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As a libertarian-oriented, free-market person, my preference would be for a greatly de-regulated health care market, perhaps not far from what we see in the auto insurance industry. However, I fear that we have turned a corner culturally, and health care is now regarded as a right by most Americans; hence some kind of 'universal coverage' must be attained. Even President Trump says that he wants universal coverage.
Deregulation and freer markets might work for our large group of generally healthy, younger and working people. But does not typically help the poor, those with disease and the elderly. And that is where the big money lies.
Quote:
Originally Posted by wutitiz
According to the CDC, 86% of all health care spending is for people with one or more 'chronic' conditions. https://www.cdc.gov/chronicdisease/overview/
Most of these are behavior-related such as obesity, smoking, alcohol, and illegal drugs. Pragmatically, we aren't going to be able to legislate these behaviors out of existence. But what we could do is tax them, and dedicate the tax revenue to health care for those who can't afford it. The beauty is that those who generate the costs, pay for them. If you don't drink, smoke, or eat junk food, you pay nothing.
We could even legalize all drugs and slap massive taxes on it, thus ending the war on drugs and all the associated problems (violent drug gangs, etc.). And while we can't really tax lack of exercise, we could subsidize exercise. Maybe even let people sign up for a fitness test to qualify for an income tax credit.
Obesity, smoking, alcohol and drugs add to, but are not the bulk of that 86%.
We certainly do tax smokes and alcohol. Obesity is about our largest targetable medical risk/problem. And I agree that positive reinforcement/rewards would be sensible with exercise and other useful methods to lower our obesity rate.
We might consider using larger annual rewards like more significant tax deductions or tax rebates if people/families tow the medical line and don't utilize large HC services in any given year.
Mircea - the primary problem with your "pay as you go" plan is it allows those that cannot afford either insurance, care or drugs to suffer and die without any treatment. Those of us that realize that proper care is likelier to not be affordable on an individual basis do not find this to be an acceptable policy. That is why I proposed a Universal Health Care program paid for by highly progressive income tax on the top 10% of the taxpayers.
Deregulation and freer markets might work for our large group of generally healthy, younger and working people. But does not typically help the poor, those with disease and the elderly. And that is where the big money lies.
Obesity, smoking, alcohol and drugs add to, but are not the bulk of that 86%.
We certainly do tax smokes and alcohol. Obesity is about our largest targetable medical risk/problem. And I agree that positive reinforcement/rewards would be sensible with exercise and other useful methods to lower our obesity rate.
We might consider using larger annual rewards like more significant tax deductions or tax rebates if people/families tow the medical line and don't utilize large HC services in any given year.
It's the good doctor!
Doc, tell us about Alzheimer's: The Rolls Royce of diseases for the insurance companies.
Applying the free market to healthcare is a joke and won't work. You'd end up with massive consolidations and mergers. One or two very large providers would have monopoly power. Once that kicks in prices would go up, not down.
We already have a proven medical delivery system called Medicare. Repeal Obamacare and replace it with Medicare For All. No new government agency required, it would only be an expansion of an existing program. The additional medicare payroll deductions would be less than what many people pay now for private insurance.
Doc, tell us about Alzheimer's: The Rolls Royce of diseases for the insurance companies.
I don't know Rolls Royce, but along with senile dementia these a huge problem and will only get larger as our demographics age. Even with proper living wills, difficult to solve. Basically long term custodial care. Like many science fiction stories maybe one day automation might make it cheaper.
Applying the free market to healthcare is a joke and won't work. You'd end up with massive consolidations and mergers. One or two very large providers would have monopoly power. Once that kicks in prices would go up, not down.
We already have a proven medical delivery system called Medicare. Repeal Obamacare and replace it with Medicare For All. No new government agency required, it would only be an expansion of an existing program. The additional medicare payroll deductions would be less than what many people pay now for private insurance.
Currently Medicare is about 40% financed by taxes. The rest is an unfunded liability.
The fact is no one is even willing to raise taxes to keep Medicare solvent now.
Applying the free market to healthcare is a joke and won't work. You'd end up with massive consolidations and mergers. One or two very large providers would have monopoly power. Once that kicks in prices would go up, not down.
We already have a proven medical delivery system called Medicare. Repeal Obamacare and replace it with Medicare For All. No new government agency required, it would only be an expansion of an existing program. The additional medicare payroll deductions would be less than what many people pay now for private insurance.
You might be surprised with how many docs oppose universal care. Mainly due to a loss of professional freedom and of course income. So please don't forget to satisfy the docs if and when it happens.
Currently Medicare is about 40% financed by taxes. The rest is an unfunded liability.
The fact is no one is even willing to raise taxes to keep Medicare solvent now.
I think your 40% is general revenues. Payroll taxes pay about the same. Then there is a significant portion with premiums, co-pays and deductibles. Deficit spending is the unfunded part. Since our Federal Gov't is monetarily sovereign and cannot go insolvent, inflation is really the potential enemy here.
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