Laurence J. Kotlikoff with a voucher-based system designed to satisfy the left and right:
Nothing would be nationalized. Virtually all of the cost would be covered by redirecting existing government healthcare expenditures as well as tax breaks. Doctors, hospitals, and insurers would continue to market their services on a competitive basis.This is not a French, British, or Canadian solution. It’s an American, market-based solution that Republicans should love. It’s also a progressive solution that Democrats should love. (Democratic presidential candidate Mike Gravel has endorsed it.) The poor, who are, on average, in worse health, will receive, on average, larger vouchers. The rich will lose their tax breaks.
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{ 3 comments }
This is very, very much like what Matt Miller, pundit and host of Left, Right and Center on NPR proposed in his book, “The Two-Percent Solution”.
A refundable tax credit is the right way to do this; in the *ONE* sound policy move of the Bush administration, he’s proposed something like this. If you want better, you can pay for better. If you can’t afford to pay the premiums directly, you can endorse your credit over to the insurer.
If you insist on using a nonprofit or cooperative, you can. If you like the service or benefit plan better at a for-profit insurer, you can.
Here’s what has to happen to make it work:
1) Everybody who isn’t Medicare-eligible has to be in the pool – no exceptions.
2) Insurers can only rate based on age, gender and broad geographic area – county at least, preferably state. They must take all comers short of the fully disabled/medicare eligible.
3) The minimum benefit provided by the plan must be comparable to the minimum benefit provided under the Federal Employee Health Benefits program.
I’m a fan. It protects private enterprise, it assures access and it doesn’t cost much more than what we’re doing now – about .5% of GDP.
Eric
How naive. The inane American belief that there is a system or technical solution to every problem is getting tiresome.
There is no personal solution. Repeat that to yourself until you get it. There doesn’t need to be a perfect solution. We are all going to get sick and die, and that is going to be inconvenient no matter what you do. Unless we develope a euthanasia/suicide culture (Heaven forbid!), it is going to be expensive no matter how you shift the beans around. Some people aren’t going to get what they want or need no matter what you do. That is life.
When my peers were drinking themselves into a stupor and smoking pot every weekend in high school, I was studying. While my old high school classmates were chasing women, getting girls pregnant, working as little as they could get away with, and getting jail time occasionally for hell-raising in their 20’s, I was spending every waking hour studying and then working 80 hour weeks.
I made my choice, they made theirs. Why should I now buy the medical care for them and their kids that I worked so hard to be able to buy for myself. I still don’t see why it is considered a national crises that the improvident don’t get what they didn’t work for.
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