There is nothing simple about our health care maze. Fixing it is not easy.
I prefer to look for the simple. The complexity will evolve naturally.
Congress prefers to start with the complex and make it more so.
Spreading the medical risk
There are two major challenges to fixing the customer side of the health care mess – spreading the medical risk and spreading the financial costs.
Spreading medical risk requires that everyone be in the system. That spreads medical risk evenly between the sick and the healthy. That can be accomplished by a system of automatic eligibility or a system of required enrollment.
Automatic eligibility describes a single payer system. All citizens are enrolled by virtue of their citizenship. To draw from known models, automatic enrollment describes Part A Medicare, Department of Defense medicine, and to a lesser extent, the Veterans Administration.
Funding for those programs is separate from enrollment and may or may not rely on direct participant financing.
A system of mandatory enrollment implies a system of mandatory participant financing. That is where we bump into the second challenge.
Spreading the financial costs
How do we transfer money from those who have it to those who need it? Continue reading ‘Health Care Reform and Ability to Pay’
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