What if the US gov't provided only Universal Catastrophic Health Coverage for huge expenses (cancer, heart attack etc) and you had your own insurance to cover yourself (or not) for general, smaller expenses (broken arm, routine Dr visits etc).
Wouldn't the cost of your personal insurance go down and the gov't could cover the big stuff with a smaller tax hit?
Seems like everybody --including the insurance co's--win. Or, as is often the case, am I missing something?
My guess is that scenario might only add to the administrative cost.
Of course, I agree it would be better than what we have now. But then almost anything is better than we have now.
The other side of that coin in controlling costs is individuals having some skin in the game. I see myself - people on medicare and private insurance (paid for by their employer), not being at all concerned with costs and therefore either agreeing or opting for things they might not if they had to pay a portion of it themselves.
My GP, who I know well was complaining about the excessive appointments his medicare patients were making when there was really nothing wrong with them. He said he would like to see a $25 copay instituted and he thinks these frivolous visits would decrease dramatically.
There of course would probably have to be a reduced fee for people very low income patients (say $10), or the doctor could have the option to waive it if he so chose.
Doctors are of the same mentality sometimes. When I saw a specialist a couple of years ago, he suggested I have an expensive test to see if my condition had worsened. I asked him, if it has, is there anything he can do to make it better? He said, "not really". So I said, "then why go through the expense of the test?" His answer to me was: "What do you care, medicare will pay for it." So, I politely told him, I did care because someone was paying for it. That is a true story.
It is a real
Catch 22 if there ever was one - when it comes to medicine. We know that making people incur some costs might greatly reduce unnecessary procedures and tests. On the other hand, it might discourage people from seeing a doctor and getting treatment they need. We know that
some doctors are quick to recommend operations and procedures that patients might not need and would not really improve their condition enough if at all to warrant such an expense.
I'd love to see physicians compensation be based on performance. They could have different grade pays. The better your overall patient outcome is, the higher your pay grade. It would be the same as lawyers with good track records (wins to loses) charging higher hourly rates or company executives competing for higher positions based on how well they do.
Maybe I'm dreaming, but more pay for good performance seems like a real incentive to do good and the American way.
I do want to see doctors receive adequate pay, especially with the high cost of education and time involved. They deserve it.
Untangling the current system will be very challenging. But if it has been done in so many other countries. It can be done here. There are people who are very knowledgeable in this area such as the doctor Midpack mentioned earlier, who has helped other countries into the transition.
