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My preferred approach for health insurance is to eliminate all of the regulations about what insurance plans must cover, and any other rules that prevent high-d

My preferred approach for health insurance is to eliminate all of the regulations about what insurance plans must cover, and any other rules that prevent high-deductible catastrophic insurance from being available on the market. You could then buy a very cheap plan that covers everything once expenses exceed, say, 20k, and be responsible for everything before that out of your pocket. Then, unlike now, people would actually factor in cost into their decisions about which doctors and hospitals to visit, which would hopefully drive down wasteful spending. The other thing I'd support is removing medical licensure from the law. People would still be free to visit only AMA-approved physicians, but there's no reason to give that guild a monopoly on providing health care. The artificial caps on medical school seats, imposed by the AMA, is one of the biggest reasons for the absurd cost of medical care in the US. >I don't know what the solution is here but if in this hypothetical reality, the garden state didn't supplement but California did then I'd move to California in a heartbeat. I am sure I'd be broke even with any supplement in San Diego but at least I'll be broke in San Diego. Sure, and when the people of California realize that they're attracting all of the deadbeats from around the country, they'd be forced to adjust.

newjersey 10y ago
I can support letting the bottom fall out like this provided we had full single payer coverage for everyone. Any additional coverage can then be whatever you want with the only protection from law being protection from false advertising. I can also support removing the ama-fia's control on licenses but I'm afraid we'll just replace it with something similar when it comes to which providers are eligible to reimbursements from the new single payer healthcare system.
- marcoperaza 10y ago
  My idea is that these catastrophic insurance plans would be affordable by anyone with their basic income. Debt financing could cover anything below the deductible, for the indigent. Getting such loans would also be easier because of the UBI. Again, people would be financially responsible for their own healthcare, which restores sane incentives, but it wouldn't be possible for it to financially destroy them. No need for a single payer system if this works as I envision it.
  - mapt 10y ago
    "Debt financing" and plans that may be absent or sometimes cover nothing much, is the dystopian nightmare we're trying to escape. Healthcare is not a normal consumer good subject to normal pricing pressures and amenable to substitutes. Single payer works extremely well.
- 0606hn 10y ago
  As I stated in a response to the parent commenter, the AMA does not control the number of medical school seats/new physicians in the country. Indeed, medical licensing is done by the states and is not a federal process.
0606hn 10y ago
> there's no reason to give that guild a monopoly on providing health care. The artificial caps on medical school seats, imposed by the AMA, is one of the biggest reasons for the absurd cost of medical care in the US. First, the AMA does not control the number of medical school seats in the country. Accreditation of US medical schools is done by the LCME, part of the AAMC. With some research, you'd find that the number of medical school seats is growing each year. Second, the limiting factor for physician training is NOT medical school but residency. In point of fact, the US imports residency trainees from overseas - we're not constraining ourselves artificially but instead of surplus training positions. Through a historical fluke, residency training depends on funds allocated by Congress through Medicare funding. I understand your frustration at healthcare costs, but please research these issues.
- marcoperaza 10y ago
  Apparently this has changed in the last decade (http://usatoday30.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm http://usatoday30.usatoday.com/news/health/2005-03-02-doctor...). But until the number of doctors rises dramatically, I think it's safe to assume that the same interests are at work as before. Further, the LCME is run in equal parts between the AMA and the AAMC. http://www.ohsu.edu/xd/education/schools/school-of-medicine/faculty/liaison-committee-on-medical-education/lcme-faq.cfm http://www.ohsu.edu/xd/education/schools/school-of-medicine/... See "Who serves on the LCME?"
- deleted 10y ago
  [deleted]

newjersey 10y ago

I can support letting the bottom fall out like this provided we had full single payer coverage for everyone. Any additional coverage can then be whatever you want with the only protection from law being protection from false advertising. I can also support removing the ama-fia's control on licenses but I'm afraid we'll just replace it with something similar when it comes to which providers are eligible to reimbursements from the new single payer healthcare system.

marcoperaza 10y ago
My idea is that these catastrophic insurance plans would be affordable by anyone with their basic income. Debt financing could cover anything below the deductible, for the indigent. Getting such loans would also be easier because of the UBI. Again, people would be financially responsible for their own healthcare, which restores sane incentives, but it wouldn't be possible for it to financially destroy them. No need for a single payer system if this works as I envision it.
- mapt 10y ago
  "Debt financing" and plans that may be absent or sometimes cover nothing much, is the dystopian nightmare we're trying to escape. Healthcare is not a normal consumer good subject to normal pricing pressures and amenable to substitutes. Single payer works extremely well.
0606hn 10y ago
As I stated in a response to the parent commenter, the AMA does not control the number of medical school seats/new physicians in the country. Indeed, medical licensing is done by the states and is not a federal process.

0606hn 10y ago

> there's no reason to give that guild a monopoly on providing health care. The artificial caps on medical school seats, imposed by the AMA, is one of the biggest reasons for the absurd cost of medical care in the US. First, the AMA does not control the number of medical school seats in the country. Accreditation of US medical schools is done by the LCME, part of the AAMC. With some research, you'd find that the number of medical school seats is growing each year. Second, the limiting factor for physician training is NOT medical school but residency. In point of fact, the US imports residency trainees from overseas - we're not constraining ourselves artificially but instead of surplus training positions. Through a historical fluke, residency training depends on funds allocated by Congress through Medicare funding. I understand your frustration at healthcare costs, but please research these issues.

marcoperaza 10y ago
Apparently this has changed in the last decade (http://usatoday30.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm http://usatoday30.usatoday.com/news/health/2005-03-02-doctor...). But until the number of doctors rises dramatically, I think it's safe to assume that the same interests are at work as before. Further, the LCME is run in equal parts between the AMA and the AAMC. http://www.ohsu.edu/xd/education/schools/school-of-medicine/faculty/liaison-committee-on-medical-education/lcme-faq.cfm http://www.ohsu.edu/xd/education/schools/school-of-medicine/... See "Who serves on the LCME?"
deleted 10y ago
[deleted]