, in decent shape and has a wife and 2 kids. His plan could be Plan A (Low Risk). This would involve an annual dental cleaning, maybe new eyeglass lenses every 1-2 years, contact lenses every 6 months, and medication copays that don't rob them blind. Perhaps a tiered plan where Tier 1 through 3 have copays of $10, $25 and $50, respectably. Doctors visits may be priced according to codes billed. I'm not too savvy on coding so this would be someone else's department.
You get me? What do you think? Have any ideas?
