All Things in Moderation

Drive by Post: Combining Free Market Insurance with Universal Catastrophic

22 Responses

1. 

   yellojkt, on March 20, 2012 at 9:03 am said:

   Great article, and it makes lots of good points. But the one I find disturbing is this:

   I might shop for a laptop based on the speed of its microprocessor and the resolution of its screen, but if I get cancer, I’m going to want the best possible care, with price as no object.

   But we make many purchases on an emotional basis. I occasionally take a date out to a nice restaurant, instead of buying her a sandwich at the grocery store, and not because the restaurant’s food has superior nutritional content. Entire industries–jewelry, say, or Hollywood–exist for no other reason than to satisfy our emotional interests.

   If I get cancer, I want it cured. Some lower level of treatment is not a good outcome. This isn’t irrational emotionalism like buying a girl a steak dinner in hopes of getting laid. I want to NOT DIE.

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2. 

   yellojkt, on March 20, 2012 at 9:10 am said:

   High deductible Health Savings Accounts are one way to cover catastrophic needs while inducing price-consciousness for routine care. On the flip side, Krugman is reporting that employer based coverage is on the decline. Looks like we will all be in those exchanges eventually.

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3. 

   Kevin S. Willis, on March 20, 2012 at 9:19 am said:

   yello: I think the point the author is making, perhaps a bit awkwardly, is that certain levels of cancer treatment can cost vastly different amounts while statistically having little appreciable difference in outcome. How often this is the case, I don’t know (not often, I would think), but, in any case, be definition you will not get the best possible care available with universal coverage, catastrophic or otherwise, you will get (ideally) the most broadly effective care for the greatest number of people that can be afforded without bankrupting the system. There may be something much better, and much more expensive, for your particular circumstance, for which private coverage (or healthcare savings accounts) would be a better solution.

   Even if the goals is universal healthcare from aspirins to bandaids to cancer treatment, universal catastrophic would be a much better foot in the door than the ACA. Strategically, some form of limited universal catastrophic healthcare has both an appeal and makes some sense (I suspect) to a majority of voters, while having the tax payer foot the bill every time I visit the Walgreen’s clinic for a cold or a minor med for a cut finger does not.

   While pharmaceuticals can be very expensive, the most expensive tend to be the ones related to catastrophic care.

   In any case, it would have been a good start, and a strong moral case could have been made, and with a charismatic Obama leading the charge, we could have been well on our way to a universal catastrophic, free market for day-to-day health coverage and supplemental insurance (universal catastrophic might feature a high-deductible tied to income, for example, for which a supplemental policy would be a great help).

   Instead, we have the ACA, which I think has left everybody underwhelmed.

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4. 

   yellojkt, on March 20, 2012 at 9:30 am said:

   That would be a much better system than the ACA. It would also have to have a means-tested public component ala Medicaid since even routine care can be prohibitively expensive for the working poor.

   It also keeps coming back to the fact that we are the highest users of health care the closer to death we are. But anytime you talk about following prescriptive care requirements, the slippery slope is to rationing and death panels.

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5. 

   bsimon1970, on March 20, 2012 at 9:40 am said:

   The author’s arguments are weak, but his conclusion is not wrong. Its a bit amusing that he argues against socialized medicine, which is not what we have. Further, if the goal is to apply free market principles to the health care market, the first move has to be pitting more decision making into the hands of the consumer, which he doesn’t address. There are valid arguments to make on the subject, but this author doesn’t make them.

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6. 

   jnc4p, on March 20, 2012 at 11:56 am said:

   “But anytime you talk about following prescriptive care requirements, the slippery slope is to rationing and death panels.”

   It all comes down to how much say you have in your coverage.

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7. 

   Troll McWingnut or George, whichever, on March 20, 2012 at 1:29 pm said:

   What if IPAB decides condoms will be the only authorized form of birth control?

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8. 

   novahockey, on March 20, 2012 at 2:43 pm said:

   I think most part D plans cover contraception already. But Part D is a different animal than the rest of the program.

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9. 

   okiegirl, on March 20, 2012 at 5:32 pm said:

   LOL, Troll. “What if IPAB decides condoms will be the only authorized form of birth control?” Do you have some indication this is under serious consideration?

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10. 

    Troll McWingnut or George, whichever, on March 20, 2012 at 8:25 pm said:

    Nope, but I don’t see why they couldn’t come to that decision.

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11. 

    novahockey, on March 21, 2012 at 7:52 am said:

    I could see something like that happening — we’ll cover condoms, but not oral contraception, because they also protect agaisnt STDs, while the pills puts people at risk yadda yadda yadda

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12. 

    yellojkt, on March 21, 2012 at 8:28 am said:

    Nobody covers condoms. They are over the counter.

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13. 

    novahockey, on March 21, 2012 at 8:34 am said:

    Could BC be OTC? I’ve seen some articles on that recently.

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14. 

    Troll McWingnut or George, whichever, on March 21, 2012 at 8:42 am said:

    I’m leaning towards a drug legalization position, my question for all who share that viewpoint, what about prescriptions? I would be for the elimination of the requirement of a Dr.s prescription. Why would that be a bad thing?

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    • 

      markinaustin, on March 21, 2012 at 9:24 am said:

      Quick answer is that parents would kill their kids with kindness, George. Further, the overuse of meds [think of the advertising we already see for Rx meds and how much more we would get] would rapidly cause tolerances to build and pathogens to mutate. It’s tempting to do this if we only consider the consenting adult, but not if we consider the ripple effects of buying for minors and educating germs.

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15. 

    yellojkt, on March 21, 2012 at 8:52 am said:

    Europe has very broad OTC rules. A great many things that are prescription only here can be bought in pharmacies there. Many people self-medicate which is a big savings on doctor’s bills when you have a recurring acute condition and don’t want to schlep all the way to the doctor just to get a new script.

    There is no way that narcotics would ever be sold over the counter. Imagine the chaos if oxycontin was available on demand.

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16. 

    bsimon1970, on March 21, 2012 at 9:13 am said:

    Moving meds to OTC vs prescription would likely cause a significant uptick in hospital admissions for harmful drug interactions.

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17. 

    novahockey, on March 21, 2012 at 9:17 am said:

    “Imagine the chaos if oxycontin was available on demand”

    one could make the case it already is.

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18. 

    Troll McWingnut or George, whichever, on March 21, 2012 at 10:36 am said:

    So, for the drug legalizers then (pot, coke, etc.) should they require an Rx?

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19. 

    yellojkt, on March 21, 2012 at 10:41 am said:

    The do in California. Every alt-weekly there has ten pages of ads in the back for marijuana dispensaries with on-staff doctors willing to diagnose you. The ads are far from staid. They make 60s era Grateful Dead posters look like eye charts.

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20. 

    novahockey, on March 21, 2012 at 10:58 am said:

    are we talking about medicincal or recreational use? i think there’s a difference between legalizing pot for medicinal use and decriminalization.

    i favor decriminilization b/c I think prohibition is an abject failure.

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    • 

      markinaustin, on March 21, 2012 at 11:39 am said:

      Agree with NoVA. In spades. Prohibition has been an abject failure AGAIN.

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