Is Obamacare imperfect? You bet. I don't like the idea of micromanaging health plans via "medical loss ratios," for example. And if I were king, I'd have started with a cheaper approach that paired a funded health savings account for primary care with catastrophic coverage for every American (which capped annual costs at some fair percentage of income).Since being out on sabbatical leave, I've gotten a health insurance policy from Blue Cross Blue Shield that is basically what Miller recommends, a high-deductible, catastrophic coverage policy. And what's interesting is how much it's caused me to pay attention to how much the doctor's visits and prescription drugs cost. If everyone were in this kind of policy, costs would come down quickly, because everyone would be bitching about it big time!
What's more, I still think the best model to emulate is mighty Singapore's, a savvy blend of private responsibility and public provision that leaves that nation with world-class outcomes at 4 percent of GDP (vs. our 17 percent). It's a breathtaking achievement that would give our overpaid medical industrial complex a heart attack.
Wednesday, January 19, 2011
Obamacare and the Republicans
Centrist Matt Miller has a good article on Obamacare (he supports it) and the Republican's plan to repeat it in the WaPO. Basically, he says that whatever plan is in place needs to both cover most people and cut costs. Then, he adds a few interesting thoughts of his own on national health care: