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Free market alternative to Medicare is commercial insurance. However, it's almost impossible to remove because it was set up as a generational ponzi scheme since the first cohort got the benefits without paying in, and cohorts since have taken more in benefits than they paid in taxes, creating a huge implicit debt that would leave the generation at the end of the scheme unjustly immiserated if it stopped since they'd bear the burden of one generation of complete subsidization and several of partial subsidization since. At this point the best that can be done is leave it in place, get it to a point of break-even so the implicit debt stops getting larger, and every generation will be a bit worse off rather than one bearing the full burden of the scheme unraveling.
There isn't a free market alternative to Medicaid in the same way that there isn't a free market alternative to food stamps, cash welfare, etc. It's explicitly a handout to people who otherwise couldn't afford a thing.
All I know I government involvement jacks up the costs...
No. Medicare has the lowest overhead of any large healthcare provider.
The highest costs are with for-profit big insurance providers. United Health, the largest insurance provider, made $12.0 Billion in profit in 2018. That's one way to save billions on healthcare -- make it a non-profit system and get Wall Street out of it.
Several states have private market modfications to Medicaid. Most seniors are in privately run Medicare Advantage programs. The most attractive approaches IMO are what is called capitation where providers are paid a fixed negotiated per capita fee for their services for a group of patients. These are generally administered by non-profits under regulation by government. Providers benefit by having more clients - scale factors. The non-profits have open enrollment periods and recruit patients just like an insurance company would but do not return a markup to share holders and that keeps overhead costs in line. A single payer gov model is probably not the best. But, no matter what, it is high time we start working on ideas from a bipartisan perspective. Our present system is busted beyond repair.
In essence, the bill would have moved us away from the employer provided health insurance model and given every citizen a health voucher. Individuals would choose their health care plan from state-approved private insurers.
It sought to make the cost of health insurance more transparent to consumers, with the expectation being that this would increase market pressures to drive health insurance costs down. The proposal created a system that would be paid for by both public and private contributions. That is there would be a sliding scale of public subsidies for low income households.
I think this sort of a "radical centrist" approach would have been well worth trying. Unfortunately, bi-partisan approaches to big reform went away a long time ago.
How many seniors and poor people had problems doing this before medicare and medicaid?
I gave three solutions, based on the free market criteria. Give a better answer...
The private insurer option mentioned above is another option.
Quote:
Originally Posted by Elliott_CA
No. Medicare has the lowest overhead of any large healthcare provider.
The highest costs are with for-profit big insurance providers. United Health, the largest insurance provider, made $12.0 Billion in profit in 2018. That's one way to save billions on healthcare -- make it a non-profit system and get Wall Street out of it.
You will have to prove that lowest overhead answer for me to believe it.
I am not against profit for private businesses. People have to have a motivation to work.
Insurers now make a bunch of profit because the government, which has deep pockets, is the main customer. If citizens were the main customer, there would be no way they could charge the prices that they charge, and stay in business.
It was the passage of Medicare/Medicaid that drove up medical costs with its "fee for service" "usual and customary" payment system. This set the stage for massive waste, fraud and abuse in Medicare and especially Medicaid payments.
When these two programs were being passed what types of free market proposals were being suggested by those who opposed them?
When private insurers declined to cover flood risk, the Federal Government filled the void.
When private insurers declined or severely limited elderly hospitalization risks, the Federal Government filled the void.
When private pension plans failed, the Federal Government filled the void.
There is a pattern, here.
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