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There are seven suggestions overall here's one example:
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2. Move away from a health care system dominated by employer-provided health insurance. Health insurance should be personal and portable, controlled by individuals themselves rather than government or an employer. Employment-based insurance hides much of the true cost of health care to consumers, thereby encouraging over-consumption. It also limits consumer choice, since employers get final say over what type of insurance a worker will receive. It means people who don’t receive insurance through work are put at a significant and costly disadvantage. And, of course, it means that if you lose your job, you are likely to end up uninsured as well.
Employment-based insurance hides much of the true cost of health care to consumers, thereby encouraging over-consumption.
I think part of what's ment here is that since many people don't know what the true cost for certain medical procedures or services are they are less likely to shop around for the better priced services.
So you would have an even bigger problem in that many who think they are healthy and young would just opt out and when sickness hit another American Family would be devastated. America is the only country in the world that is not a banana republic that does not offer universal health care. We have it for the poor, Medicaid, the old Medicare and the vets, and for the children, but for that middle ground the owns the health care industry likes to pick off for profit there is none. We are 37th in quality and 91st in life expectancy, another flaw in your thinking, In New Orleans there were many hundreds of people who showed up at a free health care clinic, 93% had jobs and worked but it was not provided, your answer is like the if they have no bread let them eat cake attributed to Marie Antoinette. How can people who are working 2 and 3 jobs and can barely afford food and rent afford 1000 a month for family health care? It is a non starter. We cannot get around this, it is like the Vietnam war, many new we were finished before the politicians did, the only question is how many have to die before they get it also? I know that conservatives are still thinking we should have stayed, but they are as nuts as Charlie Manson and I think I owe Manson an apology for ranking him below a conservative.
America is the only country in the world that is not a banana republic that does not offer universal health care.
Ok but the reality is that it's going to be more difficult to expand and sustain a universal gov't health insurance progam because of America's changing demographics. I mean we have about 78 million tax paying baby boomers about to retire and wouldn't this mean the loss of a significant amount of tax dollars needed to fund a universal system for all Americans? Even in Europe their welfare programs are being affected by similar demographic changes. So both the U.S and Europe will have to find more market oriented reforms for things like healthcare,pensions etc. This seems to be the future.
I believe that people who make these kinds of suggestions are sincere. I think they would like to believe that the free market will solve the healthcare mess. Unfortunately, that "dog" just won't hunt. Here's why:
1. Unions and employees who are the recipients of good health plans will resist these suggestions to the bitter end. The unions see employee health insurance plans (that they have negotiated) as one of the few remaining justifications for their existence as organizations. Employees who receive generous health insurance plans aren't going to give these up without a fight. Whether its a wise thing to do or not, there are people in life who are very "security conscious". A good health plan is worth more to them than its actual cost in dollars and cents. In short, unions and the employees who receive these plans will fight legislation that makes health insurance an individual responsibility to the bitter end. It won't pass.
2. If it did pass, it wouldn't be a good thing. As someone else has pointed out here there are simply too many young people who would never take their own money and buy a health plan. The money would get spent on what they deem are more pressing needs: A bigger house; new carpetting; a newer car; season tickets for sporting events; and new clothes. The public would end up stepping in and subsidizing their healthcare when a catastrophe struck.
3. This is a point I've made for a long time in other posts. The free market is doomed to failure when it comes to health care for a simple reason: That reason is that there is no profit for private insurers in insuring the chronically ill, the injured, and the disabled--or the very people who need healthcare the most. These people will always have alot of trouble getting insurance under a private system. On the other hand, there is profit insuring people who need the very least healthcare--the young and the healthy. There will always be an effort to get these people to try and buy more insurance than they really need.
I guess there are some people out there who believe axiomatically that "the free market is always better" (even when its not). They probably are never going to accept the notion that we need to move towards some sort of publicly-funded system of universal healthcare. I'm hoping the rest of us are eventually powerful enough to get the reform that is needed.
When it comes to healthcare, the free market is like an old car. The car routinely breaks down. It is inefficient. It needs to be replaced. Yet, some people are so "in love with it" they can't bear to part with it. Its time to accept reality and legislate a system of universal healthcare so that we can join the modern family of nations which include Canada, Australia, the European Countries, New Zealand, Japan, and even Taiwan now.
I think part of what's ment here is that since many people don't know what the true cost for certain medical procedures or services are they are less likely to shop around for the better priced services.
I think when people talk about "overconsumption", they mean many things. It can mean taking your kid (or yourself) to the dr. for every little sniffle. It can mean the above, but as many have pointed out, who has time to "shop around" when they've been in an accident, are diagnosed with cancer, etc? And who necessarily wants the cheapest care, either?
