Which health insurance system do you favor?
04 06 08 - 14:15
There are essentially three ways to knock down the number of uninsured Americans:
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1. The government can be responsible for insuring Americans between ages 25-65. Think a system like Medicare for all Americans.
2. Businesses should be responsible for covering all their workers.
3. Individuals should be responsible for their own insurance.
Which option do you favor? Why?
Reluctantly and slowly, I've come around to the last option. Here's why:
1. Employer-based insurance has been the model we've used for the last several decades, but it's hard to argue that the employer model is sustainable for the next few decades. It's revealing that the percentage of Americans covered by their employers has actually been declining, not increasing. With health costs so great, and businesses strapped to meet them and other expenses, it's hard for me to see how that trend will reverse itself.
If it could, I probably would favor continuing using it as the model. But I just don't see it. And I sure don't see how Congress can effectively argue that all businesses should be required to cover their employees or pay into a pool. Not with the conditions many businesses operate in today. (I do think big employers will continue to cover workers,or pay part of their insurance, as a way to attract them.)
2. So, I go to option three. There are several advantages to making the individual responsible for getting their own insurance.
For example, no longer would your insurance be tied to your job. Fewer workers would get locked in a job they hate solely to keep their health benefits. There would be much more freedom.
Second, individuals could find packages that most fit their needs. That could benefit families.
Third, any individual-based system will come with a combo of federal subsidies/credits/deductions for working families to afford their premiums.
As part of this new system, either insurers should have to cover people with preexisting conditions or those people should have the means to get insurance somehow, somewhere. Also, there must be ample opportunities for states, associations, etc. to set up pools for people to join and purchase coverage.
The advantage of this approach is that individuals could still purchase health care through their employers, if their employers are among the firms that keep offering insurance. I tend to think we will evolve into some hybrid, where individuals buy their insurance but some companies still offer it.
Undoubtedly, the individual-based system will have its own problems.
In another decade or so, we would be tweaking those. But I think this is is the wave of the future, more so than employer-based insurance.
3. I didn't argue for government insurance because the costs of insuring the 25-64 population through a Medicare-like system would be astronomical for taxpayers.
That said, I sure want to keep Medicare for seniors and Medicaid and CHIP for poor families, especially for young mothers.
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