9/29/2007

Universal health care or alternatives

This seems to be a big topic right now, especially in the political ring. The Salt Lake Tribune recently ran an article about an idea along these lines. The article says that the insurance would actually be purchased from the private market but at affordable prices. The idea is to create a "stock exchange" where individuals would use pretax money and employer premiums to purchase their coverage. The exchange would not be a government entity but a non profit entity. The plans would also follow the individual and not change with job changes. The backers of this idea claim that it would increase competition between insurance companies which would drive the cost down. The article goes on to discuss more details and how the plan would be funded.

This was a new idea that I thought was interesting and I am curious to learn more about it. I think that the traditional idea of universal health care in theory is a good idea, but the execution is tough because it decreases the incentive for the actual health care providers. I had a friend who lived in Canada for a few years who had some pretty negative experiences with their health care system. His roommate had his scrotum bitten by a dog (this is a true story) and they had to visit 3 hospitals and wait almost 5 hours for treatment because none of the doctors knew what they were doing.

Our health care system definitely has problems and needs to be fixed. How to fix it is the real question.

13 comments:

Hailey said...

The mention of Universal Healthcare sends shivers down my back. I have heard and read so many things about implementing a universal healthcare system and how it will be detrimental to the market of healthcare. I envision long lines, less qualified doctors or physicians, and lots of paperwork before individuals ever get the care they need.
This system appeared to be different in that it wasn't the government running the entire show. They stated that there would be private insurance companies and independent committees to make decisions, as well as no price ceilings. These all sound like a move away from a completely socialistic healthcare system, but I still think we need to be very wary about the plan. I agree that something needs to be done about the high prices of healthcare, but I'm not sure if this is the best solution.

Logan said...

We currently have a policy for those who do not have health care and/or cannot pay for health care. Right now, if you walk into an Emergency Room and don't have any money (or a passport, visa, or SSN for that matter) they have to treat you. In fact they have to give you the full extent of quality care that they would give you if you had insurance and could pay for it.

Universal health care in the sense that you are proposing is like saying you want to put a Slurpee machine in every home. Sure it will be yummy goodness anytime you want, but somebody has to pay for it eventually. Right now, anyone that pays for health insurance and/or pays their hospital bill(s) currently offsets the cost of our 'universal health care.'

Our hospitals currently write off millions of dollars each year for medical services performed without compensation.

We currently have the highest quality care at the lowest price in Utah. Our health care systems are world renown and we continually entertain delegates from other states and countries that come to study exactly how we do it.

If you want real reform, encourage health insurance companies to reduce your rates if you have no/limited doctor visits (healthy) and to charge those that use the health care and medication systems more (unhealthy) a higher rate.

Dr. Tufte said...

Ooh, more than I needed to know.

I had not heard about this proposal. I find it intriguing and sensible.

However, I don't think it gets around the problem that health insurance is not a product that everyone would buy if they didn't have to.

A related issue is the experience in Massachusetts with Romney's insurance scheme. They had 600,000 people who shopped for and bought private insurance plans that were best for them that were ruled to be unacceptable by bureaucrats when the new system was enacted. The bureaucrats aren't at fault though: instead, they were looking for a one-size-fits-all plan, so it had to cover everything.

Dominic said...

This is a very difficult problem. I am quite frustrated to think that I am paying for others to receive medical services. Being self employed I pay for my own health insurance. It is a large portion of my monthly bills. I try hard to stay healthy and will avoid going to see a doctor at all reasonable cost. I probably average one hospital visit per year, and that is only because you can't obtain the antibiotics needed to cure certain illnesses such as strep-throat without a prescription. I end up paying a lot of money for this small service. Why? Part of the reason is that I feel health insurance in necessary in case something really bad happens. However, the part that really rubs me the wrong way is the knowledge that some illegal immigrant can walk in the hospital and receive the same care as me for free. They may not even pay taxes! This knowledge severely weakens my moral conviction to pay for the services I receive (or may receive).

Wyatt said...

This plan does have a major flaw that Dr. Tufte pointed out. Healthy families and young adults would not purchase this healthcare because it may not be worth the cost to them. This is why the insurance would still be expensive. If the majority of the buyers will be using the insurance frequently, the price of it will have to rise.

Timothy said...

Non-Profit or not, I don't think a quasi-government/private entity could run a program like this except right into the ground. Look at what they do with all the other programs they get their sticky fingers on such as Social Security...demand or not, I don't feel that they would be successful. And what about the cost of such a program?

Dr. Tufte said...

-1 on Timothy for poor editing.

Sophie said...

It is definitely time that the United States starts thinking about the high costs of health care in this nation, but going to a universal health care system seems like a step in the wrong direction. The costs that society would have to absorb from this type of system seem too high to justify implementing such a program.

P.S. Wow! That personal experience story was something else.

peyton said...

I recently heard one advocate of some universal health care reform say the the current market has failed. I think that the problem is not that the market has failed but that bureaucrats have regulated away the market. On of Mit Romney's problem was in lack of differing insurance plans. Insurance companies could not design different policies besides what was already regulated and allowed by the government.

Matthew said...

Dr. Tufte said that “health insurance is not a product that everyone would buy if they didn't have to.” Of course this is true! Everyone knows that no one can be turned away from an emergency room, whether U.S. citizen or not. Why waste money on health insurance when you know the government will take care of you?! The same thing goes for welfare, but that is another subject. Because people naturally want to help those people in need, it is difficult to come up with an efficient system.

William said...

Dr. Tufte,
I agree with you in the part of, "health insurance is not a product that everyone would buy if they didn't have to." Health care is a luxury not a necessity. I think that too many people view healthcare as a right that they must have, when in fact nowhere in the constitution does it talk about healthcare for everyone.

If you look back fifty years ago healthcare and dental was looked at as a luxury. It seems that times have changed and we want healthcare for all but don't want to have to deal with the costs associated to it.

I just recently wrote a report on the healthcare systems and what should occur. My one advice is to look more heavily into each plan. Many plans look very nice on the initial read, but when you dig deep into what they are proposing many of them are not as good.

For instance with universal healthcare it will hurt mostly the middle class because they are the ones that are going to have to wait in long lines to get help. They are the ones that will pay the high taxes. In the end they will get worse health care for a higher amount. It will of course not affect the rich at all because they will still be able to afford private care and get all of their needs met. The poor will now get better treatment then before, but at the expense of hurting the majority of the people. Not to mention all the perverse incentives. Many people can easily abuse the system and constantly go in for minimal problems due to the free care.

In the end this is an issue that needs to be carefully analyzed and looked at. I think that we need to be careful not to just accept a proposal at face value, but rather look deeply into the plan.

carter said...

Dr. Tufte said that a plan that tries to solve everyone’s problems does not work. People have different problems than their neighbors there for there is a market for many plans. People will pay for different plans.

Dr. Tufte said...

People will pay for different plans, but my guess is that the government will not be good about offering them options.

Really ... if you think about all of this ... a lot of it seems to be restricting the choices that people can make by using guilt about the outcomes of others.

That's kind of like saying we should only have one fast food place because some people don't like tacos and some don't like burgers.