As Prime Minister Series #1: Healthcare
Good evening ladies in gentleman, please keep you hands in the car at all times as we veer to the left and into the healthcare minefield.
Healthcare is one of those parts were the "progressive" part of progressive libertarian comes in. I support public health care insurance, which doesn't seem very libertarian of me. Food is essential to life, but I have no problems with that being market driven. So why would I consider health care different?
It's your choice to drive a car, and so paying insurance is optional. However, healthcare isn't a choice. When you need it, you need it now, and you don't choose what kind of service your getting.
Still, I'm not suggesting we simply stick with what we have here in Canada at the moment. We have doctor shortages now because 15 years ago the provincial governments cut back on spaces in med schools in an attempt to contain costs. What we need is a mix between public and private insurance that ensures everyone is covered and gets the best possible care.
Without further delay, here is my prescription for health care:
- All Canadian taxpayers and their dependents will recieve a basic health care plan that covers the following:
- 1 yearly physical
- 2 elective surgeries/year
- 15 doctor visits (any referrals count as part of the same visit)
- Tests/MRIs/etc as long as within the 15 visits mentioned above
- Visits exceeding the 15 above require a 50% co-payment.
- 100% emergency coverage
- Post-operative home care & supplies
- 50% prescription drug coverage
- Pregnancey & Natal care
- other stuff that I'm overlooking might be included.
- The plan must be accepted at all licenced health care facilities in Canada
- The plan does not include
- Out of country medical
- private/semi-private hospital beds
- Cosmetic surgery
- Premiums for the plan will be set on a province-by-province basis by their respective Medical Associations, and will come off of your paycheque (similar to EI and CPP)
- The basic health care plan will be run by a not-for-profit crown corporation, and the premiums will not go into general government revenues
- The user may opt out of the plan if he/she has private medical insurance.
- All other health care decisions are left to the provinces (i.e. allowing private hospitals, etc).
What's important to note is that this won't solve all problems. There's no magic solution that allows everyone to get unlimited first rate health care for free. The best we can do is be pragmatic.
posted by Kyle_From_Ottawa @ 8:24 p.m.
8 comments
8 Comments:
It sounds great, but what about the person who really "needs" that 16th visit, or that 3rd surgery? Can individuals pay the cost out of pocket, or trade "credits" with people who don't use their allotted amounts?
The problem I have with socialized medicine can be illustrated through an analogy to travel. Everyone is free to walk. If you have some money, you can ride a bus or a subway. If you have alot of money, you can ride a taxi.
If you have to pay for medical care, you will be more likely to exercise and eat well to avoid the costs of going to the doctor. This is like the walking option. You walk as much as you can, and only pay when you have to, i.e. it's raining.
However, if taxis became free, few people would walk. Similarly, if health care is "free", then fewer people would try to live healthy, and they would surely "use up" their allotted visits to the doctor, often for unnecessary visits or procedures, thereby reducing the time the doctor has for people with more serious problems.
Bottom line: when people see something as being "free" they consume it more than they otherwise would or should.
They pay for it out of their own pocket, there's no quotas here. I'm trying to mix the best of public and private healthcare here, I feel this is one area where the adage "everything in moderation" applies.
I'm suggesting that the government will a basic health care plan to you as a "group benefit", which you can add to or replace with private insurance as desired.
When I was going to university, the university provided me with dental coverage as part of my tuition. However, if you had your own dental coverage from elsewhere, you could opt-out of the program and get your money back.
This would be a similar system. Maybe you should have the option to opt-out entirely if that's what you want.
Another option might be to avoid insurance (public or private) entirely. Doctors would be payed directly without going through a middle man, just like any other produce or service.
Quite possibly its having this middle man between you and the doctor that's caused health care to become so expensive in the first place. If you didn't pay for your groceries but instead paid indirectly through a "food insurer", I'm positive you'd be paying far more for that steak or apple.
However, this is pure speculation, and probably a tough sell with both the public and the medical industry.
Veritas, I believe your analysis is overly simplistic. After all, Americans pay for their health care and yet, unhealthy behaviours like smoking and overeating are rampant. By contrast, people in Europe, who have socialized medical systems are generally more fit and less obese than North Americans. Cultural differences play a more important role than whether health care is private or public.
Rob,
You've made my point for me, although my overview of the system may be a bit simplistic. I don't claim to be a doctor or overly knowledgable of mega health care systems.
However, my point remains the same. Why should I be mandated through taxation to pay for the health care of people who make poor CHOICES, as in the case of obesity and smoking? Will they pay me for NOT smoking? Perhaps they'll pay for my gym membership or new running shoes.
I've been to several European countries, and I think their health has more to do with the way they get around. It seemed much more common for people to make frequent trips to markets on foot, and also by walking to and from trains they get the exercise that Americans do not, since we rely on our cars too much.
Nothing would make me happier than a move in this country to popularize trains and busses in favor of cars for many obvious reasons.
Kyle,
If an individual doesn't use his "allotted" amount of services, does he receive a rebate for the unused portion? Should he?
I understand the theory that employers need healthy workers to work, but if that's so important to the employer than the company should set up a private plan, just like my employer does for me.
Also, as a reference, I have a sister-in-law living with me right now who has 2 kids and they are getting "gov't money" for food and they don't pay for medical care. She abuses it, and then complains that the facility is lacking or the doctors aren't "nice enough". I think she is the rule as opposed to the exception.
Kyle,
BTW-good job on the WW, that's what we call "walking the walk" instead of just "talking the talk".
Veritas:
It's a compromise, I admit. My system relies on the hope that people who can afford it will move to private insurance without the public system turning into a place with bad hospitals and shoddy doctors. My fiancées father happens to be a doctor, so I'm aware of the failings we have now.
I think healthcare is one of those things where there's no great solution. If you go all private, then those who can't afford it are in a real bind. If you go all public, then you end up with quotas and waiting lists when the politicians realize you can't spend money like water. Mix the both, and you avoid the worst of either, but you also don't get the full benefits of either. It's a "pick the lesser evil" question, and if there was an easy answer we wouldn't be having this debate.
As for WW, week # 2 is going to be good too!
When I was a teenager, I got depressed and gained a lot of weight. I started working out when I turned 20, and I got back in shape. However, things slipped a few years later and now I'm all the way back to where I was at my heaviest.
This time though, I have my fiancée who also is doing WW with me. Strength in numbers I say, and hopefully she can keep me on track while I return the favour.
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