Addressing healthcare issues in a NewVistas community is eased by the fact that we are starting with a skilled population, who are largely pursuing their passions and living a lower-stress life than most people are today.
NewVistas participants will have quality food readily available and unprecedented access to physical fitness resources, personal training, and various forms of healthcare service. In general, participants will have a lower exposure to environmental harms of all forms.
A NewVistas community population is not burdened by commuting and other disadvantages of sprawl, and they have the learning and work opportunities, solvency, social network, and other benefits necessary to keep them fulfilled. The propensity for improved health is further advanced by the reduced career and lifestyle stresses of NewVistas living.
A NewVistas community would be able to meet community medical needs were the community to be financially or otherwise distressed. But in ordinary circumstances, a modest self-insurance plan and a well-coordinated community will be able to address medical needs to a far greater extent than we can today.
Among other problems, excessive healthcare costs worldwide can inhibit individuals from procuring the products and services they need most.
The community-based organizations working in healthcare operate under the same principles as others in the econosystem, including balancing their purpose and profit objectives. This eases the work of the community trust in ensuring the population remains in good health.
Insuring against threats to health will still be necessary to ensure ongoing sustainable development of the community.
But the cost of insuring is reduced by the lower risk posed by the insured population. The cost is further reduced by the lower cost of acquiring quality healthcare goods and services.
The Trust can best recognize that reduced risk, and can safely and affordably protect against that risk, through a captive insurance program, which means the insurance program is required as part of community membership in order ensure sufficient volumes.
The premium is paid quarterly, or deducted from your community dividends. There will be no pre-existing condition bars to coverage, whether this is required by the jurisdiction or not.
HSAs, Insurance Limits & Crowdfunding
The captive insurance program is structured to incentivize individual responsibility for looking after one’s health, while also encouraging participants to recognize the value of the health and wellbeing of fellow community members.
Each resident will have a health savings account (HSA), where they can keep untaxed income for medical use. NewVistas will provide coverage after a $10,000 deductible has been reached.
The higher deductible is in place because residents will be able to afford it if necessary, and rather liberal use of HSA funds is allowed. Residents are simply encouraged to emphasize a healthy amount of preventative healthcare purchases over other uses of discretionary funds. It also encourages them to keep their HSA account replenished, which can also be used to help other community members.
Once the deductible is reached, the community captive insurance entity will provide up to $50K of additional eligible medical costs.
Medical goods and services within the NewVistas will be more accessible and more affordable. A large-scale hospital will not be necessary, as all the community medical equipment will be located around the NewVistas and made available at affordable rates.
Small clinics can be set up and appropriate equipment brought in when needed. Healthcare organizations and sole proprietors will often be supported by the Trust on more favorable terms.
After the $50K of insurance funds is used, a NewVistas resident must rely on family and friends. Residents are welcome to buy insurance policies from insurers within the community or elsewhere.
But crowdfunding devices would be even a more common way to raise money for the gap in coverage. Ideally, community members have more-than-sufficient HSA funds and discretionary income, and there are no instances of someone passing who wanted care but couldn’t get it covered.
If needed, NewVistas would have the flexibility to consider a policy with a higher cap and an appropriately adjusted premium. But a repeated message in NewVistas is the fact that one resident’s well-being has value to many others, and residents will likely make big efforts to preserve that value where possible.
To the extent a handful of residents need to exceed the allotted $50K, enough members of the community should be able to address the issue with a modest portion of their unused HSAs, and without much inconvenience to their lives.
Diagnostics & Preventive Goods and Services
A NewVistas resident will also benefit from the various NewVistas healthcare resources, including the information systems available. There will be diagnostic equipment integrated into homes and businesses throughout each community.
NewVistas is close to bringing a toilet to market that will be able to make a remarkable number of diagnoses using small amounts of human waste. Mirrors will be able to track critical visual health factors, such shifts in size and skin tone.
All this healthcare information, along with information generated in other healthcare interactions, such as visiting the doctor, will be stored in a private patient record.)
Much like the education system tracks information about instructors, the reputation record of healthcare professionals and organizations is maintained to ensure quality.
This all minimizes the chances that insurance needs to be used, and ensures that the $50K goes a long way if any catastrophic incident requires the full coverage amount.
- See Michael Blanding, Forbes, Workplace Stress Responsible For Up To $190B In Annual U.S. Healthcare Costs, http://www.forbes.com/sites/hbsworkingknowledge/2015/01/26/workplace-stress-responsible-for-up-to-190-billion-in-annual-u-s-heathcare-costs/#285da7824333.
- See Atul Gawande, The New Yorker, “Overkill,” May 11, 2015 (exploring the causes of inflated medical costs).
- See Robert Book, Forbes, How to Cover Everyone With Pre-Existing Conditions Without The System Collapsing, http://www.forbes.com/sites/theapothecary/2016/11/13/how-to-cover-everyone-with-pre-existing-conditions-without-the-system-collapsing/#2bec17a741d6.
- IRS rules currently only allow use of HSA funds for a spouse or dependent. The captive insurance program’s authorized HSA uses, which may go beyond those of taxing authorities, will still be incentivized by the need to reach the deductible, and will not prevent IRS treatment as income.
- A blockchain data system will likely be used because of the level of security and data integrity it offers. See, e.g., Tierion, Blockchain Healthcare 2016 Report – Promise & Pitfalls, https://tierion.com/blog/blockchain-healthcare-2016-report/ (last visited Dec. 6, 2016) (“Key characteristics include no central point of control, high availability, strong data integrity, and network-wide consensus.”