Constructive ideas!
These are good ideas.
Requiring everyone to buy insurance is very important. We can't have people choose new car payments instead of health insurance and then show up in the ER expecting free care and badmouthing the system.
I think it may be a good idea to require insurance companies to sell policies to everyone who applies.
Write the policy and the coverage, set the price where you want, but then anyone can buy the policy at that price.
The government or a mandatory private pool fund will have to help underwrite the high cost patients at first.
There will need to be some tweaks for age so low paid healthy
twentysomethings are not paying as much as highly-paid, overweight, MI-having, fiftysometings but everyone has to pay - one way or the other.
There are no easy solutions.
These are good ideas.
Requiring everyone to buy insurance is very important. We can't have people choose new car payments instead of health insurance and then show up in the ER expecting free care and badmouthing the system.
I think it may be a good idea to require insurance companies to sell policies to everyone who applies.
Write the policy and the coverage, set the price where you want, but then anyone can buy the policy at that price.
The government or a mandatory private pool fund will have to help underwrite the high cost patients at first.
There will need to be some tweaks for age so low paid healthy
twentysomethings are not paying as much as highly-paid, overweight, MI-having, fiftysometings but everyone has to pay - one way or the other.
There are no easy solutions.
Here's what I think would work to let everyone obtain care and keep things affordable. It's not what I think the country should do, but it is better than the alternative I believe we are headed for.
1) Mandatory Coverage: Everyone must buy a policy.
2) Government vouchers based on need. (Just as food stamps do for nutrition)
3) Private policies of four or five standardized types. A limited number of policy types greatly enhances price competition. Label them A-E and require that the insurers call them by that label.
4) No underwriting: If an insurer elects to sell a particular type of policy, the insurer must accept all applicants. Differences in price arr allowed based on geographic area. But--citizens can change policy types only once every 5 years (reducing the "hey-I've got a bad disease, I'm gonna go with the Cadillac policy now" syndrome)
5) All policies (of the 4 or 5 types) would cover preventative care that serves to reduce medical costs overall (Pap smears, immunizations, prenatal care, annual checkups, etc). Policies would differ by the co-pay amounts, private vs semi-private rooms, types of perscription drugs covered, degree of "doughnut-hole" that the insured would cover largely on his own, etc). All policies would feature catastrophic coverage based on the insured's household income--maybe all medical costs over 30% of income would be covered.
6) A government-run clearinghouse with with medical/consumer information. Provides info on customer satisfaction with various insurers by policy types, information on outcomes by procedures for various hospitals/centers, average out-of-pocket costs incurred by consumers in each state for each type of insurance, etc). This helps promote consumer knowledge and informed decisionmaking.
7) Individual purchase of medical care is allowed. Unlike some countries which prohibit individual purchase of medical care, it would be allowed in the US. In addition, if you want to purchase an additional medical policy to cover cosmetic surgery, experimental treatments, nursing home care, daily electroshock therapy, in-home aromatherapy, accupuncture, etc, that would be okay, too
There. The market helps provide cost controls (especially by giving consumers a stake in reducing their use of medical care and in picking insurers with the lowest costs). Provides consumers with feedback on medical care so they can make an informed choice. The "Cadillac" plans would be expensive because they cover a lot and because of adverse selection (that's the policy type the sickest people would choose), so people would be "incented" to select plans with higher co-pays, which helps drive down costs. Everyone gets the cost-effective preventative care provided in a cost-effective way, everyone is protected against catastrophic medical costs, the free market is preserved, medical costs are de-coupled from employment (which would be good for our economy as a whole), and the very poor pay nothing for their care (due to vouchers). And, if you want to take some risk by self-insuring to a larger degree, you are allowed to do it.