(04-25-2018 11:56 PM)arkstfan Wrote: Mods, this may not be fully in the spirit of our summa princeps GTS's idea for this board, but request grace because the discussion here is more sane and civil.
Now if I had my druthers, a Singapore system where people are forced to save to pay all but catastrophic expenses would be the path. I just don't see that being politically viable.
I think a Bismarck system is more viable to be accepted. The problem is getting from the point we are at to the point of such a system requires passing through some other point(s).
The flavors of the Nixon, Romney, Obama plans while following similar concepts had different implementation ideas. The general concept was conceived by conservative think tanks. On reflection I think they all suffer the same problem. The assumption that if all are covered by an insurance scheme that prices will come into some sort of sane order.
I think that is a flawed assumption because it rewards providers to bill as much as they can to maximize income. It encourages even more "if you have diabetes", "if you are incontinent", "if you need a scooter", "if you have restless legs" type advertising to drum up more billings.
So how to get from the point we are at to the point of a Bismarck plan?
I think step one is to try to do two things that will be hard to achieve but are closer to being achieved than a full blown Bismarck plan.
Part 1. We have a law that provides that any hospital accepting Medicare cannot turn away an emergent patient lacking insurance or means to pay, they are required to provide enough treatment to get the patient stable.
In that same vein, the first leg of my idea is that any PROVIDER who accepts Medicare, Medicaid, VA third party patients, Tricare or Federal employee insurance cannot charge an uninsured patient more than some percentage of what Medicare would allow. Let's say 120% for a starting point.
This actually doesn't just impact the person the we think of as uninsured. If you are in a car wreck where you are not at fault your insurance can deny coverage and you pay sticker price for treatment out of any settlement unless you can negotiate them down.
Part 2. When Medicare Part D was adopted to get it passed George W Bush agreed to a provision prohibiting Medicare from negotiating drug prices, so stuck paying sticker prices the program has been a financial pit and contributed to rising prices. Just change it so Medicare looks at the prices negotiated by the companies providing insurance for Federal employees. Take the three highest negotiated prices and Medicare pays the average of those.
THE REASONING.
Prices fixed by the state is an essential element of a Bismarck plan, limiting just prices for the uninsured and taking higher end prices for drugs is at least plausible to get adopted. Still a hard fight but at least possibly within reach.
I agree that Bismarck is the way to do. I do have a couple of quibbles with your post.
One, Bismarck fixes prices for only a part of the system, the part covered by the basic plans (the "free" side). The rest of the system (the "pay" side) operates on a free market basis. Whenever you fix prices, you will have shortages, guaranteed. It is the very viable free market pay side that covers the shortages in the free side that makes it work, that makes something like the Alfie fiasco in UK not happen under Bismarck.
Two, I think you are equating the Nixon, Romney, and Obamacare plans far too closely, and stating that they all came from conservative think tanks is not true. Nixon predated the Heritage plan by two decades, so he clearly didn't get his ideas from it. And the three are different in substantial ways, and all are substantially different from Heritage. For a couple of examples. One, Heritage included interstate purchases of health insurance, but there's a problem with that. You don't have people in Georgia selling Oregon health insurance policies, at least not initially. So you borrow the idea of exchanges from Bismarck Germany, where they are used for precisely that purpose, to facilitate interstate purchases of insurance. In Germany, each of the states (lander) has its own insurance fund which offers a variety of policies, and you can buy from any state, not just the one were you live. But Romneycare, as a state system, didn't address this issue, and Obamacare did not allow interstate purchases, so the Obamacare exchanges were just a borrowed name without the accompanying idea. Kind of a way to be deceptive, which is a theme throughout Obamacare. Two, Obamacare supposedly got the mandate from Heritage, but there's a big difference. Heritage proposed a mandate to buy health insurance, but with a tax credit up to the cost of a basic policy for those who did obtain insurance. Obamacare had the mandate without the financial incentive, so it never got anything close to 100% participation. Also, Heritage gave everybody the tax credit, it wasn't. means-tested like the Obamacare subsidies. Basically, Heritage was a variant of Bismarck without calling itself that.
What I'd like to see is Bismarck with the Singapore approach as an option. Everybody gets a basic policy free. Different carriers compete to provide the basic policy. One option they would have to offer is a catastrophic option, wit the insured also establishing a Health Spending Account to cover up to the catastrophic coverage floor, and the HSA would have all the carryover and transportability features that republicans have proposed. I think what you'd see happening pretty quickly is the insurers underwriting alternative care options (doc in a box, more stuff being done nurse practitioners/physician's assistants instead of full fledged docs) to bend the cost curve down.
I don't really see either of your Steps 1 or 2 being necessary or appropriate to shift to Bismarck. You could actually get there pretty quickly from Obamacare by changing the mandate to a formula that will generate 100% participation, and by getting rid of most of the paperwork bureaucracy that Obamacare and prior laws have imposed.