David S (12):
The more fundamental problem is that our current system has a negative impact on the health of our citizens, and costs more than superior care in other countries. Why should Americans not explore ways to improve our health care? Under universal coverage, the cost of your saline drip will no doubt be much more reasonable.
The problem is that going to a single-payer system will not improve our health care. As experienced by every other single-payer system out there, once the system is in place the bureaucrats realize that there is always more care required than the taxes collected will cover. Single-payer systems always ration care, and since the rationers are government bureaucrats they will always choose the most obvious, and least conscionable method.
The best fix to our health system is pretty simple, in theory anyways:
* Tort reform. A considerable chunk of our health-care doller goes to lawyers and liability insurance companies.
* Disconnect health insurance from employment. If I change jobs I can take my house insurance, auto insurance, life insurance, and property insurance with me. The “group” that shares risk is the entire customer base for the insurance company. I cannot – by law – take my health insurance with me. The “group” consists only of my company. The system was designed this way in order to help tie workers to their jobs.
* Make health insurance true catastrophic health insurance. Part of the problem is that what we consider as health insurance is actually a cost-spreading mechanism. True insurance covers only unexpected, but statistically predictable, costs – not routine maintenance costs. Health insurance should cover things like heart surgery and broken legs. Routine exams and maintenance medications should not be covered by insurance, they should be paid directly by the customer. One good compromise which the government could make would be a modification of the medical-flex spending account, which is a cost-leveling mechanism, allowing people to roll over unused funds from one year to the next.
* Finally, the U.S. government can and should pass policies that would encourage other countries to pay their share of medical development costs. One big problem with single-payer systems is that they discourage – on a cost-cutting basis – development of new medicines and treatments. These are almost always extremely expensive and take many years to bring to market. However, the cost-cutting policies of the governments that run the single-payer systems in Britain, Canada, France, et al, who mandate low prices which cannot support R&D, mean that almost all new medical developments on this planet are made in the United States and paid for by U.S. customers.
