ACA Repeal/Replace: Progressives Face Moral Dilemma

[Warren Dew]

(01-17-2017, 12:38 PM)The Wonkette Wrote:

(01-17-2017, 02:51 AM)Warren Dew Wrote: In an ideal world, the government - or the federal government, at least - would just get out of medical care entirely, limiting its role to safety regulations.

The big problem with our present system is the economic distortion introduced when the beneficiary of a product is different from the payer of the product.  That's a recipe for overconsumption and overcharging - or at least overpricing - and is what causes health care expenses to keep going up and up.  And we have that distortion both with government provided medicare and with employer provided health insurance, which together include the vast majority of the market.

What that means is that we spend too much on medical care, and that takes away from the money we could be spending for things like a higher quality diet that would be a more cost effective path to good health.

Return the money and control to the people, and we'll see a more rational health care system and better health.  And yes, people will likely start paying for doctors' visits and drugs out of pocket and medical insurance will likely be limited to relatively inexpensive policies that only cover catastrophic needs.

How do you handle the affordability issue?  Most Americans don't have a couple grand lying around that they can use to procure routine preventive care such as colonoscopies or managing chronic conditions such as diabetes or asthma, common medical emergencies such as broken legs or pregnancy.  (I'm assuming that the catastrophic coverage would cover things such as heart attacks, strokes, cancer, and postnatal care for preemies.)  And do you really want people having to pay out of pocket for public good items like vaccinations?

For people at the age where colonoscopies are common, health insurance typically costs $500-$1000 per month, or $6000-$12000 per year.  If you get that money back - for example if it's paid by an employer now and instead they pay that money to you as wages - you can easily afford the colonoscopy.

Alternatively, people who don't do money management well could continue to just buy the same health insurance they have now, at the same price - though the price will come down as going rates are reduced from the competitive effects of people who choose to buy their medical care a la carte.

I would expect catastrophic coverage to cover broken legs.

Vaccinations might be a special case where the government - the state government, not the federal government - might choose to pay for them due to the general public benefit from people being vaccinated.  Vaccinations tend to be cheap anyway.  I do have to say, though, that I presently pay for my own vaccinations under Obamacare.