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I agree with your overall point that the U.S. medical system suffers from overregulation. We could (and should) allow more primary care to be performed by, for
by gabrielroth 17y ago
I agree with your overall point that the U.S. medical system suffers from overregulation. We could (and should) allow more primary care to be performed by, for instance, qualified nurses, RNs, and nurse-practitioners. As you point out, the existing guilds hate this idea.
But your first point needs some correction. Health insurance is only tax-deductible when it's paid for by your employer. [EDIT: Just noticed you mention this lower down, but your first paragraph gives a misleading impression.]
This is perverse in multiple ways. There's the way you mention: that it subsidizes health care over other forms of compensation, so we wind up spending more on health care than we would otherwise.
But also, with particular relevance to HN, it subsidizes employment over other kinds of work. If you leave your job to start a startup, you lose a substantial tax advantage.
- russell 17y agoIf you are self-employed you can deduct your insurance as a business expense, Schedule C.
- ams6110 17y agoIf you are employed but your employer does not offer insurance, ask if they would pay for an individual plan out of payroll withholding. I've done this and it lets you buy insurance pre-tax even if your employer does not have a plan. This is a significant savings.
- niczar 17y agoLook outside the US, and you will find that your solution (primary care done by nurses) isn't unlikely to be the right one. In France, going to the doctor (general practitioner) costs €22, before insurance (it's €5 or €1 after insurance, the co-pay as you'd call it). It's much cheaper because: - he didn't have to spend 200k to go to med school, it's free - he doesn't need 5 employees to fill insurance forms, or waste 2h a day calling insurers -- it's all automagic, no paper involved.