No matter how you do it, there will have to be decisions made on who pays how much to take care of the funding. Just saying the new system will be free to all and we'll just pay for it with taxes doesn't at all answer the question of who will pay how much.
Exactly. That is why I prefer to give a voucher to
everyone, pauper and millionaire alike. It is an equation that needs to be balanced, so do it the simplest way possible. Put the "means test" on
one side of the equation (the payment of taxes), not *both* sides (the payment of taxes *and* the distribution of vouchers). To do both sides adds complexity, which always results in additional inequalities, unintended consequences, loopholes, and added administration costs. None of which goes to helping people get better health care, which should be the goal. The KISS plan.
However, I see no point of having insurance companies in the mix as they don't seem to offer any value and just another layer of cost but I probably will have to live with them.
I understand your point, and I'm struggling with it too. It would appear that the ins cos are just an added layer, sucking up costs. The only reason to consider them is if the competition helps control costs over and above their profits. That is a net benefit to consumers, even though the ins cos did rake some off the top. A real world voucher example:
The recent Digital TV conversions. The govt provided $40 vouchers for the converter boxes. They set guidelines, any "voucher qualified" box had to meet some minimum standards. At that point, the free market took over. I researched on-line, found boxes with the added features I wanted, did some comparison shopping to get the best price, and I'm pretty happy with the result. Only $5-$15 out of pocket per box.
Now, lets eliminate the middle-man (ins cos or the TV Box cos). Hmmm, so the govt would manufacture the converter boxes and offer them for sale direct to the public? How does that spur competition? How does that give the consumer choice? Who do I complain to if I don't like the one and only box offered? No, I prefer the voucher system. Imperfect as it is, and even with the added middleman raking a profit, I think it served me better than only having the govt brand of cheese.
edit/add - here you go:
http://en.wikipedia.org/wiki/Comparison_of_CECB_units
Dozens of companies competing for my voucher. And public information helping me decide which one best suits my needs. I like that!
I also don't see how the post I linked to above is consistent with that concept. But no matter. We aren't designing the plan.
I was simply responding to this post:
http://www.early-retirement.org/forums/showpost.php?p=792860&postcount=214
Sorry, maybe I'm the one misunderstanding here, but I think samclam just threw the special groups out there as examples of the problem. I think he is saying he would not support picking out one group over another for favored rates, as that throws a wrench into the whole system. Exceptions would be paying for added service, or trading higher deductibales for something.
But you are right, we are not designing the system. All I really hope for out of these exchanges is to get a better understanding of the problems, potential solutions, and hopefully talk intelligently when people ask me about this subject. In some small way, that might help us and others figure out what plans we want to tell our govt reps we support. Tilting at windmills I guess, but I'm not dead yet, so I will.
-ERD50