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In light of the ruling on "ObamaCare" that will likely come out tomorrow, I thought it would be a good time to discuss what we feel would be the best way to reform healthcare in the US.
I am not supportive of "ObamaCare" or of a single-payer system, though I understand why people favor both.
This would be my plan for healthcare reform:
1) Allow insurance to be sold across state lines, increasing competition.
2) Discourage employer-provided insurance. More people would be buying their own insurance and would be more aware of the costs. Competition would drive rates down and consumers would see how exorbinant the costs actually are and would force insurance companies to reduce their rates. Perhaps tax breaks could be given to individuals/couples, and not to employers, for buying insurance. Allow health insurance to be offered in more of a free market.
3) Shift co-pays more to an actual percentage of the costs, to provide further incentives for people to not use healthcare excessively.
4) Give incentives for preventive care.
5) Shift as much care as possible from ER's to clinics where costs are much lower. Require medium-sized and large hospitals receiving federal or state funds to have clinics open 24/7 in addition to ER's, or to refer patients to clinics nearby instead of seeing them in the ER's when possible.
6) Encourage plans with high deductibles to allow people to use insurance for only emergencies/unexpected costs.
7) Focus more on collection when uninsured people receive care at ER's and don't pay their bills. Obviously many of them cannot pay, but some can.
8) Reduce the term of drug patents from 20 years to 7 years. This would be long enough to provide an incentive to drug companies, but would allow much cheaper generic drugs to be used far more often.
9) Have high-risk pools for those who are high-risk who insurers are unwilling to insure.
1) Tell the AMA to allow more medical schools to open, or else risk losing their privileges. There is a huge under supply of medical professionals from the AMA essentially imposing scarcity to keep prices high for med schools, and salaries high for doctors. Not a single new med school was allowed to open for 20+ years. Our country has added about 100,000,000 people since the AMA started squeezing supply in the 1970s.
In light of the ruling on "ObamaCare" that will likely come out tomorrow, I thought it would be a good time to discuss what we feel would be the best way to reform healthcare in the US.
I am not supportive of "ObamaCare" or of a single-payer system, though I understand why people favor both.
This would be my plan for healthcare reform:
2) Discourage employer-provided insurance. More people would be buying their own insurance and would be more aware of the costs. Competition would drive rates down and consumers would see how exorbinant the costs actually are and would force insurance companies to reduce their rates. Perhaps tax breaks could be given to individuals/couples, and not to employers, for buying insurance. Allow health insurance to be offered in more of a free market.
I agree with the others, but would prefer a differnt tweak for the above. Adopt McCain's 2008 idea, tax employer Health Care as employee income, and give them a tax credit. He liked $7,500 single, $15k family. I'd prefer $5k and $10k, respectfully. Get employees to want to control policy costs via healthier lifestyle choices.
7) Focus more on collection when uninsured people receive care at ER's and don't pay their bills. Obviously many of them cannot pay, but some can.
Eliminate statute of limitations on collections, offering community service as a means to pay it off. This would encourage the solidly middle class who opt not to buy insurance to either opt in, or save via Medical Savings accounts for this "rainy day".
Eliminate statute of limitations on collections, offering community service as a means to pay it off. This would encourage the solidly middle class who opt not to buy insurance to either opt in, or save via Medical Savings accounts for this "rainy day".
Good idea. And thanks for bringing up the medical savings accounts. I completely forgot about them when writing my OP.
That would give drug companies incentives to cut corners/make medications more carelessly to reduce costs to maintain the same profits. It would reduce incentives to produce higher-quality medications. It would reduce incentives to innovate. Not to mention drug companies might lobby for the price ceiling to be raised.
So far I've only heard terrible ideas... What's missing are 1. a single payer system. 2. price controls for meds...
~16% of the American economy is healthcare spending....over 8% of that is private. Now, in a single-payer world with full access across the board you'd have greater consumption, and unless you offered the system through medicare advantage style plans (which I somehow doubt most single-payer advocates intend) you'd have far less cost controls built into the system, so, you're probably talking substantially more than 8% of the economy to pay for it, but, I'm going to go with the initial 8% figure for simplicities sake.
Now, our current GDP is $15 Trillion dollars. .08 * 15 = $1.2 trillion a year. Where the heck are you going to come up with $1.2 trillion a year?
To give some context, the costs of the Iraq and Afghanistan war are often estimated at around $3 trillion. So imagine doing a repeat of Iraq/Afghanistan where we pick 2 medium-sized countries at random to invade every 2.5 years and then stay there for a decade, and you have a rough idea of the cost.
Another way to think about it is by comparing to current entitlements. Social security, for example, cost 600 billion a year in 2008 (most recent date available on wikipedia table). So you could for the same price fund social security, twice.
Or you could compare to discretionary spending. This is all the non-entitlement, non-military, non-debt payment stuff the government does. Everything from education to energy to research to agriculture to infrastructure to federal jobs to law enforcement the list goes on. This all costs about the same amount as social security. Single payer then would cost twice this.
Want to pay for it by dismantling the military? You don't have nearly enough cash there either: again, excluding the Iraq/Afghan wars, also similar to the cost of social security (all three are about 20% of the federal budget) so you're only halfway there.
What about raising taxes to pay for it? Well, the current total tax take of the federal government is 2.3 trillion a year. So, you'd have to raise every single federal tax by 52% to pay for it. Of course, that assumes you wouldn't cause a major depression by doing so, so in reality you'd need to raise by even more to compensate for the fact that the economy would get significantly smaller after the crisis that would be caused by jacking up every single federal tax by half to start with.
Let's say for illustrative purposes you wanted to limit yourself to raising specific taxes. Income tax is 1 trillion, so, if you DOUBLED income tax and then went in for 20% more on top of that you'd get there.
Or you could do it by raising corporate taxes........actually, nevermind, you can't: corporate taxes, at 181 billion would have to be multiplied by 6 times to cover single payer....that's a nominal rate of over 100%.
Its easy to argue for single payer if you imagine we live in a world of inexhaustible resources but, there just isn't a feasible way of paying for it.
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