OFF TOPIC
Duncan,
Any kind of insurance brings higher cost and takes away some of the rational caution of the uninsured. When I was a kid, I remember my father taking a car to the shop for body repair. The first thing the mechanic asked him, was whether or not he was paying himself, or whether the bill would be paid by insurance. The implication was clear to a twelve year old: The bill would be padded for the insurance company.
The same thing happened when Medicare started in the late 1960s. Fees and hospital costs skyrocketed.
Now my liberal side believes that nobody should want for medical care in this rich country. But I believe the "national health system" which is available to everyone should be "bare bones" and "no frills". My conservative side says that there should be other tiers of medical care for those fortunate enough to pay. Those who want semiprivate rooms, choice of hospital and doctor should be given a choice between various private insurance plans, ranging from the expensive, private room type to the prepaid HMO type, and all levels in between.
For those not destitute, a copayment should be required for each day in the hospital, each procedure or test, etc. Then real free market forces will begin to prevail, and the doctor and the patient can decide on what is best and feasible for the patient. With such a system, no controls are necessary. It is self-controlling. No bureaucrats or utilization review nurses are necessary. The legions of former real nurses who prowl the hospital corridors in business suits with clipboards going over charts for financial review could all be redirected into nursing again. Everyone would be happier.
This would result in tiered system. Politically untenable, of course, although nobody seems to worry about the tiered system we have for housing, food, or automobiles.
Jack |
