I have just read this remarkable commentary on Medicaid from Avik Roy at Forbes.
Mr. Roy discusses the most recent results of an ongoing analysis of Medicaid costs in the State of Oregon. This is important for many reasons, not least being the fact that ObamaCare hopes to reduce the number of uninsured by extending Medicaid coverage. I think Obamacare chose this strategy because, overwhelmingly, the lack of medical insurance is a creature of poverty – and Medicaid is the government medical insurance program for the poor.
I urge you to read Mr. Roy’s entire comment. This passage near the end strikes me as an especially bold and fresh breath of air:
“Let’s build a new health program for low-income Americans, one that pays primary care physicians $150 a month to see each patient, whether they are healthy or sick . . . Hell, put the entire country on that kind of plan, along with giving people the opportunity to use health savings accounts to cover the rest.”
I think this is a great idea especially the idea to put the entire country on a uniform primary care plan.
The taxpayers would share the cost of every citizen’s primary care up to an annual amount - $1,800 in this example. That number could be adjusted in the future as necessary to keep up with reasonable increases in the cost of delivering such care.
This plan would establish a basic level of primary medical care guaranteed to every citizen. Individuals and families could then purchase insurance for catastrophic medical events on top of that, at their own expense. I think it would be necessary for the taxpayers also to subsidize the catastrophic insurance subject to a sliding income scale. People who can afford full or “comprehensive” coverage beyond that may simply go ahead and buy it – at their own expense.
Paying PCP’s $150 a month for every American patient they see would cost about $567 billion per year. Isn’t that about half the annual cost of Obamacare? Of course that cost would rise as population rises and as medical costs rise. But, still . . . Obamacare’s cost will rise too. So isn't this a more effective and less costly approach?
btw, I think a $2,000 per person calendar year deductible is a little light – I’d suggest $3,000 accompanied by an HSA. But now we’re just quibbling about how exactly we will drain the swamp.