“Jonesy55 – The problem with your healthcare plan is that you want people penalized for risk factors which the Euros and Asians rejected because it would mean a police state to monitor people’s weight, miles driven…inspectors coming in to evaluate your home and what your “risks” were in employment and diet…and so on.
You also want to allow people to divert money out of healthcare accounts for whatever they wish to spend it on.”
No, it would mean that insurers asked questions about these factors when quoting for cover, the government wouldn’t need to be involved in this. It’s no more a ‘police state’ than when car insurers or life assurers ask similar questions.
As for letting people divert money to other things, yes why not? As long as they are covered by casualty insurance for major health problems, they can choose how much risk to take on for minor healthcare costs.
I would mandate casualty insurance (maybe with a prescribed maximum deductible) though otherwise you would get the problem of people choosing not to get insured and saving themselves the money then getting free treatment when they get seriously ill anyway because civilised society won’t just let them die.
“The Euros and Asians have found that unworkable. The risk must be spread around. Otherwise, you end up with wildly different rates for the same coverage and just repeat two great flaws in the American system (1)Younger and healthier people “opting out”, greatly increasing premium costs of families with medical problems or the aged. (2) You would just recreate the awful American problem of denying insurance and healthcare to those with a significant pre-existing condition until they bankrupt themselves on expenses then the state must give them care free……”
Well, I said that the amount paid by the government into an individuals health account would be adjusted for their age, gender and other risk factors not chosen by the individual, so a 65 year old with a family history of heart disease would get more than a 25 year old with no genetic risk factors. This would address your first point. I would let individuals take on the cost of chosen ‘lifestyle’ factors as this provides an incentive for individuals to reduce their own health risks.
Insurers and government could work together to come up with a list of pre-existing conditions that the market is unwilling to insure and individuals with those conditions could have an extra amount paid into their account to be spent on treating those conditions based on the cost of current treatments. This would keep the coverage universal while retaining the efficiency and choice of the market for the vast majority of cases.
Interestingly the British NHS is introducing ‘personal health budgets’ along these lines for people with chronic conditions, so a person with diabetes might get £x per year to buy NHS or private healthcare products and services with rather than just being passive recipients.
http://www.guardian.co.uk/society/2009/jan/16/nhs-health-personal-budgets
