Healthcare: The Hybrid Model

Target KPI: LYI-Health ≤ 0.6 years of median labor for essential annual family care.

The current U.S. system is a festival of rent extraction. Example: A benign tumor removed in <60 seconds. Doctor charged $400. Surgical center charged $35,000. Blue Cross sent a $150 reimbursement check. The surgical center settled for $150.

That $35k is pure facility-fee ransom - propped up by billing rules and insurer collusion.

The South Korea Model (What Works)

We lived there for 6 years. Had a baby. Great care. Only really paid into national health insurance.

• Universal contribution: Everyone pays in via payroll deductions
• Single national payer: Collects contributions, pays claims at set rates
• Mostly private delivery: ~90% of hospitals/clinics are private, but contracted at the national fee schedule
• Volume, not margin: Providers make money through patient throughput, not monopoly markups
• No $35k facility fee nonsense: Can't inflate charges above the fee schedule

Our Free Market Upgrades

1. Site-Neutral Payments

Same CPT code = same pay, regardless of setting. That $35k collapses to $400-800.

2. Ban Facility Fees Off-Campus

If a doc can remove your tumor in 60 seconds in an office, the reimbursement is the same as hospital.

3. Doctor-Owned Risk Pools Only

Ban commercial insurance unless doctor-owned mutual. Aligns incentives: docs profit by keeping people healthy, not by denying care.

4. No Medical Debt Credit Reporting

Same logic as education. Bills can be collected, but no state-backed financial hostage-taking.

5. Catastrophic Reinsurance

State/federal pool covers >$50k events. Allows doctor-mutuals to survive without overpricing.

6. Real Price Transparency

Machine-readable prices with teeth. Private right of action for violations.

Office-Based Procedure Authority

Allow licensed physicians to do low-risk, short-duration procedures in accredited office settings. Safety protocols can be codified without requiring $35k overhead.

Effect: The real provider sets the price. Patients stop subsidizing idle ORs.

Expected Outcomes

• Admin load: 15-20% → 5-8%
• Outpatient prices: ↓ 30-50%
• Drug net costs: ↓ 15-25% with PBM pass-through
• LYI-Health: ~1.0-1.2 → ≤0.6 in 4-6 years