ACA Repeal/Replace: Progressives Face Moral Dilemma

[Bob Butler 54]

(08-15-2017, 02:19 AM)Warren Dew Wrote:

(08-14-2017, 03:49 PM)David Horn Wrote:

(08-01-2017, 04:19 PM)Warren Dew Wrote: I myself am in the "not-quite-elderly" category, so I have a strong incentive to give us the best system.  However, the best system is not one that makes us sick and then gives us expensive, counterproductive medical care by bankrupting the next generation.

The best system is one that keeps us healthy.  That involves better diet and lifestyle, not more medical care.  The more money you throw at the medical system, the worse it gets.

OK, but don't have cancer, a stroke, any of a hundred ailments involving internal organs, or a major accident requiring surgeries and rehab.

No worries.  Better diet and lifestyle prevent cancer, stroke, etc.

Quote:The purpose for insurance is to cover unexpected or preexisting conditions with a structure that permits the affected to get affordable care.  Everybody for himself is not an answer, so pick an option that is.  There are easily 25 of 30 decent models in use somewhere.

Pick whatever option you want, as long as you pay for it yourself instead of trying to get others to pay for you.

There are people, Christian Scientists for example, who just don’t believe in modern health care.  I’m half tempted to let such people opt out and go pay as you go.  

Currently, one of the many mandates that form Obamacare says if you are sick enough for the emergency room, the emergency room has to take you.  It is almost tempting to say that the emergency room does not take those who opt out.  Currently, the healthy and wealthy can gamble with their health, and it’s a decent gamble often profitable.  If they are unlucky though, if they develop a condition, the kluge of Obamacare bales them out.  It seems proper that those who do not pay into a system do not get the benefits of the system.

Warren’s faith in diet and lifestyle can produce decent profitable gambles.  The question is whether the public is expected to bail him out if his gambles fail.

Currently, there are tax penalties if one hasn’t health coverage, attempting to collect enough funds to pay for the gambles that don’t luck out.  Can we reverse that, reward those with no health coverage lower taxes, but not be expected to bail out those who do not contribute?  Let those who want to gamble pay the stiff cost of gambling?

While there might be a default normal level of health care, should and could there be a cheaper variation that does not cover certain procedures?  Again, if you do not want to pay for certain procedures, you are stuck with the bill should those procedures have been helpful.

If one wants extended coverage above the default, should a variety of supplemental plans be available?

I can see that folks like a christian scientist or Warren might be dissatisfied with the modern norm.  Hey, I’m not thrilled with the modern norm myself.  However, if we humor such eccentrics the modern norm doesn’t get implemented.  Their values are utterly incompatible with most.  Their thinking seems pretty far out to me.  The healthy and wealthy, willing to gamble, perhaps believers is some type of holistic medicine, might be allowed to set up their own system but not expect more normal folk to bail them out when trouble hits.  Statistically, it will hit a certain percentage of them.  If they want to risk their life being ruined by absurd expenses, should we let it happen?

Myself, I’d rather look at health insurance like fire or automobile insurance.  Everybody contributes.  If you’re one of the unlucky one, the contribution of the lucky ones cover it.  I’m not the sort of gambler and rejector of modern medicine as some.  Warren seems to reject the idea of spreading risks.  I don’t mind him gambling, but I don’t want him forcing everyone to gamble, I don’t want him preventing others from sharing risk.

Given the the 4 choices listed by Kinser’s PBS web page, my own preference would be starting from Beveride or National Insurance models.  Those are risk sharing systems suitable for single payer.  That encourages one size fits all coverage, equal for all.  Obviously, this isn’t the ideal system for the gamblers.  Is it worth giving them the choice to opt out?