Educated guy wrote:
Every damn health insurance thread on Letsrun is terribly void of identifying the root of the problem with our health care system. Hasn't anyone taken an economics class around here? Jeez.
Here's what needs to be addressed in the US "health insurance" system:
1) It's based on a fee-for-service business model (incredibly inefficient), and 2) it is "managed" by a third party payment system (also incredibly inefficient).
The ACA did virtually nothing to address either of these characteristics. It approached the problem from the demand side. Which, of course, only exasperates the problem by increasing demand [for the inefficiently-provided care].
Neither party wants to actually fix the problem. If you believe otherwise, you're a fool.
Fixing the problem would involve reducing health insurers' involvement for basic health-related goods and services. Eliminating it in most cases. If I have a cold or flu, or have a basic broken finger, or need a prescription for something, I shouldn't need to have Mr Health Insurer come in and skim some off the top of every single transaction between me and the doctor/hospital. Those prices should be published and doctors/hospitals can compete for the business of helping me resolve these basic health problems.
Complimentary to the above, fixing the problem would involve more properly defining and allowing insurance companies to actually do what "insurance" is supposed to do (risk/actuarial management). They are currently NOT allowed to do this. I repeat: Insurance companies are not allowed to function as real insurance. Anyway, since the basic health-related issues would now NOT skimmed off the top by the health insurance companies, they'd be making their money here. We could have a true "risk pool" for the truly catastrophic health events that occur in our lives. And yes, go ahead and cover everyone here. This could be a relatively standard proportion of an individual's income, with perhaps some progressiveness built in for the upper few percentile folks.
With just these two changes (albeit major changes, in the current climate), we'd greatly reduce the fee-for-service business model and the third-party payment system we have in place, and costs would actually start to come down. And AFTER costs start to come down, then guess what you can do? That's right, you can COVER MORE PEOPLE.
Our genius lawyer-trained (also a FEE-FOR-SERVICE industry, mind you) politicians tried to cover more people first, and not deal with the costs at all second.[/quote]
Your points about what insurance should and should not have in the "risk pool" are good in my book. They sound similar to thoughts from Mark Cuban, who I hope runs in 2020.
http://www.businessinsider.com/mark-cuban-healthcare-plan-2017-3