It doesn't have to start out costing a damned thing. Let anyone who wants to buy into Medicare at Cost Plus Ten percent. That would put money INTO the system, and automatically put pressure on insurance companies to watch their premiums. The extra profit could be used to extend services to the poor. A simple, simple proposal, and never on the table--for my money, that tells you the magnitude of the resistance this administration faces.
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Saturday, February 27, 2010
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10 comments:
You still have never explained, Steve, if Medicare is already flawed and unsustainable, as even Barack Obama has said it is, why should anyone believe that adding a bit more money and many more dependents will make this badly-structured and/or ineptly-managed program something other than badly dysfunctional? Where the evidence that this has worked before? Is it rational to think that if something works badly, that it will suddenly start working well if you give it much more responsibility? This reminds me of the sort of thinking that you (correctly) attribute to those fat people who "really don't eat very much."
Marco
Lots of simple proposals sound great, but the devil is in the details. Take the whole concept that people with preexisting conditions should have the right to buy into insurance plans. It appeals emotionally, but consider that many young healthy people may decide not to join a plan or if forced take the cheapest plan with the least coverage. Then they develop a serious health problem and need $100,000 dollars in medical care. They quickly join a plan that covers the required care and then leave when treatment is completed and the insurance company or medicare loses a bunch of money.
Marty S: Exactly. This is why the best option is a tax supported single payer system. That way everyone is covered with no such conundrums. For most of us, the tax increase necessary to support this would be about the same as the cost of healthcare that we or our employers woulde no longer need to pay.
Pagan,Steve:
Its great when you can through ideas around without hard numbers, but in real life we have to deal with hard numbers and reality. So here is a link with some hard numbers.
http://www.ebri.org/pdf/publications/facts/0709fact-medicare.pdf
The hard numbers are this in 2008 the government received 5 billion dollars from enrollies and paid out 49.4 billion. So if cost plus ten percent is ten percent higher than current enrollies the cost to the government would only be nine time what they pay in instead of ten times what they pay in. If they buy in at the true cost plus ten percent they would pay eleven times what current enrollies pay and that would be at least as expensive as private insurance. What it comes down to is "There ain't no such thing as a free lunch". So in any health care system there are going to be winners and losers and it take's a real honest look at all the hard numbers before we can evaluate what is really the best solution, not politically good sounding proposals like cost plus ten percent without looking at what that really means and it consequences.
So in any health care system there are going to be winners and losers
If we let conservatives design it, no question. And of course the losers will be all the people conservatives wish would die in the first place ...
Dan: While I find your statement unduly critical of conservatives as a group, in some sense you are right. If I design a financial model to help people select investments and its any good it will make different suggestions to different investors with the same resources depending on how they answer questions about things like their risk tolerance and goals. However, there are some investments it won't recommend to anyone. That is why we need to take a rational look at the country's investments like health care and build the best health care system based upon careful analysis and not pure emotion.
Marty, for a fradction of what we're spending to bomb brown people half the world away, we could have first rate health care for every person in this country. This isn't a resourceds issue, it's a priority issue. I'm not particularly interested in "careful analysis" designed solely to delay, which is all conservatives really want in this particular debate.
Apologies for spelling mistakes. Hainvng a moderately hard time seeing the screen today.
Dan: Actually I see no purpose to delaying if its not going to improve the final product. But careful analysis can prevent mistakes. For instance one of the things I would be concerned about would be medicare cutting its fees tp doctors by 20%, which could end up costing the government money instead of saving it money. There are a number of ripple effects that could occur from a fee cut and a through analysis is in my opinion definitely called for.
"if Medicare is already flawed and unsustainable"
Not steve but...
As correctly pointed out below current medicare is not set up to take in enough to fund itself. It exists to subsidize health care costs for those who can't afford it. Steve's idea radically changes the nature of the beast. Essentially this would create a government sponsered insurance co-op. I happen to live in an area with a very successful healthcare co-op. It's a good way to go.
I don't know if Medicare is inherently flawed; it is however overly complex. I was recently helping my father in law with his paperwork, it's really not an easy process.
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