People nitting it up EVERY. SINGLE. TIME. someone says "free healthcare" meaning some variation of UHC is the worst nittiest pointless hijack ever. Clearly they arent talking about enslaving people to perform operations! Its very VERY clear they are talking about some variation of UHC.

I dont understand the second paragraph as its phrased but the first is just lulzy. Clearly there will be rationing of healthcare regardless of what system is being used because a private insurance based healthcare model that can pay off on a billion dollar operation will not be affordable by 99+% of people anyway.

If you think that same problem of expensive treatment doesnt effect the current American healthcare model then im going to go find Dr Ikes to demonstrate his bedside manner cos i have some really bad news for you.

This seems like a hell of an efficient system.

The answer to everything isn't 'government' though.

In health care, it seems like the answer is, "single payer" or "get government completely out." This in-between stuff will never work. Too many entrenched special interests.

Our health system is so screwed up that I don't even know where to start. Since "get government completely out" will never ever happen, option 1 is it, unless you have the solution we've been waiting for for 10 years now. One time?

Even if we had an NHS-style system in the USA, the rich and upper-middle class would still have better healthcare than the poor because they would pay for better access with their private medical dollars. The UK still has private health insurance. And I bet David Beckham doesn't wait in an NHS clinic. That's all "Medicare for All" would end up being. It would be no direct cost health-care for the lower classes at the local county hospital.

Wait, so these aren't examples of the government providing for your basic needs?

You said you didn't want or need the government to provide for your basic needs. I will clarify my response - I think you do want or need the government to provide for many of your basic needs.

Bad credit is a disincentive to not walk away from a huge medical bill, but a huge medical bill is a huge incentive to walk away from a huge medical bill.

I mean you recognise they wont pay it, you recognise the bill exists and from that you can deduce the cost exists. So presuming you realise the cost isnt going to magically disappear i really dont understand how you can conclude free riding doesnt exist. When you recognise it does you need to conclude that someone (aka everyone) is already paying for that free riding so i can only assume you are choosing not to recognise the existence of free riding to avoid the inevitable conclusion to its existence, namely that America already has UHC under the table but the costs are funnelled to people in a highly inefficient way compared to what would happen if America had UHC on the table.

Im confused if you are backing the NHS or not here. But you should be as you have all the ingredients in that post for a much better healthcare model than what America currently has.

Awval Health Care System:

Federal government catastrophic care ($10,000 deductible) covering only unanticipated things like, car accidents, cancer, premature babies, genetic conditions, gun shot wounds, etc. If someone can't pay it no big deal, just garnish tax returns to do it, or put it on a repayment plan. All you need is a social security number.

Market based care for everything else, make health care like every other sector of the economy. Dr. A charges this, this and that. Dr. B charges more but has a nicer office, etc. Hey this drug is generic and cheap I'll choose that one instead of this new fancy one that has a cool commerical.

People don't want to pay for their own care, sorry bub. No dialysis for you. Odds are they caused it themselves with a lifetime of Type 2 Diabetes.

Anyway, I'm sure you'll say this idea sucks, and it's hard to explain in two paragraphs but pretty much my idea that will never come to fruition.

Um, I guess we are arguing semantics? They get a service and don't pay for it. The fact that their credit goes down the tube doesn't lessen the burden on the taxpayers who ARE paying it.

What about people who already have bad credit. What cost do they have for going to the emergency room?

Just re-reading my health care plan, I like it. I am interested in what you all think, constructive criticism and all. This is me trying and realizing the government does have a place for truly catastrophic care.

Is leukaemia an unanticipated catastrophic thing?

Isnt that identical to what America has now?

It is a cancer. So it would be subject to a $10,000 deductible. Sure in make believe awval world.

Question is, how much would catastrophic care cost if the govt wasn't so involved in health care? I'm not sure anyone can answer that.

What about those that can't pay? What's the cost of dialysis these days? Or are you talking about those that don't pay for insurance? Can't tell.

I don't think dialysis is a human right. I believe it is here where you and I disagree. Maybe charity dialysis? Regardless in seven days or so the situation would take care of itself.

Also in my magical world it would be covered under the $10,000 deductible under the hospitalization.

And that sums up why libertarianism will never stop being fringe.

I brought up something similar in the health care thread. I just upped the deductible amount and didn't get into the whole "define catastrophic" mess. I like it in a big, big way. At least a million times better than what we have. It also still gives a role for private health insurance, who will drop prices significantly now that their losses are capped at $X.

So if I disagree with the method you like for addressing a problem you assume I disagree with your goal?

So unlimited end-of-life measures are a right in your opinion? Unlimited experimented procedures?

Dialysis isn't a human right. I'm sorry. It never was and never will be.

Wow, that's a very age-defining choice.

But seriously, I feel all americans should have access to christy turlington blow jobs. After all, I'm pretty sure that falls under the third right in that document.

True. most people in the mainstream are and want to continue to be ignorant of economic realities.

I think the basic idea is a good one. The hardest part of a plan like this is determining what is "unanticipated" and what ailment someone caused themselves.

What exactly are the odds that they caused it themselves? 60%? 90%? If it was 5%, do we still deny them treatment?

How do we judge that they caused it themselves? Skinny people can get type 2 diabetes too. Genetics can predispose someone to type 2 diabetes. For example, Indian men have 3-4x higher incidence of insulin resistance compared to Caucasians. What happens when a skinny Indian comes to the hospital with diabetes? Probably not his fault? What about a fat Indian? Skinny Caucasian? We could easily get these judgments completely backwards even if we spent a large amount of time and money investigating them.

I know dialysis/diabetes was just an example used to illustrate your plan, but these types of questions are going to apply to ailments across the board.

How about a plan that covers pretty much everything, but we pre-emptively tax the worst health-injuring behaviors? Or to flip it around, offer incentives for people who avoid these behaviors?

Non-smoker tax credit. Non-obese tax credit (this is probably a political nightmare).

Maybe the healthcare tax is tiered in such a way that high-risk people pay a larger premium? In Germany, if you make above a certain amount of income, your healthcare tax actually goes DOWN compared to low-income workers because, as a group, high-income workers are less risky.

There are political problems with all of the solutions, of course, but it is an interesting problem to think about.

If we're off talking about human rights now, I think we need to get back on track. None of us need this tangent.