It springs from an entirely different philosophy, reducing costs through the marketplace. It is assumed that national insurance policies would produce an active market with lots of competitors. If the object is to get costs down, I think it has merit as part of the solution
I'm not opposed to the concept of insurance policies that transcend state lines, but I think your assumption of lower costs isn't totally warranted. Two reasons. One is that insurers prefer to sell big, bloated, frilly policies that cover stuff most people will never have need for. The profit margins are bigger.
The other thing is that premiums must factor in the actual costs of the healthcare in a particular state. So the same Blue Cross coverage, i.e. same benefits, will always cost more in New York than in Arkansas because New York docs and hospitals charge more.
This was one of the reasons Southern Blue Dogs were somewhat opposed to Obama's proposals. The assumption was that any kind of national health insurance would actually raise premiums for folks in lower cost states like mine.
Having said that, I still could get behind a true single payer system of health insurance. If done right, it should lower costs for everyone. Or to get costs down for everyone, the premiums could be somewhat regionalized. Why should it lower costs? Because not only is the profit margin stripped out, so are most of the sales and marketing costs.
If the government is the only insurer, as with Medicare, there's no need for a sales force, an advertising budget, not to mention overly compensated upper management.
But it's a mischaracterization to speak of taking the profit out of all the levels of healthcare. Better to stay with a system that has private, profit-driven doctors and hospitals delivering the healthcare like all of Europe has (with the exception of Great Britain.) |
