[jnbiche]

>There are number of ways medicaid can be made completely redundant. Destroy the monopoly of AMC on the number of doctors. Let Indian doctors apply for a cap-free H1B and flock to US to give Americans a better health-care.

This is an excellent potential solution. If you've been to Thailand, India, and Mexico, they all have pretty good healthcare available for a cost that poor, working class families in the U.S. could afford out-of-pocket.

But whereas having cheap software programmers is clearly a god-given right in the U.S., having affordable healthcare is not.

[simonster]

I agree that the impossibility of paying for health care out of pocket in the American health care system, but I don't agree that this would solve the problem.

First, some people don't have any money, because they are mentally ill, homeless, or both. But our current system doesn't really do a good job of caring for these people, so perhaps that doesn't matter.

Second, while I agree that doctors are overpaid, the cost of living in America is substantially higher than in Thailand, India, or Mexico. You will have to pay the doctors more than you would in those countries. You will have to pay staff more as well. You will have to pay more for virtually everything. While working class families could afford health care in India out-of-pocket, it seems possible that those families could not afford the same health care in the U.S., assuming everyone involved is paid the same cost-of-living-adjusted salary.

Third, it's hard to provide good care if you can only give patients drugs that are out of patent. India and Thailand avoid this by refusing to recognize certain patents or granting compulsory licenses so that the drugs can be made affordable (not sure about Mexico). If the U.S. did this, it would get sanctioned by the WTO and the American pharmaceutical industry would cease to exist. Poorer countries profit from richer countries' investment in drug development, but if no one develops the drugs then everyone suffers.