Best health care reform article I've read to date.

[Cache Landing]

Admittedly, the background leading to the proposed restructuring is a bit tiresome, but the author does do a pretty decent job providing some merit to his argument. Some stats are misrepresented as usual. But overall pretty decent.

I think the proposal at the end of the article strikes a good balance between allowing free markets to dictate price and realizing that without some sort of forced savings, the general population just isn't forward looking enough to save for medical expense later in life.

What I appreciate most about the solution is that it addresses what I've long considered to be the root of our problem. Third-party-payment and opacity. Those in favor of free markets must admit that for free markets to work there must be transparency. Our health-care system doesn't work because of a severe lack thereof.

http://www.theatlantic.com/doc/200909/health-care

Summary:

1) Catastrophe insurance with age based premiums required of every person.

2) Forced health savings accounts from all post-tax income. These funds used to pay common medical bills. Unused accumulations can be borrowed against like a 401K and will be passed on at death as inheritance.

3) Gov fund allows for borrowing against future payments for large expenses early in life such as child birth.

Subsequently, as consumers are paying out of pocket for all medical services, providers would be required to divulge full details of service costs and there would be a very healthy competition in the industry.

 

[Nattdog]

How about no "forced" anything.

Completely dismantle the govt/corp cartel that has damaged our entire perception of healthcare and health in general.

"No way! We can't have freedom! How would our rulers feel important?? How would those who parasite off others with their largely lifestyle related conditions get by?"

 

[maninjapan]

Guys, please excuse my ignorance, Im not american and cant say I have too much of an understanding of the US healthcare situation, but why are so many Americans against a nationalized healthcare system. America currently have some of the highest (if not the highest) healthcare costs in the world, yet is the only advanced nation without a public healthcare system. Our system in Australia is far from perfect, but everyone gets care and you pay based on your income. People who want better cover take private insurance. I mean there must be a good reason why so many people are against it, I just cant see it. Any enlightenment on the subject would be much appreciated.

 

[Cache Landing]

Quote from Nattdog:

How about no "forced" anything.

Completely dismantle the govt/corp cartel that has damaged our entire perception of healthcare and health in general.

"No way! We can't have freedom! How would our rulers feel important?? How would those who parasite off others with their largely lifestyle related conditions get by?"

that is always my first reaction too, but we have to be realistic about this. I'm a free market capitalist through and through, but we have a really messed up system and certain moral obligations to acknowledge.

That is similar to saying that we should dismantel the corrupt government roadways and traffic signals that take away our freedom and force us to stop when we don't want to.

Obviously the current system is screwed, but we must operate within the realms of reality. And zero g-ment role does not have a place in that reality.

The reality is that forcing individuals to suddenly pay for massive health care costs for an aging population results in enormous negative externalities.

If you ignore every traffic signal on the way to work in demonstration of your freedom, it negatively impacts many other people whether you want it to or not. If taffic signals/laws were taken away all together it would likely take longer for you to get to work, which is exactly the opposite result that was intended by taking away the stop lights.

The idea that an individual would be forced to save a small percentage of their income in anticipation of future costs is ok with one disclaimer. That once a certain threshold has been met, the person has complete discretion with the excess funds and the entirety of the account be passed through inheritance upon death. IOW, the g-ment has no claim on those funds and even though the person is forced to contribute to it, he isn't forced to use any of it.

 

[Cache Landing]

Quote from maninjapan:

Guys, please excuse my ignorance, Im not american and cant say I have too much of an understanding of the US healthcare situation, but why are so many Americans against a nationalized healthcare system. America currently have some of the highest (if not the highest) healthcare costs in the world, yet is the only advanced nation without a public healthcare system. Our system in Australia is far from perfect, but everyone gets care and you pay based on your income. People who want better cover take private insurance. I mean there must be a good reason why so many people are against it, I just cant see it. Any enlightenment on the subject would be much appreciated.

Americans view their level of care as the best in the world. The general populace also considers the private sector more capable than the g-ment at running a business, which is exactly what the health care segment is.

Most are also against any system that requires someone to pay based on income. The idea that the rich should pay more simply because they are rich, only becomes popular in America about every 50 years during a severe recession. We have gotten the three worst programs in the history of this country from that mentality. They all came during severe recessions and are currently bankrupting our country.

 

[maxpi]

Quote from Cache Landing:

the general population just isn't forward looking enough to save for medical expense later in life.

I wonder if that is not related directly to the fact that 13% is taken out of our wages for our entire lifetimes of work in the US? One can put away just 5% for 5 years at age 25 and retire with millions in sound dividend paying companies... 13% for 50 years starting at age 18 and having nothing but a promise from the government sucks very badly by comparison... maybe we just gave up? Some families have older people guiding the savings of younger working ones too... that is frustrated by the theft of 13% of income... personally I'd like to get these monstrous Democrats off my back, if they want to distribute money to people that vote for them, let them do it with their own purses...

We can have a great healthcare system any time we want. Congress would have to stop being just tax manipulators and actually regulate the industry... and Democrats went ballistic, and they still think they are right, when Bush wanted to privatize Social Security.. they are not EVEN going to go for savings accounts.. smacks of capitalism too much for their weak little stomachs to tolerate it...

 

[Cache Landing]

Quote from maxpi:

I wonder if that is not related directly to the fact that 13% is taken out of our wages for our entire lifetimes of work in the US? One can put away just 5% for 5 years at age 25 and retire with millions in sound dividend paying companies... 13% for 50 years starting at age 18 and having nothing but a promise from the government sucks very badly by comparison... maybe we just gave up? Some families have older people guiding the savings of younger working ones too... that is frustrated by the theft of 13% of income... personally I'd like to get these monstrous Democrats off my back, if they want to distribute money to people that vote for them, let them do it with their own purses...

