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Single Payer Major Disaster Only Coverage

MrWonka

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I had a thought the other day about a way to possible move the U.S. to a system that would be half what we currently have under the ACA, and half single payer that would allow for a major reduction in what people pay for deductibles and premiums in general. The idea is that private insurance would only cover health care expenditures of less than X amount per year, or potentially X amount for an individual lifetime total. If the health care costs of an individual ever exceeded that X(which could be let's say 1 million dollars hypothetically just to give it a number) then the government would step in and take over.

The idea here being that private insurance would primarily only be designed for relatively simple things like, if you break your arm, or tear your ACL. Things that are expensive enough that you'd want to be covered against, but not so ridiculously expensive that it would likely bankrupt you. The government single payer system would then be used primarily for the worst cases only. Things like your kid getting leukemia. You're entire family getting in a bad car accident.

This would allow private insurance companies to drastically reduce their premiums and or the deductibles people have to pay knowing that they would never end up being on the hook for a lifetime of cancer treatments or something ridiculous like that. Obviously it would require some additional taxes to cover the government side of things.

I look at it sort of how we do major disaster type stuff. Most people have homeowners insurance, but at the same time if a hurricane, tornado, massive flood, or earthquake came along and destroyed an entire town, the government declares it a disaster area and gives aid above and beyond that.

Discuss.
 

Carjosse

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I think you would like the Dutch system, small things are covered by private health insurance usually in a basic package that the Dutch government sets the content and price of (and also subsidizes) but more longer term care is paid for for by the Dutch state. You can also buy additional coverage for different things as you see fit and even opt out of state coverage even though people rarely do.
 

joG

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I had a thought the other day about a way to possible move the U.S. to a system that would be half what we currently have under the ACA, and half single payer that would allow for a major reduction in what people pay for deductibles and premiums in general. The idea is that private insurance would only cover health care expenditures of less than X amount per year, or potentially X amount for an individual lifetime total. If the health care costs of an individual ever exceeded that X(which could be let's say 1 million dollars hypothetically just to give it a number) then the government would step in and take over.

The idea here being that private insurance would primarily only be designed for relatively simple things like, if you break your arm, or tear your ACL. Things that are expensive enough that you'd want to be covered against, but not so ridiculously expensive that it would likely bankrupt you. The government single payer system would then be used primarily for the worst cases only. Things like your kid getting leukemia. You're entire family getting in a bad car accident.

This would allow private insurance companies to drastically reduce their premiums and or the deductibles people have to pay knowing that they would never end up being on the hook for a lifetime of cancer treatments or something ridiculous like that. Obviously it would require some additional taxes to cover the government side of things.

I look at it sort of how we do major disaster type stuff. Most people have homeowners insurance, but at the same time if a hurricane, tornado, massive flood, or earthquake came along and destroyed an entire town, the government declares it a disaster area and gives aid above and beyond that.

Discuss.


Interesting. It is almost the exact opposite of the public health care systems I have looked at.
 

Carjosse

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Interesting. It is almost the exact opposite of the public health care systems I have looked at.

It is actually really similar to the Dutch system which is the best in Europe apparently.
 

MrWonka

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It is actually really similar to the Dutch system which is the best in Europe apparently.

I guess my understanding of the Dutch system that it was a pretty much entirely single payer. I know Bernie seems to be in love with the Dutch, does anybody know if the system he's proposing would be similar to this already. My understanding of his system is that it would be entirely single payer, and eliminate the need for virtually the entire private insurance sector.
 

MrWonka

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I guess my understanding of the Dutch system that it was a pretty much entirely single payer. I know Bernie seems to be in love with the Dutch, does anybody know if the system he's proposing would be similar to this already. My understanding of his system is that it would be entirely single payer, and eliminate the need for virtually the entire private insurance sector.

Actually I take that back sort of. I always confuse the Dutch with Denmark. Bernie seems to love Denmark's system not the Dutch system.
 

MrWonka

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Actually I take that back sort of. I always confuse the Dutch with Denmark. Bernie seems to love Denmark's system not the Dutch system.

Which, by the way is really veird because I'm actually almost entirely Dutch.
 

MrWonka

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Another analogy I had for this was kind like the concept of FDIC. Most banks in this country are insured by the Federal Deposit. Generally it is the bank's responsibility to protect your money, but if something ridiculous happens or they get robbed or something the Federal deposit steps in and covers the bank. My idea would be to have Medicare behave in a similar way. They would essentially act as an insurance company for insurance companies. The private company would worry about covering things up to a certain point, but if they had a customer who's bills radically exceeded that Medicare would step in and cover their private company.

The only difference I think is that it likely wouldn't matter if an individual had private insurance I still think I would have medicare cover them over a certain point.
 

joG

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It is actually really similar to the Dutch system which is the best in Europe apparently.

I know too little about the Dutch one other than that the drugstore actually seemed to have to fill out a form and make me provide identity papers before filling a prescription. The filed data was available a year later, when I happened by. The gave me a cut price as a return patient.
The other thing I know is that it is forbidden under normal circumstances for an inpatient in Germany to be switched to a Dutch hospital to prevent msra from Germany being brought in.
 

Carjosse

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I know too little about the Dutch one other than that the drugstore actually seemed to have to fill out a form and make me provide identity papers before filling a prescription. The filed data was available a year later, when I happened by. The gave me a cut price as a return patient.
The other thing I know is that it is forbidden under normal circumstances for an inpatient in Germany to be switched to a Dutch hospital to prevent msra from Germany being brought in.

Is that not normal? I have to do that here in Canada, I thought it was to record who actually picked up the prescription especially if it was something like opioids. Also so that if you come back they know what you need.
 

joG

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Is that not normal? I have to do that here in Canada, I thought it was to record who actually picked up the prescription especially if it was something like opioids. Also so that if you come back they know what you need.

I have never been asked in Germany, London, Paris or Spain for ID. But maybe that is just because I make such a honest and respectable impression in my jeans. ;)
 
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