IndependentlyPoor
Thinks s/he gets paid by the post
I can make no reasonable value judgement, because I have no idea of the cost of anything.
I have no interest in the "first dollar coverage" discussion, but I think that there is an even more important point here.
I cannot make a reasonable value judgment about treatment even if I know all of the costs in advance, and that is the basic flaw in the free market approach to our medical system's problems.
I do not have the knowledge or skill to decide whether a treatment is necessary or cost effective; that is why I seek the service of a professional. What is worse, the self-policing medical guild makes it almost impossible to find out whether a doctor is good or bad, wasteful with treatment dollars or a great bargain. Whether a hospital has high rates of secondary infections, good or bad mortality rates, or high or low cost-per-procedure is almost impossible to discover.
A side rant: Keeping tabs and controls on doctors and hospitals is what HMOs and PPOs were supposed to be about. After the scare tactics of Harry and Louise helped defeat the Clinton health plan, we got insurance bureaucrats instead on government bureaucrats inserted between us and our doctors and look how that turned out.
A free flow of information and knowledgeable consumers are required for a free market to function, and neither exists in the case of medical care. As far as I know, there is no "Consumer's Reports" for doctors and hospitals.
I agree that an insurance company inserted between me and my doctor makes things worse, but I believe that free market economics has almost nothing to offer in solving the problems of our medical system. Shopping for a doctor is not like shopping for an DVD player.
I do not believe that medical care is a right, but I do believe that insurance is a great idea. Spreading risk among a population has great value, and the larger the population the better. OTOH, if insurance companies could not deny coverage for preëxisting conditions, they could not stay in business if young healthy folks were allowed to opt-out until they got sick.
The insurance companies would howl about it, but I do not think they should be allowed to compete on an actuarial basis (read: cherry pick the healthy clients). Once everybody is required to have insurance, the playing field would be level if the first three federal regulations were:
1. Exclusions for preëxisting conditions are prohibited.
2. Insurers may offer any policy features they wish above a required minimum set, and may set any price it wishes for this optional coverage, but the prices charged must be the same for everybody.
3. Policies may be canceled only for non-payment or other breach of contract, not because the client was seriously injured or contracted an expensive disease.
Essentially, such regulations would just create one giant group comprising everybody in the country. Insurers would compete to sell policies to the members of this group just like it sells policies to employee groups. Want to raise the rates? Fine, but you have to raise them equally for everybody. Want to change the rules on say, deductibles? No problem, but the changes apply to everybody. There would still be plenty of room to compete. Insurance companies are competing just fine with their employer based group policies now. Why not just extend the existing model? Indeed, the precedent for required minimum insurance already exists in our auto liability policies.2. Insurers may offer any policy features they wish above a required minimum set, and may set any price it wishes for this optional coverage, but the prices charged must be the same for everybody.
3. Policies may be canceled only for non-payment or other breach of contract, not because the client was seriously injured or contracted an expensive disease.
I know that this does not solve all of the problems, but straw men arguments are fun and sometimes useful. As I understand it, this is similar to the Swiss system, and I present it to show that there are potential "solutions" that do not involve a big-brother type government autocracy.
I am not capable of assessing what effect this would have on medical costs, but it would solve many of the cruel and unfair situations that our existing system creates. I contend that it would even reduce costs (although I can't say how much) by eliminating the free and extremely cost-ineffective care hospitals are required to give in emergency rooms, and in uncollectible bills. If I recall correctly, a major hospital lobby group has estimated that universal coverage would save something like 30%-40% (although that sounds high to me) just for these reasons. If somebody insists, I will go Googling for some data to back that up.
I'm recovering from a minor surgical procedure and writing this under the influence of pain medication, so I reserve the right to disavow it after the hydrocodone wears off. However, if I were completely sober, I wouldn't have the nerve to post this.
Anybody know where I can get a good Nomex suit air-freighted to me?
Last edited: