Some thoughts about health care — this will be developed.
The issue about healt care boils down to the question of whether it is a commodity or whether it is a basic right.
If health care is a commodity, then its price will be set by the (more or less) free market and it will be available to those who can pay for it. The rest will be dependent upon charity, which has never been a reliable source of health care.
Any attempt to combine health care as a right and health care as a commodity will necessarily have internal contradictions and lead to a compromised and ineffective delivery system.
If we (as a country) decide that health care is a right, then the most rational approach would be the British system, which is a mixed, not a socialist system.
Since health care is viewed as a right, it is publically supported and managed.
Hopitals are owned and managed by the state, physicians and nurses are public employees.
Thus, there is no incentive to deliver unnecessary treatments.
Since Britain is a democracy that has a private sector, private health care and insurance are available to those who can afford it.
Since this type of system does not seem to currently be politically feasible, we must attempt to approximate it by instituting tighter controls on the insurance industry which finances and thus manages much of our health care system, and by providing a publically funded managed alternative which will compete with the private sector and thus drive down its prices. This system will emphasis cost/benefit analysis and concentrate on maintaining health for the greatest number consistent with an equitable use of the available resources.
Right now, medical technology has reached the point where treatment is a scarce resource: not everyone can have any treatment they want. There must be some system to allocate this resource. Germany and Switzerland are models of this approach.
France has an intermediate approach: parallel public and private systems, with most people receiving publically subsidized health care supplemented by private insurance.
Presently this is done here through the ability to pay; either directly by those wealthy enough to pay directly for any treatment they want, or somewhat less directly to those who have access to and can afford comprehensive insurance policies that will pay for most but not all treatment.
One anomaly of our system is its tie to employers.
This is an artifact of WWII wage freezes. With a scarce labor supply and employers unable to compete on wages, they competed for available workers by offering generous health care benefits. This (particularly when a larger part of the population were industrial workers with union contracts) was effective for a generation or two, but is now breaking down. It is particularly vulnerable as job stability breaks down and workers find themselves losing health care insurance when they lose or change jobs.
Thus the allocation (‘rationing’) question cannot be avoided; just fudged by those who do not want to face it.
The issue about healt care boils down to the question of whether it is a commodity or whether it is a basic right.
If health care is a commodity, then its price will be set by the (more or less) free market and it will be available to those who can pay for it. The rest will be dependent upon charity, which has never been a reliable source of health care.
Any attempt to combine health care as a right and health care as a commodity will necessarily have internal contradictions and lead to a compromised and ineffective delivery system.
If we (as a country) decide that health care is a right, then the most rational approach would be the British system, which is a mixed, not a socialist system.
Since health care is viewed as a right, it is publically supported and managed.
Hopitals are owned and managed by the state, physicians and nurses are public employees.
Thus, there is no incentive to deliver unnecessary treatments.
Since Britain is a democracy that has a private sector, private health care and insurance are available to those who can afford it.
Since this type of system does not seem to currently be politically feasible, we must attempt to approximate it by instituting tighter controls on the insurance industry which finances and thus manages much of our health care system, and by providing a publically funded managed alternative which will compete with the private sector and thus drive down its prices. This system will emphasis cost/benefit analysis and concentrate on maintaining health for the greatest number consistent with an equitable use of the available resources.
Right now, medical technology has reached the point where treatment is a scarce resource: not everyone can have any treatment they want. There must be some system to allocate this resource. Germany and Switzerland are models of this approach.
France has an intermediate approach: parallel public and private systems, with most people receiving publically subsidized health care supplemented by private insurance.
Presently this is done here through the ability to pay; either directly by those wealthy enough to pay directly for any treatment they want, or somewhat less directly to those who have access to and can afford comprehensive insurance policies that will pay for most but not all treatment.
One anomaly of our system is its tie to employers.
This is an artifact of WWII wage freezes. With a scarce labor supply and employers unable to compete on wages, they competed for available workers by offering generous health care benefits. This (particularly when a larger part of the population were industrial workers with union contracts) was effective for a generation or two, but is now breaking down. It is particularly vulnerable as job stability breaks down and workers find themselves losing health care insurance when they lose or change jobs.
Thus the allocation (‘rationing’) question cannot be avoided; just fudged by those who do not want to face it.
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