| An ACA thread always seems like a good time to throw in a plug for socialized medicine, but I do want to remind everyone: Many people think that without ACA, the US healthcare market is free, which is why it has so many problems. This could not be further from reality. We have more government distortions in our healthcare market than countries with completely socialized healthcare. For example: Medicare: socialized medicare for the elderly, which alone creates more distortion than a universal program would cause by inflating demand/prices for non-qualifying citizens. Medicaid: socialized healthcare for specially qualifying poor people, which creates the same distortion as Medicare. An oppressive FDA: which, coupled with overly-powered IP laws, grants de-facto monopolies in the medical product industry. We have an incredibly expensive and subjective medical equipment pre-approval process (as compared to a less-terrible FDA that would just be in charge of labeling, preventing fraud, and maintaining accountability in the event of incidents). Then there's the length and flexibility of patent protections in our current system (maybe we could cut those protection times in half, and patent trolling would not be a lucrative industry). Oppressive occupational licensing: It's way too hard to become a doctor of any kind, even the kinds that don't manually put things into your heart. This will be a major battle as AI comes to the point where it can better diagnose conditions and largely replace generic/non-specialized pediatrics. Of course, the government will not make this easy. Plus a slew of more minor things like malpractice regulation, and now the ACA (which is not so minor, and which will apparently be replaced with something similar). If we cleaned up/removed all of the problems in the above and replaced it with single payer, it would be OK and we would have something similar to New Zealand/other countries with long wait times, not as much access to specialists, slow innovation, and a system where the government gets to decide who gets the last liver transplant and who dies. That would be a less distorted market than we have today, but ONLY if accompanied by fixing the aforementioned problems. Or we could try going the free-ish market approach and try to find a much freer balance with the FDA/USDA/occupational-licensing/scrap Medicare/Medicaid,etc., which we do not currently have AT ALL. And maybe even declare health insurance fraudulent and pay everything out of pocket (accident insurance makes more sense as a hedge against risk, which is what insurance is supposed to be, whereas all people are expected to develop health problems at some point, with a probability approaching one). |
http://kff.org/medicaid/state-indicator/medicaid-spending-by...
(When people have no money left, Medicaid pays for nursing home care)