Quote:
Originally Posted by Motion
Ok but the reality is that it's going to be more difficult to expand and sustain a universal gov't health insurance progam because of America's changing demographics. I mean we have about 78 million tax paying baby boomers about to retire and wouldn't this mean the loss of a significant amount of tax dollars needed to fund a universal system for all Americans? Even in Europe their welfare programs are being affected by similar demographic changes. So both the U.S and Europe will have to find more market oriented reforms for things like healthcare,pensions etc. This seems to be the future.
That's true. We probably should have done this thiry years ago when the boomers were much younger and healthier.
Here are some pieces of that article I take issue with:
We need to increase competition among both insurers and health providers. (Etc)
I don't like the whole idea of the provision of health care being a "competition". What works for selling cars does not necessarily work for healing bodies. This idea that selling insurance across state lines being such a panacea is not reality oriented. What the ins. companies want from that is to be able to circumvent state insurance regulations, which set minimum standards. They want to be able to sell stripped down policies that pay for practically nothing.
We also need to rethink medical licensing laws to encourage greater competition among providers.
Again, the "competition" model, as if health care providers are selling popcorn at a movie theater or something. I like the idea of nurse practitioners, I'm not so sold on PAs, and I don't know what other kind of 'non-physician practitioners' the article is talking about. It is usually not difficult to take a license from state to state. In nursing, many states are in a "compact" which means that a license in one state is the same as a license in another. Generally, all that needs to be done is a little paperwork to get a license in another state, as long as you're not on probabtion. There are clinics in retail stores. They have their pros and cons.
Congress should give Medicare enrollees a voucher, let them choose any health plan on the market, and let them keep the savings if they choose an economical plan.
"Economical plan" is generally a euphemism for a plan that doesn't offer much coverage.
States may also wish to experiment with high risk pools to ensure coverage for those with high cost medical conditions.
This is already being done in some states. It hasn't seemed to solve the problems.
First of all I believe there are for more people that underconsume healthcare (appropriate screenings not procrastinating on problems until they are outrageouslty expensive etc.) than those that overconsume, this is a stereotype of a few individuals that is just used for fearmongering.
Second, after working in an ER, I am against the free market trying to squeeze out every bit of efficiency. I'm sorry if this offends conservatives ears, but in some areas preparation should trump efficiency, you never know what may happen any given night, and you shouldn't be understaffed because its more 'efficient'. Quality and thoroughness should as well. Perhaps if providers didn't need to see 4-6 patients an hour they would miss less and there would be fewer missed diagnoses and fewer malpractice suits.
I think when people talk about "overconsumption", they mean many things. It can mean taking your kid (or yourself) to the dr. for every little sniffle. It can mean the above, but as many have pointed out, who has time to "shop around" when they've been in an accident, are diagnosed with cancer, etc? And who necessarily wants the cheapest care, either?
That's true. We probably should have done this thiry years ago when the boomers were much younger and healthier.
Here are some pieces of that article I take issue with:
We need to increase competition among both insurers and health providers. (Etc)
I don't like the whole idea of the provision of health care being a "competition". What works for selling cars does not necessarily work for healing bodies. This idea that selling insurance across state lines being such a panacea is not reality oriented. What the ins. companies want from that is to be able to circumvent state insurance regulations, which set minimum standards. They want to be able to sell stripped down policies that pay for practically nothing.
We also need to rethink medical licensing laws to encourage greater competition among providers.
Again, the "competition" model, as if health care providers are selling popcorn at a movie theater or something. I like the idea of nurse practitioners, I'm not so sold on PAs, and I don't know what other kind of 'non-physician practitioners' the article is talking about. It is usually not difficult to take a license from state to state. In nursing, many states are in a "compact" which means that a license in one state is the same as a license in another. Generally, all that needs to be done is a little paperwork to get a license in another state, as long as you're not on probabtion. There are clinics in retail stores. They have their pros and cons.
Congress should give Medicare enrollees a voucher, let them choose any health plan on the market, and let them keep the savings if they choose an economical plan.
"Economical plan" is generally a euphemism for a plan that doesn't offer much coverage.
States may also wish to experiment with high risk pools to ensure coverage for those with high cost medical conditions.
This is already being done in some states. It hasn't seemed to solve the problems.
Health insurance has been marketed just as you would buy popcorn from the movies for years now, and was very successful right up until HMOs and other bureaucratic processes entered the fray. Incidentally, you purchase car insurance that covers your body in the event of an accident, not just the property cost. Competition is high and prices are low, relatively speaking.
I don't have any problems with Cato's suggestions, except that point #3 is not a free-market solution, and I have no idea what #7 means. What is "health status insurance" and how is it related to pre-existing conditions?
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