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Politics : The Trump Presidency

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To: TimF who wrote (65922)4/10/2018 1:37:44 PM
From: neolib  Read Replies (1) of 359797
 
As I argue for healthcare, and it applies to education as well, indirection in payment is a major problem for cost containment. If you pay tax to fund education or pay your healthcare insurance premium to cover your medical expenses, when you show up to consume the resource, you have no motivation to contain costs. You have already "paid" and now you want the best service. Which then drives a cost spiral. Its more a problem in healthcare because of the lack of price transparency as well as the perception of risk than it is in education, but I think the same does apply to education.

How can you design a payment system that does two important things 1) risk averages across the population and 2) amortizes payments monthly over a lifetime (or at least significant fraction thereof). It is a bit different between education and healthcare, but a similar issue exists in both. College is a one off event (generally) and now quite expensive. It happens earlier in life. Health issues tend to be weighted toward the end, but again, they are now quite expensive. Healthcare has a bigger individual spread because of the statistics of many diseases, so risk averaging is more important here. But almost all such systems discourage individuals being vigilant about cost containment. After all, the best Universities open doors for employment, and the best Hospitals have better outcomes. Who wants cheap??
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