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View Diary: The Healing of America--by T.R. Reid (20 comments)

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  •  akmk - "All other rich countries" (0+ / 0-)

    don't have a one-size-fits all universal health care system and it isn't smart politics to try and legislate one in the US. England has had a parallel private pay system for more than five years. Several other developed countries also have hybrid systems that allow a private pay component to be part of the healthcare delivery options.

    The best chance we have here is a hybrid system much like the K-12 public and private school system. There would be a nearly free basic universal health care that covered everyone. However, no patient or physician would be required to participate in it. People and physicians could choose to be part of a private pay system that would be separate from the government funded universal access system. Everyone would pay taxes to support the universal access system, just like we fund universal K-12 education for all children. People using the private pay system could have insurance or not, it would be their choice. This has the advantage of choice, which most people would support. In addition, it silences the most vocal, and politically powerful, critics of any universal access system who would ask only to not be part of the system if they wanted a different level of service or care, and would be willing to pay for it themselves.

    "let's talk about that"

    by VClib on Wed Apr 25, 2012 at 06:55:21 PM PDT

    •  pragmatically it sounds reasonable enough... (0+ / 0-)

      ... but we have to be sure about hospitals.

      In an emergency there's no market, there's only saving lives.  So hospitals, in exchange for the various permits and considerations needed to operate, and the enormously lucrative private markets to which they can serve various forms of voluntary care, have to be precluded from any form of cherry picking.  

      And while we're at it, vaccinations need to be covered under the public system and under all private systems, no exceptions.  It would be one thing if unvaccinated people were only at risk themselves, but by decrementing "herd immunity" they put everyone else at risk, as the recent outbreaks of measles and whooping cough have shown.

      I would also eliminate "religious exemptions" from vaccination, except for individuals who lived in communities that were entirely self-quarantined from the general public.  As with the Amish, who don't generally do business directly with non-Amish except via the intermediary services of Mennonites, this could work out satisfactorily for all parties concerned, without putting the general public at risk for dangerous disease outbreaks.  

      "Minus two votes for the Democrat" equals "plus one vote for the Republican." Arithmetic doesn't care about your feelings.

      by G2geek on Wed Apr 25, 2012 at 07:48:00 PM PDT

      [ Parent ]

    •  There are many details about the systems of other (0+ / 0-)

      countries in the book that are not in the excerpts reprinted here in the diary.

      Many of the issues you address here are addressed in the book.  An extremely small percentage of folks choose private systems where they are available.  

      It is necessary to have universal coverage for even the private portions to work, according to the analysis.

      Otherwise, there is a two-tier system, with the lower tier being underfunded and under-served.   There needs to be universal coverage with a basic set of services that are the same for everyone.

      Beyond that the wealthy can always find something special almost anywhere.

      Just like with schools, everyone pays for public schools.  Those who choose can choose to pay extra for private schools.

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