After 77 years, I'm still waiting for someone to explain why ANY of the money I spend on health care should go to executives or shareholders of insurance companies.
IMHO the German system is the most convertible to US needs. Simple overview: The states (they call them Länder), not the national government, pays the bills (few payers not single payer), and the federal government subsidizes poorer Länder. A body made up of state and federal officials in cooperation with health care professionals and actuaries makes up at least one but possibly more standardized package(s) of services, and financial management companies step up as the HMO/health maintenance organizations to administer the packages. Consumers can change providers at any time.
The difference between them is about quality and efficiency of the administrative and management service they provide; they do not get to decide what procedures are to be performed, and they do not get to advertise scary outcomes and special options. In other words if Blue Cross stinks you go to Aetna or vice versa, and no one may say No to that. The result is that in general the lousy HMOs go out of business and the good ones make LOTS of money.
This approach preserves and perhaps even expands the private sector role, and as an independent business owner, I can imagine support roles I could offer to insurance (to become HMOs).
Instead of scheming RE how to steal the other guy's customers, each provider works on how to improve service. Terms and coverage do not vary from company to company, as all are obliged to meet the same criteria. The companies get a predictable cash flow. The best insurance/HMO firms will make huge amounts of money.
The government saves by the vaunted efficiencies of the market, and relatively few government employees would be needed. In addition it allows us to move into the future one step at a time, while we debate, plan and refine the techniques while reducing political stress.
The medical establishment benefits by getting the decision-interruptors, both private and governmental, off their backs and by a more predictable cash flow.
As to the public, the stabilization of factors like annual preventive care can be built into the service plan making everyone healthier.The principle difference is that no one is locked into an employer, and employers cannot use health insurance as a club to ensure docility of their workers. Career advancement is also facilitated, as the employee can change jobs without fear of losing health care.
Our problem is not inability to conceive of better and improving health care. Our problem is the best government money can buy.
If you saw the 1930s movie "Lloyds of London" with Tyrone Power you know that insurance was a great 17th Century concept. Why anyone would want to live or DIE by it today continues to mystify.
Win, win, win!
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