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Getting to universal coverage | |||||||||||||||||
Instead of imposing universal coverage as a hugely expensivegovernment program, design a government program to put allthe other health plans out of business by attracting theircustomers. If the claims of those who advocate universalcoverage are accurate, this should actually save money. Phase 1 is to set a price for which *ANYONE* can subscribeto one or more od the current government healthcare programs. This pricewould initially reflect the true cost of the program, soinially would require no additional funding. The obviouscandidate plans are medicare (as an entry level program),and whatever plan covers congress (as the gold plated model). The idea is that the enormous market power and lowadministrative costs of these plans makes them muchmore effecient than private plans, so even at equivalentlevels of service, and without subsidies, they are much better value. The more expensive and less effecientprivate plans will be hard pressed to compete. Phase 2 is to simply start increasing the subsidy by lowering the price, and start broadening elgibility forsubsidized membership. This will attract people outof private plans and out of the uninsured pool. Eventually,private plans will be completely marginalized. Phase 3, when nearly universal coverage is a fact, and mostemployers subscribe to one of the official plans, the cheapestplan can be made "free and universal" and the former subsciptionfree can be recovered as a broad based tax; but since for mostparties it will be swapping a fee for an equal tax, thefinal transition will be relatively painless. The beauty of this approach is that it doesn't punishemployers who are providing coverage now - it simplyoffers them a better deal.
ddyer, Oct 29 2003
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Hi,
I'm in the UK, so we already have universal coverage. Surely the entire reason that you don't have it in the US is because people don't want it!
E.g. Your plan would ultimately end up with the (enormous) bill being picked up by the taxpayer.
The most bizarre and unfortunate aspect of US healthcare is that it is a function of employment. The better employed you are, the better the healthcare you are entitled to. Where's the connection?
Health should be a right, enshrined in the constitution if necessary. You have right to speak, to vote, to pray, but not to stay alive? It's all very nonsensical, and no one else in the world looks at this way. Plus, while spending less money per capita, many countries have longer life expectancies - and the gap is increasing!
It is NOT the case that Americans don't want universal healthcare. It is specifically that the American Medical Associaiton does not want universal healthcare, precisley as the tobacco industry fought off regulation, and as the recording industry now has the right to have people arrested for copying music. The people don't get a say in any of this.
The problem appears to be that the TOTAL lifetime healthcare cost for uninsured individuals and this impact on the taxpayer... as in degrading care for 40 million people, they will ultimately end up costing more with chronic illness.. as the bills ultimately fall on the public, in either rised insurance costs or whatever... a health version of moral hazard... the public underwrites your heatlh one way or another... better to work in a life-care relationship preserving the human right to medical care.
Its rather simple. Provide universal healthcare coverage just like "assigned risk" insurance for preexisting conditions and take the money out of the military budget... where the escalation of war making is a greater threat to american strategic health than any bid to take care of american disenfranchised and deprived people. The money can also come from ending the drugs war turning all the guns-enforcement cash in to universal treatment cash. So much of these problems are self created by bad government.
For universal health care of some sort to have a chance in the US, the insurance model currently in use to finance it must be overhauled - I will even go so far as to say it must be abandoned. The reason not everyone has health care coverage is because not everyone can afford the insurance premiums. Whether these premiums are subsidized by an employer or the government does not matter. Health care for all is simply unaffordable. Why not change the very dynamics in which we pay for health care and the incentives used to provide and consume health care? (I will attempt to provide an answer to this in a latter submission.)