Here is a basis for discussion for healthcare insurance reform:
Eliminate the tort system for malpractice and replace it with binding arbitration.
Make everyone part of the same risk-pool so you could switch insurers and individuals would get same rate as business. Let people switch insurers during yearly open-enrollment period.
Have an alternative govt-run insurance option similar to medicaire, but allow private insurance to compete.
Remove restrictions on govt negotiating with drug companies on presciption prices.
Remove tax exemption on health insurance benefits.
Give a voucher to each family to buy insurance of their choice, with voucher being the cost of the govt plan.
There seems to be know way around having some sort of mandatory insurance requirement, otherwise young healthy people would take the chance of having no insurance and then join when they got older or sick.
This is a self-inflicted problem, caused by the use of insurance (the provision of stability, which benefits all customers) as a means of wealth redistribution (deliberately overcharging some customers to subsidise others). Stop trying to use insurance to do this (even if you use welfare to acheive the same goal), and the problem disappears.
I think point 1 is grossly unfair, 2 and 3 cancel each other out, and i’m not quite sure what 6 entails. 4 and 5 are fine.
If everyone’s in the same risk pool, then the actuarial premiums you have to set are for the entire pool of people, no? How does that comport with different people selecting different insurers?
Binding arbitration blows and is so grossly biased (both procedurally and substantively) against the party injured that you may have well proposed to eliminate the notion of professional malpractice (which I suspect is your goal). It also privatizes law, causes no precedent to be set (coincidentally the precedent that arbitrators now use come from the public law fora) which would have the end result of an incredibly foggy standard for “professionalism” in the medical field, and guts the right to appeal bad decisions (from both sides). Here’s a better idea: collectivize the risk pool for medical error - one insurer.
I don’t have any “goal” to get rid of professional malpractice, but our current system of awarding huge sums for punitive damages (with lawyers sometimes getting hundreds of thousands of dollars in fees) seems out of hand. Litigation is expensive and I’d rather see the money go to providing health care than to lawyers or insurance companies.
For the sake of argument, yes. If you’re going to make subsidising people’s healthcare mandatory, I would prefer that you don’t take this as an excuse to make buying the insurer’s services mandatory too. By separating the two you force the insurer to provide a service that benifits its customers, or perish as people cut out the middle-man.
True, but arbitration is the wrong way to go about this. Instead, you would need someone to set a standard of care that applies to all plans and physicians, so that the courts don’t have to make these decisions on a case-by-case basis. And that someone can only be the government.
Also, I don’t think malpractice litigation amounts to a very large portion of healthcare expenditures. Substantial to necessitate reform maybe, but not the primary factor in healthcare spending increases.
The OP is more or less where the discussion in the US has been going. I’m afraid whatever Max Baucus comes up with will be something “almost like this” but so adulterated by concessions to special interests that it doesn’t really function in a way people like.
I think I agree with what Grumman is saying. Personally, I would unify Medicare & Medicaid, & just make everyone eligible. (This does not mean all medical bills would be tax funded; it would cover basic care, & supplemental insurance would exist as well.) The funding base could be a flat tax instead of premiums.
Also, what we really need to do is to train more physicians. We’re not keeping up with demand, & that’s diminishing access to care & driving up prices. That’s possibly a greater inflation driver than health insurance.
It was my understanding that the most egregious malpractice awards were in obstetrics; I see this as jurists/juries not understanding the science well enough to decide fairly. We need better general education on the inherent & inevitable risks of childbearing.
I don’t want to keep dragging up med mal reform every time there’s a healthcare debate, but… there are almost no punitive damage awards in medical malpractice cases. full stop.
i think people dislike medmal for this reason: people are jealous of the award amounts while oblivious to the pain and suffering that comes along with those awards.
it makes it very easy for insurance companies and doctors groups to lobby that “something” needs to be done about it, when it is demonstrably shown, time and time again, that the rates and amounts of awards aren’t that ridiculous. most of the reason that awards are high is because the cost of the injured party’s future medical care is correspondingly high…
100% agreed. I would love if our federal government build 25 new med schools, provided free tuition for all enrolees and extract a commitment to work for a set salary at government-owned (not necessarily federal - alot of counties own hospitals) healthcare facilities for 8-10 years or so.
and while i’m at it, i would ban the practice of doctors having any ownership stake in any medical diagnostic or care facility. it’s a big, fat, disgusting conflict of interest that needs to be stamped out.