You want a policy that will force health care to work? Fine. This will work.

All licensed medical third-party payers must publish a public, free, unrestricted web service from which anyone can simulate any and all medical insurance decisions. These insurance decisions include:

• Determination of coverage and all policy purchasing qualifications
• Premiums, co-pays, deductibles, and all other payer financial details
• Reimbursement per submission, necessary medical documentation and justification, and all other medical provider-submitted details

No health insurance decision can be executed that cannot be publicly simulated via this web service in advance. Any simulation can be authorized by a patient policy holder and medical provider to become an executed health insurance decision. All documentation necessary to simulate all possible decisions must be published on a public, free, unrestricted website.

Each submission optionally includes a simulated date of submission. The web service will return the decision as of that date. In effect, one could map a decision given a submission from now each day back until the date of service implementation. Submissions without a date specified will be assumed to be for the current date.

Any health insurance decision that does not comply with this policy is grounds for a declaration of Policy Corruption by the federal government. Continued violations will result in the forced restructure of the third party payer. This restructuring will resemble an FDIC restructuring an insolvent bank, including a federally-insured ceiling policy in the event of an insurer failure.

Simply: given this submission, what do you do? In a payer contract, any inability to give an absolute answer to this question immediately can only be for two reasons:

• flagrant incompetence (bad)
• fraud (bad)

Why would there be any ambiguity? Think: there is no medical decision making. There is no clinical participation. There is no interaction with patients, the human body, or the environment. It’s simply: discrete data in, discrete data out. And: SOMEHOW decisions are being made. Are these decisions made by:

A) a consistent, understandable, fair, contract of discrete cause and effect? (good)

or

B) “some guy” making some arbitrary decision about who gets what whenever? (bad)

Because if you want A (good) and not B (bad), this test enforces it with an obvious true / false test without divulging trade secrets or private health information and without snowing regulators. (i.e. the Law and Order “we’ll fill your office with boxes of incomprehensible paper forms —that will teach you to mess with the Bureaucracy!” trick) And there is no need for new regulatory committees, laws, and policies. Any medical provider could very simply verify the integrity of the system: here’s what we submitted, here’s what you said you would do, did you do it? Y/N.

Further, it solves the incentive to health care providers to submit their claims electronically, and it stimulates entrepreneurs to build high-tech businesses using the new wealth infrastructure.

And finally, it’s a policy that can actually be DEFINED and ENFORCED to create real WEALTH and directly SOLVE THE PROBLEM of modernizing American health care by empowering the public with concrete data and services —rather than some vague and useless policy like “it is illegal to be inefficient, and you (somebody?) must complete all these forms to prove it.” That crap only makes more Yahbles. Yahbles are intellectual toxins that gradually weighs us down and makes our institutions sick. The Solid State health system clears the air and plants seeds of innovation and productivity.