Thinker25:
Just so someone says it: There's a more fundamental issue as to whether health care is a "right" that we can forcibly cause one individual to buy for another individual. I don't believe it is, but as a society we have made a different decision.
- We have a system that does pay for care for people who have exhausted their resources. Medicaid. You have to be really broke, then the government (i.e. other taxpayers) will pay for your care. Apparently this, too, is not sufficient for popular appetites. We want individuals to suffer far less financial distress when poor luck hits them. Okay, so how do we do that in the most efficient way?
- I think you'll find that people here understand what adverse selection is.
- There are market-based solutions that do not involve the government setting prices, do not involve the government directly providing health care, that provide lower-cost access to health care insurance for the sickest among us. There would still be some transfer of the private property of some people to others, but not nearly to the extent of the present House or Senate bills (where
most Americans would be on the dole).
The Swiss model is a very promising approach, you might look at it further if you aren't familiar with it. Universal coverage, overall costs per person about 30% less than we pay in the US, patients are allowed a lot of choice in their treatment/doctors, and market forces are largely used to keep costs down. The government doesn't run health care there--they just set up the system that meets their societal goals and lets the private market accomplish those goals. Efficient and effective. The "government" (i.e. other taxpayers) do provide funding to help the poor buy insurance, but it is nothing as extreme as what we see in the House plan. Overall, people in Switzerland pay about 10% of their income for health care. It also gets rid of the crazy link we have in the US between employers and the health care of their employees, which would be a big boost to the US economy.
Here's a great article about the Swiss system that was identified by MPaquette . From another article linked to that one:
In the Swiss healthcare system:
- there is an insurance mandate for all individuals,
- the government defines a what the insurance benefit will be for all standard health insurers,
- insurance companies are not allowed to deny coverage to any individual,
- health insurance and medical procedure prices are made publicly available,
- in exchange for providing health insurance to consumers, insurance companies receive premiums from consumers and risk-adjustment payments from the government in order that insurance companies are not punished if they decide to insure a sicker population,
- premiums are community rated, meaning that sick and healthy individuals pay the same price within each age group (the age groupings are 0-18, 19-25, >25 years old).
- individuals are allowed to purchase supplement insurance as well (there is no regulated benefit for supplemental insurance),
- there is significant cost sharing in all insurance plans (i.e.: deductibles, 10% coinsurance rates up to an annual ceiling),
- open enrollment occurs twice per year (June and Ddecember).
In 2003, 49.7% of Swiss individuals choose ordinary deductible health insurance, 42.0% choose higher deductible health insurance, and 8.2% chose insurance with limited choice of provider networks (HMO-style contracts). Since only 8% of individuals are in managed care insurance firms, quality is fairly homogeneous across insurance companies.
The Swiss government does get involved with establishing treatment protocols, so it's not entirely consumer-driven. But it looks better than the plans on the table today.
Right now we have a system where people are unable to get affordable health insurance if they are not employed and not in good health. If you are desperately ill sometimes you can get on Medicaid and SS Disability but that is not easy or certain.
Yes, there's a problem. But there are many rational ways to fix it. If you see legislation quickly crammed through with little public deliberation or buy-in across the political spectrum or the American population as a whole, I think that is an indication of an immature plan that has not benefited from the careful deliberation this big problem requires.