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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Road Walker who wrote (24249)	7/18/2012 11:01:33 AM
From: TimF	Respond to of 42652

Again your pushing an irrelevant concept. Moving aside from the big theoretical issues about the size of government - "Something must be done, this is something, therefore this must be done", is a lousy argument for change. Something that's done can always make things worse (Also in this case the "something must be done" wasn't true, we could have muddled through with the old situation, just as we will muddle through if Obamacare sticks, or even if something worse replaces it, all sorts of sub-optimal situations can be, have been, and will be endured.) The problem with this change is that in almost no case (other than the tax/fine/mandate, which probably isn't big enough, and is problematic in other ways) does it shift the incentives people face in a direction that contains costs, in many areas it doesn't address the incentives at all, and where it does it shifts them to encouraging more cost increases. Covering more people, might be a good thing, but it causes more demand, driving prices and costs up. Forcing coverage for people with preexisting conditions, creates and incentive not to buy insurance. One of the main reasons to buy insurance (the only reason to buy "real insurance" rather than a "health care payment plan") is to remove the risk that some situation could wipe you out financially. If you know that if the situation arises you can still get coverage, the smart play for many healthy, reasonably young, people at the margin is to not buy insurance beforehand. (Even if you care about being prudent you could take the money that you would have spent for premiums and save it, which would also help you cover non-medical problems.) Forcing coverage for people in their early 20s under their parents policy is a relatively minor issue, but it also drives up cost. Outlawing catastrophic insurance, adding a very high level of minimum coverage, and restricting deductibles and co-pays (in some cases to $0), increases cost insulation, reduces the incentive to care about prices, and helps make the whole system more expensive. This isn't entirely new, cost insulation by insurance (and esp. insurance that third parties pay for), was one of the biggest drivers for increasing health care costs under the old situation. In a number of ways Obamacare takes what was problematic about our existing situation and makes it worse. If I wanted to greatly increase government involvement in health care (which I don't), I'd at least look at something that might make things better for a number of people, without greatly growing the problems we already had. Perhaps something like a single-payer catastrophic insurance coverage for everyone. Better than that would be to eliminate laws that ban or disadvantage insurance with less cost insulation, and laws that get in the way of competition. I'd also look in to ways to consider reducing the cost and time to approve new drugs and medical devices (perhaps making the approval non-mandatory, it would be more of a seal of approval, which might even be done privately, and it would be legal to sell drugs without it, but insurance probably wouldn't cover such drugs, if that's too radical perhaps the safety tests could be mandatory while the effectiveness tests would be a non-required seal of approval) If I had to make new active government interventions, rather than removing negative interventions, I might find ways to push transparency in pricing (which I might support without even needing the "if I had to", depending on the specifics of the plan), and consider improving the benefits and usefulness of HSAs. Its not all about shrinking or growing government, there are some ways where growing government might help, but not if the main effect is going to be to reduce flexibility and increase cost insulation.