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Why Can’t We Have Market Solutions in Health Care?
Some time back, I asked “What Are We Going to Do When Republicans Don’t Repeal Obamacare?” And I got a fair amount of grief for doubting the sincerity of the Republican leadership that voted 30+ times to repeal Obamacare, but only when they knew the repeal would be vetoed. The House “repeal” bill barely repealed Obamacare at all (it offered the states some waivers over parts of the law), and now the Republican Senate Bill is even weaker.
Although Senate Republicans had initially indicated that they would scrap the House bill and start from scratch, the Senate plan looks more than a little like its House counterpart, which kept much of Obamacare’s structure in place. But even more tellingly, the Senate plan looks even closer to the health care law that is already on the books.
In other words, it is exactly what critics predicted: a bill that, at least in the near term, retains weakened versions of nearly all of Obamacare’s core features while fixing few if any of the problems that Republicans say they want to fix. It is Obamacare lite, the health law that Republicans claim to oppose, but less of it. It represents a total failure of Republican policy imagination.
Here’s what I don’t understand. To set this up, I don’t think the government has any business regulating health insurance beyond protecting people from fraud. People should be able to work out any contractual arrangement with an insurance company they want. The government’s only role should be to enforce that arrangement should either party try to renege; which would be done through the judiciary, not the legislature.
That’s what I believe, but apparently, I’m in the minority. All right, fine. So, the majority believes that the government should be able to tell insurance companies what kinds of policies they have to sell.
OK, if that’s the parameters for this discussion … why would it be so bad, even in that scheme… for the government to set a Minimum Coverage Baseline that was just Catastrophic Coverage plus one check-up per year? People would be covered if they got cancer or had a heart attack or were attacked by a bear … big expensive stuff. And they could get an exam from a doctor once a year if they want. That wouldn’t cost much, and the minimum that anyone needs. And if you have a minor medical issue, you assume the risk of paying for it out of pocket. From that baseline, you could modularize coverage, paying more for prescription coverage, and more for mental health treatments, depending on what you think you might need in the future.
You may not personally like that choice … but why doesn’t the government even allow that choice?
I kind of suspect that its the insurance companies that want the Government to force middle-aged gay men to pay for insurance that covers obstetrics and gynecology, and tee-totaling Mormons to buy coverage for alcohol and drug addictions. And forcing normal people to pay for sex reassignments for those with body dysphoria. Having the government force people to buy stuff they’re never going to use is sort of Crony Capitalism 101.
Published in Healthcare
Obamacare is a very, very, very, bad version of it, in effect. The Swiss system is a pretty good deal for everyone and it isn’t imploding everything. Socialism with a very light touch and done honestly and transparently.
see above.
If that’s the case, which version would you suggest and why?
France? UK? Australia? Canada?
How about Switzerland ? It’s similar to Obamacare.
A less rosy view of the Swiss system, including:
The consequence of the new law is that every citizen now receives health insurance and every licensed doctor is able to obtain a contract with an insurer, within the national TARMED framework. Every service is therefore paid by a third party and all prices are fixed.
Neither is socialized medicine, just private sector subsidized.
It all comes down to how large the subsidy is and how many people get subsidized and for which procedures/drugs.
You could have a “universal health care” system where everyone receives a free box of cough drops in January of each year. All other health services would have to be paid for with private dollars.
Technically, that’s universal health care. But it’s not what the Left wants.
What Spiral and anonymous said.
IMO, the problem is 70 years of never ending and increasing political and economic stupidity. We have to get rid of Medicare, Medicaid, and employment based group rates. We can’t get rid of the law that makes all hospitals take everyone at the emergency room. I really think the best thing is an improved, very stripped down Americanized Swiss system–Politically Forced Universal Coverage–because the structure of health care and health insurance is so skewed away from private now. It could be done with Large health Savings Accounts and taxpayer cash. Face it: we are going to shave off too much of our never ending ***2%***GDP to keep the national news happy. The danger is the Left can use it to force single payer and hand out all kinds of graft. We have some very smart leaders in Minnesota that are very nervous about this stuff.
Name a Democrat that is both informed and honest about this stuff: there are none. We are in a very, very bad spot and this thing is the ultimate tool for Leftist control. The UK NHS is the fifth largest employer on the planet in a country of 50 million. They control the whole political system and it sucks, big time.
Read Kevin Williamson article.
There is nothing good about a system that isn’t structured like this.
CATO always says the Swiss system is the same thing as the ACA. It’s not.
How about skipping the slippery slope and just heading straight over the cliff? Do not pass Go, Do not collect $200, Go directly to Cuba.
This is what we have to stay away from, big time. Our Rulers are not up to it. So we will get Death Panels or civil war or something.
Think of all of the effective employment and business graft involved with Medicare, Medicaid, the ACA, the VA etc. Supposedly the average senior takes $300,000 more out of Medicare than they put in. Something like that. Medicare Part D was an instant $9 trillion unfunded liability (to save Iraq LOL).
Also, blacks get massively shafted by the FICA tax due to actuarial issues. There is nothing good about government actuarial systems.
***Trump and the GOP should have done a one year road show explaining how we got into this mess and what the consequences are***. Intelligent town halls that mitigate the Alinsky nonsense. Then they should have just given us the choice of an improved Swiss system or the full CATO. The problem is, our Rulers are too stupid and corrupt for the latter.
If we don’t get the GDP up and create a more disbursed prosperity we are going to have huge social problems. All kinds of wealth is getting moved to Singapore and the Cayman Islands etc for good reason.
Think about it: what is the limiting principle in collectivism? There isn’t one. So how does that resolve? I have my guesses.
Also, Mises.org and David Stockman are right about everything.
Honestly, that’s what some hospitals in India look like. (On the right, at least.)
Because you get what you pay for, and that’s all that some people can pay for.
People need to pay closer attention to what Kevin Williamson says about how socialist policy “works” or not. There are cultural and institutional issues (honest bureaucrats for one) that facilitate it (or not). The other thing is some of those places more practice welfare capitalism than actually screw with every part of society willy nilly. Minnesota is going absolutely nuts with this crap.
@aClassicLiberal is really good at getting on the weeds on this stuff on twitter. He’s from Sweden and has a CPA and a Series 7 etc.
Good explanation of Denmark at 25:00. (The beginning of this podcast, ContraKrugman, is funny as hell, BTW.)
We have to get the GDP way, way up including a disbursed prosperity or things are going to get very, very bad. Romney 2012 was the last chance IMO.
If you wonder why the GOP is in such a tough spot.
This is excellent.