(08-02-2019 02:09 PM)Owl 69/70/75 Wrote:  

(08-02-2019 01:27 PM)RiceLad15 Wrote:  

(08-02-2019 01:18 PM)Owl 69/70/75 Wrote:  

(08-02-2019 01:02 PM)RiceLad15 Wrote:  

(08-02-2019 12:50 PM)Owl 69/70/75 Wrote:  That's why I've backed Bismarck, which is basically free market (or a lot more free than ours is now) universal health care. Government pays for a basic plan of your choosing (essentially something like single-payer or a bad HMO) either directly (France) or indirectly through a tax credit (Heritage). You are then free to supplement your coverage, and employers can offer upgrades as an employment incentive. Or you can purchase an alternative plan, using the government contribution (where the government pays directly) like a voucher. Alternatives can include high deductible plans coupled with health savings accounts, which is probably the most economically sensible approach.
Heritage proposed a Bismarck-type approach 25 years ago. I don't know why republicans didn't pass it when they controlled both houses. Bill Clinton would have signed it just so e could have his name on health care reform, and we would have avoided the whole Obamacare debacle.

What's the mechanism that keeps the supplemental private options? I'd imagine in a single payer program you would have the same options available if companies wanted to offer those options.

The mechanism that keeps the supplemental private options is demand in the marketplace.
No, you would not have the same options available in single-payer because you don't have companies to offer them. Single-payer means one payer. That's why it's called single-payer.

See bold above.
That's what led to my question. I was wondering how something like single payer differed from single payer and allowed for the private options. Would a Bismark-payer (let's just call it that to not be confusing) offer plans that would offer lower levels of coverage from a single payer program? That would drive the demand for supplemental insurance.

I meant that the basic plan works sort of like single-payer, with long waits and queues. If you don’t want to wait, you go the the “pay” side. The difference is that the”pay” side is an integral and intentional part of the system, whereas it is outlawed in single-payer systems and generally discouraged in single-provider systems.

That makes sense. I'm far from a healthcare policy wonk, and really have no firm opinion on where we should go with healthcare, other than somewhere besides our current system. I wasn't aware that single payer systems expressly forbade private insurance plans, and had assumed most operated like you said - where private markets were available for more premium coverage.