It would be a huge improvement over the current mess:
I think that from the libertarian perspective, either of these proposals should be preferable to Obamacare. I’d even argue that they should both be more appealing to progressives. But the administration didn’t want simple, modest and stable; it wanted a massive, transformational legacy. Which is why, four years later, we’re still fighting about it.
Yup.
Yup. Any sane person would have preferred just taking the same trillion bucks and cutting checks to people who really need it for their medical care. But that wouldn’t have satisfied those who want the government to have regulatory control.
I’ve always liked the Federal High Risk pool to drive down costs for people who *really* need it.
Although once again, the management is the trick – you have to prevent people who would game the system (i.e. aren’t high risk) from presenting themselves as high risk.
Also I’ve always liked passing a law that prevents an insurance company from canceling a policy (i.e. breaking a contract) if a person gets sick.
If it’s legally possible, it might be useful too allow people to sign up for a policy for several years. i.e. the contract is set for several years. Costs more though – there has to be a benefit to the insurance company for offering that.
A hefty chunk of any insurance is pretty much the definition of “middle-man”.
And the problem with that isn’t the profits, it’s the needs-to-be-paid salaries of every single warm body at the insurance agency. Now add every aspect of the hospital/clinic/practice/doctor side that’s responsible for fielding requests and arguing claims.
Yes, you’re also ‘pooling risk’. That doesn’t affect the fact that you’re not only paying “probability of disease X”*”estimated cost of disease X” for everything covered, a large slice is directly billing, adjusting, evaluating, reacting, litigating, litigating, and litigating.
This says nothing about the defective price-fixing schemes of Medicaid and Medicare that this is built on as if those were a stable platform. Or the ‘different price for every customer!’ pricing/billing schemes from the medical front. Or the total lack of cost-evaluation as everything is near complete opacity and ‘someone else’s money’.
Start at the start along the path of total “self-insurance”. No, we shouldn’t -have- to be told. No, we don’t -have- the money in a brand new Personal Health Account -now-. But authorizing them is easy. And lean on the same levers that started off for IRAs: tax-free, company contributions, etc.
I would also support the move from maintenance insurance to catastrophic:
You pay out of pocket for check ups and vaccinations. Insurance kicks in when things get serious.
Where that line is drawn is a reasonable debate between well-meaning people. That would exclude Statists, lib/socialist/marxist kool-aid drinkers, shark jumpers and other dictatorial rump swabs.
Here’s a thought: Instead of trying to solve the “health” “care” “problem” wholesale, why not do the following: 1) subsidize care for pre-existing conditions directly (subject to means testing); 2) Take care of all other coverage needs on a sliding scale analogous to income taxes.