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Originally Posted by wajobu
An overhaul is needed, but the approach is wrong.
Our health insurance premiums will be rising again next year between 20 and 32 percent (240% increases in the last 8 years...the 20 to 32% I quote is what Anthem Blue Cross has submitted to the State Insurance Rate Commissioners). I think that we should ALL be responsible for our own healthcare to a certain extent, and that there should be a National Major Medical baseline plan for EVERYONE who is a citizen. If you want more than baseline coverage, you pay on the private market...if you can't afford it, that's life. But EVERYONE gets a baseline plan that comes out of your taxes...everyone pays and everyone gets.
I think that many folks don't realize how much employers pay for group health insurance plans--no clue. We have a private non-group plan that generally costs about 35 to 50% less than a group plan provided by employers (but with a private plan you can be denied from the plan...this is a managed risk pool like auto insurance...with a group plan you cannot).
Next year, with the projected price increase, our insurance will again EXCEED THE COST OF OUR HOUSING!! Read that again. This is for a basic hospitalization plan with $5K deductible and an HSA that we fund out of a bank account every month. We pay for everything out of pocket against the deductible.
The plan that most employers pay for (if they have a group plan) will be thousands per month for a family plan. The larger the group (read ENTIRE COUNTRY) the larger the risk pool and the more the costs can be spread amongst many people thereby decreasing many costs with economies of scale. The private add-on plans will keep the private market alive.
A baseline National Health Plan is the right way to go.
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What you're describing is the way the NHS was originally set up in the U.K in 1948; cover for medical emergencies, extras available for those who could afford them. This is why in the main, Doctors and Specialists were not employed by the NHS, they worked for the NHS under contract. Part of the deal was they did NHS work for free as long as they had access to NHS equipment for their private work.
The problems began when medical emergencies was expanded to include things like Cancer, long term heart problems etc. that were incurable in 1948, therefore not included in the costing. Once these treatments became available to private (fee paying) patients, the public demanded that they be available for everyone. You can see their point; would you accept seeing the Boss's wife being cured of cancer while your wife died of it?
I think this is basically how it should be; if you wanted a private room with fresh flowers in a vase and top quality food it was available, but you had to pay extra for it.
Now, alongside medical centers and NHS hospitals with good medical care for all, private medical care and private hospitals complete with TOTL equipment are available to those who can afford it, funded either by private insurance schemes or for those with very deep pockets, paid for when needed.
As things stand, the NHS gives very good medical care, but has become terribly top heavy; beurocrats of all descriptions outnumber medical staff. This can change, but it's a hot potato; effectively you'd be asking the beurocrats who presently milk the system to devise ways of making it more efficient and put their own jobs at risk.
Could the above be improved and made to work in the USA? I don't see why not.