Last week’s Open Thread has turned into a debate about health care in America. Instead of just posting a comment there I figure I would go ahead and create a separate posting to debate health care in America complete with my two cents of course. I think a national health care system is needed in the US, but not a completely government run one. A universal government run health care program would become extremely expensive and a huge debt burden with people taking more from the program than what they paid into it like so many other government programs.
That doesn’t mean that government doesn’t have a role in providing health care. I think there are certain catastrophic conditions that a national health care program should cover such as cancer, heart attack, stroke, etc. for everyone. As far as appointments to see a doctor because you have a sore throat, an upset stomach, or broken bone there should be a limit on the appointments that are covered by the government. Maybe five appointments a year that the patient pays $20 an appointment. Over 5 appointments than the person pays the full rate.
This needs to be done to avoid people making an appointment every time they have a headache and flooding the hospitals with appointments because it is “free”. If the patient has some skin in the game then maybe they will think to themselves that it may be better to wait a day and see if the headache clears up before spending $20 to see a doctor. I always wondered what would happen to Army sick call if the Soldier had to pay $20? I can guarantee there would be a whole lot less Soldiers missing PT because they feel sick. As far as the emergency room and using the ambulance patients should pay the full fee. These are finite assets that someone should not feel like they can just go and access at anytime because it is “free”. There are other things I think should not be covered by the government such as eye doctors, dentists, plastic surgeons, chiropractors, etc.
With the government providing catastrophic and basic health coverage the insurance companies should then provide policies to cover everything else. A customer should be able to tailor a policy according to what they need. For example maybe somebody wants a policy to cover the $20 deductible for the first 5 appointments and the full cost of any appointments after that, ER and ambulance coverage as well as dental and chiropractic coverage. This person may not want eye doctor coverage because there is nothing wrong with their eyes. Each coverage should have a price and whatever the total price per coverage is will become the monthly premium for the customer. Customers should not be forced to purchase all or nothing premiums. Without having to insure what the government is already covering this will bring down insurance premiums tremendously and make them affordable for all Americans.
This will also get US businesses out of the health care business. Wouldn’t US business owners feel a whole lot better about creating jobs if they did not have to worry about providing health care and the expense that comes with that for everyone they hire? This program could reduce the amount of money the Pentagon spends on health care as well. The national health care program would pay for health expenses of servicemembers and then Tricare would cover everything else. So servicemembers wouldn’t see any change in services provided, there would only be a change in the funding mechanism. This I believe would save the Pentagon billions.
Now the big question is how do you pay for this? I am not a believer in the class warfare rhetoric that is so en vogue in America right now. I believe in people paying their fair share for this program and I think the best way to do this is through a national Goods & Services Tax (GST) that many countries use today. So a study would have to be done to determine what the expense of the health care program would be. So let’s just say that the study determines that a GST of 10% is needed to fund the program. This means every time someone buys a good, like a car for example a 10% tax is added to the cost that goes to fund the national health care program. If you go to a restaurant where they are providing a service than 10% is added to the bill. This tax is progressive because the rich in theory will be buying more expensive goods and services compared to the poor and middle class. However, the GST causes the rich to not feel like they are paying high taxes to fund a bunch of freeloaders because everyone is paying into the program.
This is of course a major tax increase but I believe that over the course of the year it would be less than what people and employers are paying in insurance premiums right now while providing more efficient health care that covers everyone. Plus I think it would have a positive economic effect due to a major burden lifted off the backs of employers. Unfortunately I don’t think such a pragmatic program like I described is realistic in America due to the lack of enlightened leadership in this country. When you have one side that thinks government has no place in health care and is adverse to any tax increase and than the other side that wants complete government controlled health care that is funded by the wealthy than you throw in the special interests influence over each party and that is how you end up with the Affordable Care Act that does little to nothing to solve the health care crisis enveloping this country.
Well that is my best idea, does anyone have anything better?