Rather than something that has competed whole cloth against alternative models, our current health care system is a band-aided-all-to-hell version of a system that was inherently flawed form the start, but which conservatives have not let us meaingfully reform. So over the years, rather than evolve, our system has instead mutated sprouting arms and legs as needed to fill one more role until, in the end, we're left with an ungangly mess of appendages that NO ONE would have concieved naturally, if they just sat down one day to design a health care system with the laudable goal of providing universal care.
If someone had presented me with the following, as their initial proposal for a system, I'd ask them if they joking, and have them fired on the spot if the said, "No." This is my interpretation of what that might have looked like, given how our system has ended up looking like:
Just LOOK at this mess! FYI: The Blue Arrow represents CARE. My Doctor provides me with care. Green Arrows represent PAYMENT: I currenltly pay out to (1) my doctor, (2) my insurance comapny, (3) my employer and (4) the government, who is also paid by my employer. Doctors recieve payments from three different sources: Me, the Insurace Companies and the Governement. Insurance companies are also paid from three sources: Me, my employer and the Government. Then you have the Red Arrows. These represent RED TAPE or DA RULZ. Governement tells (in far too few cases, I might add) the insurance companies how to operate as well as any doctors, who collect medicare/medicaid payments. (And this is not even considering standards of care, regulating safety, the FDA, etc... I'm only considering the PAYMENT side of things here!) Insurance companies make the doctors jump through hoops to get paid, and also create all kinds of red tape for their customers, just to justify not paying out or not covering them in the first place. In addition, because of their involvement, my company gets to dictate all kinds of stuff to me. A couple of gems that my company madnates: We have to declare our non-use of any tobacco products or else face a $50.00 insurance surcharge. And don't think for a minute that the insurance company's are giving us non-smokers a break. (Yeah right!) Even if they were, I'm not sure the $2 a month I'm saving is worth the invasion of privacy. (And lying on this form is grounds for termination!) What's more, if you have a working spouse that qualifies for benefits under her employer's health care plan, the s/he MUST be insured with them, otherwise you'll pay an additional premium to inusre your spouse under our plan. Yes, it's already more to insure a spouse, so why the hell should it be EVEN MORE just be she'sotehrwise insurable?! Insuring a spouse ALREADY costs more! WTF?
Bottom line, you shouldn't have to pay out to (or get paid by) three or more different entities and you shouldn't have red-tape going in every direction. None of this complexity is necessary or has anything to do with providing health care. And it doesn't even WORK! We're the wealthiest nation in the world, with health care RESOURCES to spare, and yet tens thousands die (or declare bankrupcy?!) every year from lack of coverage! And even putting that aside, NO ONE, if tasked to design a health care system form the gound up, would have come up with anything like this monstrosity right form the start. No way. It's like... if you asked someone to design the perfect household pet, chances are they come up with something simple, like a dog or a cat. There's basicaly no way they'd invision something resembling some sort of land-based octopus with five mouths.
By comparison, here is the same chart, based on what I proposed with my own health care plan:
See how simple this is? The Gov't creates the policy. A UNIVERSAL health insurance policy with little or ideally no out-of-pocket expense to me. Everyone is covered the same way: Completely. They pay for it with increased taxes (from me and my employer), but the increase in taxes is offset by none of us having to pay insurance premiums or other health care costs out of pocket. They then contract and pay the insurance companies to manage it, negotiate prices with doctors, etc... Insurance companies pay the doctors and the doctors give me care. There. Done. Simple. And if you read my original post, and the few follow-up posts I think you'll see that market forces are harnessed in functional ways that keeps costs low, using good old fashioned competion, in a way that guarentees universal care, rather than promising more profit the more people get refused coverage.
Now... I'm not saying this MUST be the BEST plan EVER, but thus far I have not seen one that's really made me think, "Yeah, that could work too!" Not even truly single payer. (The laws of Microeconomic[supply and demand] guarentee that true single payer will always either have shortages or cost more than it needs to.) Based on what we have as far as resources, THIS is how I'd have it work. And depending on your POV, it's both more conservtive than single payer, or even medicare/medicaid and yet more radical that anything being proposed by congress. And it's sustainable.
But it would never pass. It just make too much sense!
