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Dateline, Vancouver, January 2018
I just read that the Democrat congressmen are looking for suggestions on how to reform the Affordable Care Act. A few years back I came up a fairly simple plan that could supply services and control costs better than the other proposals. The idea has some problems, but I think it would outperform the other plans that I've heard, and I'd like to pass the idea along. I was going to mail this plan to a few Senators but I don't think I'll bother. Congress is choaked with ideological extremists and proposing any out-of-the-box idea would be a waste of time. So I'll post it here instead.
Nationalized Health Care
Any health care subsidies will have to address the problem of out of control costs; for the patient, hospital and government subsidies. But none of the proposed plans that I've heard will do this. This plan will reign in overhead and costs while supplying full services.
The idea is that rather than managing millions of policies for individuals, each county will have a single policy that covers everyone in the county. The plans are then regulated and subsidised by the federal government, just like the ACA is now.
Managing plans at the county level has several big advantages over both individual and single-payer plans:
* A county's big population will give them the clout to shop for the best cost break between insurance companies.
* With one policy for a hospital's entire market, it would allow both the hospital & insurance company to dramatically reduce paperwork.
* Since nearly all patients will have the same policy, the hospital won't have to research which services and specialists are available to a patient, nor the billing rate.
* Since only one insurance company covers the whole county, they could invest in pro-active programs in that county.
* Counties will be able to compare their programs with other counties to see what works best.
* These advantages use innate efficiency and free markets to control costs, rather than regulations.
* The main drawback of this idea is that it requires the whole county to buy in.
Both the individual and single-payer plans will drive up costs. This is becuse there is no incentive for insurance companies, health care providers, or drug companies to control costs. In fact, these groups are likely to increase costs because that's almost always what happens whenever the government subsizes a program. This proposal has built in mechanisms to reduce costs, such as reduced paperwork, simplified planing, and free market clout. Plus, the single payer plan puts the government in the insurance business and wrecks the existing insurance industry, while this program leaves the industry industry in charge with the government just regulating it.
There is no longer any question of whether to subsidize health care or not. Our current medical system is so wildly expensive that it will bankrupt people who need to use it. It is now too expensive for anyone to use and too expensive for the government to subsidise. This has us in a situation where the government will have to cut costs dramatically in order to subsidize health care. Any proposal that doesn't reduce costs will fail, and none of the other proposals will do this.