Before We Go ‘Single Payer’: Insurance Reforms We Should Try
By Michael Kinsley
The Washington Post
March 17, 2006
The small fraction of people involved in auto accidents in any year is responsible for almost all of the cost of auto insurance. You insure against the risk of being in that group.
What’s different about health insurance is the opposite: Much of it isn’t insurance at all but a subsidy. The value of the subsidy is the difference between what the individual pays and what the insurance would cost in the free market. If people were buying health care or insurance with their own money, they might or might not spend too much — whatever “too much” is — but no one else would need to care if they did.
A subsidy has to take from someone and give to someone else. Everybody can’t subsidize everybody. Or, to put it another way, society cannot give the average citizen better health care than the average citizen would choose to buy on his or her own.
There are the makings of a deal here. Better-off or better-insured people could be told, individually or as a group: Give up your health care subsidy and you may opt out of any rationing-type restrictions that the system imposes. And if a few smaller reforms like that don’t work, maybe it will be time for single-payer.
http://www.washingtonpost.com/wp-dyn/content/article/2006/03/16/AR2006031601311.html
Comment: By Don McCanne, M.D.
What are the policy issues behind Kinsley’s proposed reforms? The wealthy are already free of rationing-type restrictions since they can purchase whatever care they want. The only real substance in his proposal seems to be that tax policy should not be used to subsidize the purchase of insurance. That would partially address only one flaw in our current system of funding health care: the regressive tax policies of employer-sponsored plans.
We don’t need to rehash here all of the flawed policies of our current system, which Kinsley fails to address, to understand that the $2.1 trillion that we are already spending is more than enough to provide comprehensive health care benefits for everyone.
Aren’t you growing weary of the before-we-go-to-single-payer-let’s-try-(insert-deficient-policy-here) approach to reform?