How would proposals to reform the health care system in the US avoid rationing of services?

Question

How would proposals to reform the health care system in the US avoid rationing of services?

Answer 1

Which proposals are you referring to? Your question is vague.

Answer 2

No proposal can avoid rationing.  Like anything else, health care is a scarce good.  Its scarcity may be thought of in terms of the time and effort it takes to train professionals, the time required to administer treatments and the time required to research new treatments.  The materials required to make medicine and equipment are also scarce.

Absent government intervention, health care would be rationed like anything else - through prices arrived at by the voluntary exchange of goods and services.  People unable to afford health care would either go without or need to find someone willing to pay it for them (charity).

People not liking the idea of anyone going without health care sometimes advocate that government intervene to assure that everyone has it.  However, government has yet to solve the problem of scarcity.  Once the provision of goods or services comes under control of some planner, their rationing is no longer done through voluntary exchanges resulting in prices.  Rather, the rationing must be done by the arbitrary (good intentioned, or not) decision of the central planner.

Answer 3

which proposals?

services are always rationed, in pure cash fee-for-service, rationed to those who can afford, who buy what they think that they need

in mixed format (current) is mostly rationed by insurance company bureaucrats who can lose jobs if they s***w up badly

in national health system, will be rationed by political appointee bureaucrats, who have nothing to lose

Answer 4

The problem with not rationing services is that it is more expensive; my proposal is to set up a system where everyone can chose for themselves how much they want to pay vs. what kind of services they would like available to them. The single payer system I propose is different from other single payer systems because it would have three levels of public insurance, deductible, basic, and premium. Premium public insurance would be available to everyone at a higher tax rate than basic public insurance. All types of insurance would cover all preexisting conditions, prescription drugs, any and all medically necessary tests or procedures, and cover preventive care (Basic and Premium with no deductible). Premium insurance would have lower copays, not require referrals, and have a few other perks compared to basic insurance. Since the cost of premium insurance would be based on percentage of income, not charged at a flat rate, it will be an option for everyone. Deductible insurance is discussed below. In creating several levels of public insurance we solve the debate over lower taxes vs. more benefits by letting each individual chose for themselves which they prefer.

Insurance would be mandatory. Everyone pays a 3% tax for the public insurance program, and a higher tax rate depending on the plan a person uses. If a person has private insurance the 3% is all they pay, because it's not unlikely they would get dropped by private insurance and begin using a public program, and this would act as a progressive tax on the wealthy who would be more likely to have private insurance. Deregulate private insurance, let them drive themselves out of business, pick their insurance pools, drop people at will, etc. Anyone not covered under private insurance is immediately covered by basic public insurance (or their preselected type of public insurance) at a higher tax rate.

Each type of public insurance would set it own tax rate based on it's costs. Premium public insurance would be provided for free (subsidized by the general population) to certain groups, such as children, the elderly, the poor (people currently receiving Medicaid), and people with some serious chronic illnesses (including Cancer during treatment). The 3% base tax would be used to help pay for this. Full public insurance would be provided to people on Social Security disability, or people who fall in two of the above groups (lower income children & elderly people, lower income people with a serious chronic illness, or people who've spend more than 10% of their income on medical expenses). Full public insurance would be the only type of insurance that doesn't provide an opt in for anyone who wants it.

The 4 Levels of public insurance. All levels cover any & all types of medical treatment required for any disease or condition, including mental health coverage, and pay a 100% of hospitalization expenses.

1) Deductible insurance

    ÃƒÂ¢Ã‚œÂ¯ The government pays for medical expense over a 5% of a person's annual income

    ÃƒÂ¢Ã‚œÂ¯ A medical savings account containing the deductible would be required for this to prevent people from walking out on hospital bills

    ÃƒÂ¢Ã‚œÂ¯ After the deductible is reached you continue paying the deductible rate & get basic healthcare, or pay less 2% more of your income (or the difference between premium and basic healthcare, whichever is less) to get premium care. 1 year after you reach you deductible you start paying the normal rate for either of those plans.

2) Basic Public insurance

    ÃƒÂ¢Ã‚œÂ¯ Pick your primary care physician, and get a referral to for specialists

    ÃƒÂ¢Ã‚œÂ¯ Copays around 20$ for appointment with you PCP (primary care physician), 35$ for a specialist

    ÃƒÂ¢Ã‚œÂ¯ 20% of any prescription under 125$, all prescriptions over 125$ cost 25$

    ÃƒÂ¢Ã‚œÂ¯ Higher fees for other tests & services, none above 50$

3) Premium Public insurance

    ÃƒÂ¢Ã‚œÂ¯ Pick your PCP specialists do not require referrals, but there would be limits on how often you could see a specialist in the same field without a referral (physicians could refer themselves if they wanted to see a patient often)

    ÃƒÂ¢Ã‚œÂ¯ 15$ copay for any dr. appointment

    ÃƒÂ¢Ã‚œÂ¯ 10% any script under 100$, $10 for anything 100-175$, $15 for anything 175$ +

    ÃƒÂ¢Ã‚œÂ¯ Fees for other tests & services stay below 20$

4) Full Public insurance: you would qualify for this type of insurance if you had certain serious medical conditions and/or have a lower income, so you cannot afford to use another plan

    ÃƒÂ¢Ã‚œÂ¯ No copays for any services or medication, expect...

    ÃƒÂ¢Ã‚œÂ¯ 10$ copay the first time you see a specialist, after the first time it's free (to prevent doctor shopping)

    ÃƒÂ¢Ã‚œÂ¯ 5$ copay for medications that cost more than 200$ per month (up to 3, after that it would be free, like all other medication)

Emergency Rooms

Charge a 100$ fee for inappropriate emergency room use, 20$ for "non-critical care", and free if someone was directed there by a doctor, or has a serious enough condition to warrant going to the ER, and free for catastrophic accident use of the ER (if a persons would be unable to work for a period time after being admitted, or their were other significant economic consequences).

Profit

The fundamental problem with our current system is that profit is being made by denying people care. I have no problem with people making profit by providing quality healthcare services to patients, and I believe the profit motive can serve as an incentive to provide high quality care. Under a single-payer/multi-provider system, medical establishments make profit while working for the greater good. This involvement of profit is in everyone's best interest, as it increases patient chose and quality of care.

I have no objection to the government using tax money to massively subsidize biomedical research and the development of new treatments for illness. So I don't mind using tax money to pay high drug prices, if everyone who needs the drugs has access to them after they are developed.

Answer 5

Americans consume antidepressants as the most prescribed medication.

When you are healthy and your neighbor is not, there is that risk you could be in trouble. Your unhealthy neighbor who is mentally unstable for example could come shoot your children etc.

We are suppose to be our brother's keepers as social animals.

If the greedy million airs allow our health system to work for everyone, then you will see that there is enough money in the system to make it work for everyone.

Answer 6

What ration? What is the GOP spinning today?