I'm quite opposed to private health insurance. Mostly because it's unethical, but also because it doesn't work at all unless you're willing for some people to die of being poor. Which most of us aren't I suspect.
But you have the problem of how to discourage people from using health care a lot when they don't have to pay for it, or pay higher premiums if they're expensive customers. This is more of an issue about "the gap" than about private health insurance, because it would be less of a problem for private insurers if the industry was deregulated and they could discriminate. But there are obviously other problems with them being able to discriminate.
One of the things health policy people get muddled about is how much the gap should be, whether there should be any gap at all, and whether there should be exemptions. How to you discourage people from consuming arbitrary amounts of health care, without excluding people who are very poor, or particularly bad budgeters. Tertiary education had the same problem, and it mostly solved it with HECs. I think you can apply the same principle to public health care. Except don't lend people money which they pay back later, give them money which they only receive if they don't use it on health care. Give every family a $1000 allocation at the beginning of each year. When they go to the doctor, they don't pay anything but an amount gets taken off their allocation. At the end of the year give a cash payment of whatever is left over, or nothing if they've spent it all. The effect is that the day to day problems of money shortages (which affect the poor most strongly) don't impact on the decision to take your kid to the doctor, but you'll think twice before visting the doctor every day. If people spend the whole amount, then everything after that is just free. You're not trying to recover your costs in any way, just attempting to ration health care out sensibly.
For students, a large friendly HECs-type debt is unlikely to be a reason not to go to university, but it will stop people from spending their whole lives there without a good reason. Hopefully it will work for sick people too.
What a lovely and clever boy you are
working busily on essay / 6:25pm / 25 April 2006
> but you’ll think twice before visting the doctor every day.
Why? You mean to say that people will think twice, because if they don’t consume a lot of care, they get the leftover money?
> If people spend the whole amount, then everything after that is just free.
I don’t think those couple hundred dollars are a very big incentive to limit your health care consumption.
But, backtracking to before all that:
Why would people consume a lot of care in the first place? It’s not like people WANT to be in hospital. People try to prevent getting sick anyway, and if they have to spend more than the yearly $1000, it’s free anyway. So while the money gained is nice, it’s not very effective as a means of limiting one’s care consumption. People will go if they need to go.
In people, the tendency to not lose money is stronger than the tendency to gain money, so I very much doubt such an allowance system would work, unless it’s NOT free above $1000. And in that case, the socialist tendencies of the idea become moot, because that’s giving people money… and then punishing them for not having enough!
Willem / 12:41am / 26 April 2006
Yep. I reckon the thought of money at the end of the year will influence people’s decisions.
I don’t know why people would want to consume it, but some do. Doctors also encourage people to consume services they don’t need because the doctor gets paid, and it costs the user nothing. That probably obviously won’t go away completely but it would improve.
Very sick people are just something the system has to deal with, and you can’t continue to charge them. And if people are hypocondriac enough that they’ll forego $1000 and then keep using health care for free, then you probably just have to deal with that too. If the only way of telling the difference between a poor hypocondriac and a poor sick person is by charging them real money, then it’s not worth telling the difference.
It’s not about limiting consumption, but about relating consumption to illness. If someone’s ill then they should go to the doctor no matter what.
In Australia at least, this system would be less socialist, not more socialist. :) I know that’s unusual for me.
Ryan / 10:27am / 26 April 2006
A new study published this week says American seniors are far sicker than their British counterparts.
Tony Martin / 10:22am / 4 May 2006