Wednesday, October 23, 2019

The great health care insurance debate of 2020

There is no free lunch in health care. Either you pay for it with higher taxes or out of pocket or some mixture of both.. The trick is: what will reduce the cost of all health care. Medicare for All will accomplish that. The advantage of Medicare for All is a huge pool, spreading the cost around us all. In theory the larger the pool, the risk and costs of risks are less per person. There are other ways to deal with costs. It is called competition: competitive bidding required for drug companies to be approved as suppliers for Medicare, Medicaid, and others. Another is the public option that forces private insurers to compete with a cheaper, non-profit or government system; Competition can also come from other countries with similar standards to ours, like Canada. The problem is consumers have no choice if medicare for all forces them to give up private insurance they like. What nearly killed Obamacare was that contrary to Obama's promise, you can keep your insurance if you like it and found out they could not. The moderates have a powerful message: consumer choice. I am looking forward to the debate and the polls with an open mind. In Europe even those who have a government-funded health system, private medicine is permitted, and may or may not be covered by insurance or a supplemental. Only Canada forbids private insurance but does permit supplementals. Switzerland is like Obamacare without a public option. It is the most expensive system in Europe, but consumers like the choice and just voted against medicare for all proposals. They would rather pay more in order to have choice and privately provided insurance. In any case, the current US system costs 2 and a half times per person as the rest of the industrial world.

I do not fear a government health program. I have a family by blood and marriage in Europe and they think we are nuts to be against it. There are problems, but they are able to shop for doctors they like and change them and pharmaceuticals are so much cheaper there. They can afford health care regardless of their income. It is hard to say if their taxes are more of a burden than ours because they spend less on defense and military than we do. I do not hear complaints about taxes because they feel they are getting their money's worth.

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