One Piece of the Health Care Solution Puzzle

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From time to time people who are inclined to support heavy government involvement in healthcare will ask me what the alternative is.  My answer has been a system that disengages health insurance from employment, drives down the cost of insurance, and creates incentive for people to make prudent decisions and spend wisely.

Basically, the law would end existing incentives to route health insurance through places of employment and ease mandates to make high-deductible plans that really are insurance, rather than health management programs, more feasible.  With that done, opening up the insurance market across state lines would be no problem.  To compete and to manage their own costs, insurers might throw in things like a free check-up every year, but the idea would be that the purpose of their service is to manage risk, like car insurance, not to negotiate every detail of a person’s medical consumption.

To fill in the gap, everybody would get health savings accounts into which anybody concerned could put money — the people themselves, their employers, the government (for low-income people), and charities.  It would be tax free and would be an asset that could (maybe) be spent in retirement or at least passed down.

I bring this up because a bill for Achieving a Better Life Experience (ABLE) accounts passed both chambers of the Rhode Island General Assembly, this session.  Basically, it would create accounts for blind and disabled Rhode Islanders that the state would manage and into which any supporters could put money.  As designed, the system probably has more government involvement than needed, but the concept seemed familiar.



  • ShannonEntropy

    My answer has been a system that … creates incentive for people to make prudent decisions and spend wisely.

    I believe that is what the sky-high deductibles, co·pays, and max out-of-pocket costs that Rhodent·care imposes are intended to do

    When you have a $5,000 deductible and a $10K OOP ,, you would prolly rather die than seek medical attention … and that is *after* your $500 / month premium

    This essentially turns Rhodent·care into catastrophic insurance
    … at a much Much higher price than you would pay for, say, flood insuranc

    I have a friend who needs a steroid injection in his shoulder and his wife will need minor surgery this year. When you add up and amortize all the money they will need to spend before their Rhodent·care kicks in, it works out to over $1,000 a month

    AFFORDABLE Care ?? Don’t make me laugh

    p.s. the history of HOW medical insurance came to be tied to employment is kinda inner·resting … it parallels in time at least how the UK’s NHS system came to be. Hint = WW2 was integral to both

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