That's easy to do.
There is access to care and then there is delivery of care. Our Health Care Reform worked on the problem of access to care costs. I'm particularly sensitive to these because there is a conflict of interest between paying out for care and profit. Most nations have solved that by either socializing the access problem, or using a hybrid (france), or through serious regulation, like a utility, or bank used to have here, for a reasonable and consistent, though not sexy profit. (Sweden, I think)
The French system is attractive to me because the basic care, "mutuele" (SP?) is inexpensive and the default. That will get you though, with few frills, but nobody is losing homes, etc... Add on coverage, or "value added" coverage is available through private insurers, where they don't have to deal with the conflict of interest, instead providing a nice value for dollar coverage, that covers co-pay and supply bills not covered in the base system, and with lots of riders that address different coverage needs and choices. If you want to be pampered when sick, you can get that! Or, if you want to keep it strictly business, you can get that too.
It's a very nice hybrid, and the beauty of that is the massive load on access costs and risks is well distributed nationally, no conflict of interest there, costs low. From there, private companies can sell add ons, in what is a nice market place. Seems more American than what we have right now, frankly.
BTW: Here, private insurers operate on very thick operating costs, some up to 30 percent of every dollar. We get nothing for that, other than them bearing some risk, but there is the conflict and no real competition, because we tie it to employment and such.
Then there is the delivery of care. As Andrew mentioned, our VA is that kind of system. I don't think it's desirable for most of the reasons given, though I would take it, if forced, instead of the mess we have now, because I would still have the work product of my 20's and 30's today. 
Anyway, again there are variations, ranging from all private, to hybrids, to socialized, each with trade-offs.
If anything, we really should consider a hybrid here, just for cost and preventative reasons, with private care, specializing on top of that.
Of all the things discussed, I too prefer Medicare for all, just because it's a huge savings on access costs. (25 percent by most metrics I've seen) There would have to be some adjustments in how it pays and why it pays, but honestly, those are great discussions to be having.
After learning how people in nations with good, functional systems experience lower overall personal cost and risk, it's a no-brainer for me. Those are direct conversations with people in France, UK, Germany, BTW. I know them well from one of my electronics hobbies.
If we decoupled it from employment, we would seriously improve how competitive small business is. In the small business I work in, health care costs for good coverage, comparable to what we see in other nations, low deductible, most things paid, low out of pocket, etc... it is the single highest cost growth center in the company, costing us about a full time position, we all work some extra, on salary, to fill that gap today.
Increases have been double digit each year for many years now...
Posted on April 5, 2011 - 11:57 PM
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