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by monero-xmr 906 days ago
After thinking about this a long time, and doing a lot of reading on the subject, here is my solution to American healthcare and perhaps in other countries with collapsing healthcare like the UK and Canada:

Most medical interventions, even ones that are serious like hip replacements, can be scheduled. It’s annoying while you are waiting, but it’s the rare case where emergency medical attention must be applied immediately.

All hospital systems should be deregulated - no more “certificates of need” and monopolist hospitals that can veto additional competition. If any entrepreneur wants to open a facility with licensed medical doctors, they should be able to service any and all ailments.

Finally, there will only be 2 official options for payment - retail and single payer. Single payer will kick in whenever bills go above $X, call it $50k. Retail will be out of pocket for anything lower, and people will shop for their own solutions. They can always buy additional insurance, and fund tax advantaged health savings account, but the single payer will not kick in until a catastrophic amount is reached.

The nightmare of medicine stems from the desire of doctors to be paid what they are worth, and the desire of government to cover everyone for “free” but never having enough money. We need to unshackle the market to let doctors get what they are worth, but drastically increase competition and the entrepreneurial animal instincts to destroy the bureaucratic mess that has bogged everything down.

2 comments

Does this mean that someone with diabetes effectively has to pay 50k/yr for health insurance? Or do you mean diabetics can pay more than 50k/yr because no individual vial of insulin costs over 50k, so a diabetic is expected to pay for all of their insulin out of pocket for their entire life?
I can be down for this. To anyone who doesn't deal with the innards of US health insurance, this is better coverage than every health insurance plan in America despite the bar seeming so low.

I do think your bar for catastrophic is far too high and should probably be ~$10k cumulative spent in any span of time less than 12 months because $49k is ruinous to almost every American.

My counterpoint is that for a family of 4 it’s $28k total per employee at my company for health insurance. If even half of that was put directly into an HSA the bar could be hit quickly. It’s just amazing how unbelievably expensive and wasteful US healthcare is.
That's a good point. Throw in a provision to handle workers that don't have benefits packages and still make shit pay and I think that's all my concerns.