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by kaushikktiwari 2369 days ago
Medical debt in the United States is another one of those defining monuments to inequality we have erected in the past decade another being the student debt crisis.
2 comments

Ironically, the severity of the student debt crisis would be reduced significantly if we made need-based scholarships illegal
Could you expand on this?

On first glance it seems like only the well-off would go to college. I won’t respond further unless I’m sure I understand your proposal

Need based scholarships allow universities to have nearly perfect price discrimination. This allows them to charge different prices to different consumers and extract the maximum amount each consumer is willing/able to pay. If they had to charge everyone the same price, that price would be considerably lower than the sticker prices now.
Are there studies on this, or is this just what we expect from economic theory?
Just think of it like this. If Harvard would charge $2000 in tuition each year but they raise the price $1000 for every $10k your parents make.

Sounds ridiculous right?

So the make the price $30.000 and give discounts if your parents don't make $100.000 instead.

Schools would not close but adjust their spending and stop building luxury campuses

Education loans just bring more money into the system and inflate tuition, just like how 0% down mortgages inflate real estate prices

The issue is that whenever anybody tries to fix it they're labelled as a socialist because that's how the right wing media has trained people to react. Apparently the only options are absolute survival-of-the-richest capitalism or Soviet Union socialism with no in betweens, go figure. In my opinion, democracy is dead and we're at a point where you can buy votes via professional gaslighting and mass misinformation.
People aren’t labeled socialist for fixing billing surprises. Trump is pushing a bill to do just that. People are labeled socialist for proposing new federal programs that will cost trillions of dollars more per year, on top of the $6-7 trillion a year that federal, state, and local governments already spend each year. Moreover, people are labeled socialist for proposing solutions, such as single payer, that are in the more government-run end of the overall spectrum of universal healthcare systems. Instead of trying to refine the ACA, for example, which would give us something like the Dutch or Swiss system, people are pushing for single payer and banning private health insurance, which is overall to the left of the various universal healthcare systems that exist.
> people are pushing for single payer and banning private health insurance

Single-payer does not mean abolishing private insurance.

Take the UK’s NHS for example - there’s a thriving private healthcare insurance and private healthcare provider industry there.

Trump’s bill is about price transparency - while the bill is not a bad thing it won’t solve the problem of inflated prices to counter insurance lowballing - I believe the end-result will be something like the “room rate” signs you see in hotel rooms in many states that show the maximum legally allowed billable rate for the room which is usually very high compared to the rate you’re actually paying.

As for the cost argument - people will NET save money because the tax increases to pay for universal coverage will be less than most people’s current healthcare expenses (assuming employers will pass on the savings from not having to pay for workplace health insurance as salary/wage rises for everyone).

> banning private health insurance

I don't think anyone is opposed to letting people buy private insurance on top of the obligatory single payer. Does any country actually ban additional private insurance?

https://www.nbcnews.com/politics/2020-election/does-medicare...

“ In fact, the bill would outright ban private insurance that provides similar coverage to the new Medicare for All plans after a short transition period. That means everyone with comprehensive employee benefits or a private plan through the Affordable Care Act today would be moved onto Medicare.

[. . .] Sanders has said he envisions these remaining plans covering a handful of items like cosmetic surgery that are left out of Medicare. For everything else, the only option is Medicare.”

It's not entirely clear, but I think the plans that are 'banned' in that case are not "on top of" Medicare, but instead of. I.e. there's a contribution you'd pay to private insurance that you don't pay to Medicare under those plans. Because otherwise... why bother banning them?
I believe the reason they are banned is to avoid a situation where doctors refuse to accept patients who only have Medicare-for-all insurance, and only care for patients who have private insurance.

Since private insurance is willing to pay far higher rates than Medicare, this would lead to Medicare-for-all failing. Doctors already exist who refuse to accept Medicaid-insured patients because the reimbursement rates are low compared to privately-insured patients.

Everything I can read about this plan says it would ban plans “on top of” Medicare, and contrasts it with other countries like the UK, Canada, and Denmark, which do have supplemental private coverage for medically necessary services available.

Canada kind of does.

As a physician, you have to pick either the public or private system. You can’t practice in both.

Well... Cuba, I guess.

I wonder how travel health insurance works for tourists there.

That’s not true, other people with ideas to fix it are labelled “heartless libertarian eugenicists who want to watch poor people die”