Re:I'm a Brit and America, your health care system is tortur...
by kasey_junk on Saturday January 05, 2019 @03:18PM
(#18833958)
You’ll note most of my commentary centers around employee provided health insurance. That’s because it’s the outlier. Other countries have similar systems to ours on the provider, Medicare & Medicaid side. Employee provided insurance is, as far as I know, unique. And it’s a dramatically stupid way to fund health care.
Further, it’s a less dramatic thing to change. We’ve already been through a much more impactful change in living memory in the form of moving away from pensions.
My position is that changing that are of funding brings price transparency to the biggest segment of the population & it derisks the migration.
It's possible that the pathologies of our system created those other structural flaws; like, if we had an NHS instead of private insurers, we wouldn't have built all these inefficient hospitals. But whatever the cause, we are where we are, and switching to single payer won't undo those problems.
Which sums up my concern about single-payer: it might be a good way to lock in a lot of structural problems for a long time. Meanwhile, if you just directly address the problems themselves --- stabilize the markets, enact strong price transparency rules, aggressively incentivize efficiency --- you might not need single-payer (an immense, disruptive change) in the first place.
Also, if we want cost outcomes approaching that of the NHS, we have to do more than simply enact single-payer. We also have to aggressively set rates, reduce compensation for doctors, fire a lot of nurses, and make people wait years for knee surgery.