We can have a great healthcare system any time we want. Congress would have to stop being just tax manipulators and actually regulate the industry... and Democrats went ballistic, and they still think they are right, when Bush wanted to privatize Social Security.. they are not EVEN going to go for savings accounts.. smacks of capitalism too much for their weak little stomachs to tolerate it...

Yes but I wasn't attempting to imply that they will go for it, but rather that it is the system that makes the most sense.

Forced contributions to an HSA for every working american, that they can handle just like their 401K. They choose where they want it invested and what risk/return they are comfortable with.

Excess monies can be withdrawn and used at the discretion of the account holder. Funds passed on to pad the HSAs or pockets of beneficiaries. All this allowing the consumer to shop around for the care that they want, rather than the coverage that they want. They should be paying more for better care, rather than better coverage.

Bad doctors/facilities wouldn't have to be sued out of business, but rather they would be shopped out of business. Currently the recourse for poor service is a law suit for which the doctor simply purchases insurance. But no amount of insurance can protect a doctor whom people simply stop visiting.

The system would be much more simple and all the g-ment would have to do is provide stop-loss insurance with premiums based on age. It is much harder for them to foul that up.

 

[piezoe]

Quote from Cache Landing:

Admittedly, the background leading to the proposed restructuring is a bit tiresome, but the author does do a pretty decent job providing some merit to his argument. Some stats are misrepresented as usual. But overall pretty decent.

I think the proposal at the end of the article strikes a good balance between allowing free markets to dictate price and realizing that without some sort of forced savings, the general population just isn't forward looking enough to save for medical expense later in life.

What I appreciate most about the solution is that it addresses what I've long considered to be the root of our problem. Third-party-payment and opacity. Those in favor of free markets must admit that for free markets to work there must be transparency. Our health-care system doesn't work because of a severe lack thereof.

http://www.theatlantic.com/doc/200909/health-care

Summary:

1) Catastrophe insurance with age based premiums required of every person.

2) Forced health savings accounts from all post-tax income. These funds used to pay common medical bills. Unused accumulations can be borrowed against like a 401K and will be passed on at death as inheritance.

3) Gov fund allows for borrowing against future payments for large expenses early in life such as child birth.

Subsequently, as consumers are paying out of pocket for all medical services, providers would be required to divulge full details of service costs and there would be a very healthy competition in the industry.

It would be a very good idea for consumers to pay a greater fraction of their cost directly so that they would be acutely aware of costs and might cut down on unnecessary trips to the doctor and become much more interested in following through on billing errors, etc. I don't see, however, how this proposal, which is attractive none the less, would result in "..a very healthy competition in the industry," and I don't see how it would do anything dramatic for costs, which is where the real problem lies.

The reason U.S. medicine does not operate in a price competitive environment has very little to do with the payment mechanism.

The reason there is no competition is because American Medicine operates as a government sanctioned, via the FDA, Cartel in which access is very tightly controlled, and that Cartel is selling something you desperately need: your health! When you break your leg are you going to say: "No thank you, the cost is too much." I think not!

Peripheral measures such as the one proposed are nice and perhaps a very good idea, but until the power of the Cartel is broken there will not be free price competition, and prices will remain out of line with the rest of the world.

Medicine will have to be deregulated to some extent if prices are to come down. This may be an imperfect solution, but until a perfect one comes along it would be far better than what we have now -- a system that can easily bankrupt someone even with insurance! In fact, the truly poor may be better off with regard to paying for medical services than a lower middle class family with insurance. I ask you, what kind of a "system" is that?!

I also would ask why the non-profit Blues (Blue Cross-Blue Shield) are not enthusiastic about a proposed government insurance option paid for by premiums (Not tax dollars). If the Blues are so efficient, and they don't even have to make a profit, why should they be worried by premium-supported, alternative insurance administered by the government --"a government that can never run anything half so efficient as private enterprise." (Could it be that the board will miss their sets of alligator luggage at Christmas time should they lose customers to the government plan?)

Yes, the Cartel must be broken if real progress on costs is to be made.

 

[maxpi]

Quote from Cache Landing:



The system would be much more simple and all the g-ment would have to do is provide stop-loss insurance with premiums based on age. It is much harder for them to foul that up.

Well I like the idea but I think that the Left doesn't care how bad they foul things up, they are on an idealogical warpath and they want control of all of us... I'd say the best we can hope for is to keep the Left entirely off balance for as long as possible and hope we can sort out the wreckage later on... I wonder if the Right has any actual plans to try to fix all the problems that we supposedly have with health care... if they could not get interested in something this simple and obviously effective then they are as big a bunch of throwaways as the Left are...

 

[jd7419]

Quote from maxpi:

Well I like the idea but I think that the Left doesn't care how bad they foul things up, they are on an idealogical warpath and they want control of all of us... I'd say the best we can hope for is to keep the Left entirely off balance for as long as possible and hope we can sort out the wreckage later on... I wonder if the Right has any actual plans to try to fix all the problems that we supposedly have with health care... if they could not get interested in something this simple and obviously effective then they are as big a bunch of throwaways as the Left are...

The right is salivating. They want the dems to succeed in the complete overhall of the us healthcare system. They view this as their meal ticket for decades to come. Time will tell if the US populace is happy with Obama care or not. One thing I am sure about is we will get huge change in our health system, Obama and the far left know that time is ticking and they will ram it through soon. Heck they might dedicate the new healthcare system to their God Teddy boy Kennedy.