(Todd Hixon, Forbes) Massachusetts, the canary in the health care reform coal mine, is starting to have a two tier health care system. That means that people with limited means have one system available to them, and those who can pay up have another…
I’m not a radical, but this does evoke images of the Soviet state where the Vlasti (political elite) had access to well-staffed, western-standard clinics and the rest stood in line for overworked, miserably underpaid docs. Or of U.S. Congressmen, with their platinum-plated, government-paid health plan for life, making the ACA sausage for the rest of us…
Fundamentally, we’re spending about all that we can on health care. Restraint has to occur some how. The main ways to restrain demand are shortage/queuing (as in the UK), administrative fiat (as in the Soviet Union), or economic incentives, e.g., a two tier system. Each of us gets to decide whether it’s worth the extra $5,000 (hypothetically) to have the hip done at Mass General, or at the Mt. Auburn hospital, a perfectly good but less prestigious alternative. The Saudi princes will no doubt stay with Mass General.
I’ll vote for economic incentives. Each of us gets to make his/her choice in light of the medical facts and our circumstances. And entrepreneurs who find ways to deliver quality care for less have a fair chance to attract customers and change the world.
Community: Here’s a better two-tiered system: Insurance companies really don’t want to cover catastrophic illnesses, so why not have them covered by a national program, either administered by Medicare or some private company? If the whole country were involved, the cost per person should be minimal. Then the insurance companies could compete on basic coverage only.
I’d like to get all profit-making entities out of the health care business in the long term, but before that can happen, we need to build a real opposition to the exaggerations and outright lies promoted by the right wing.
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