Monday, January 28, 2013
DeGrazia on Health Care Reform p. 693 (Luke & Megan)
Summarize DeGrazia's position, give some strengths and weaknesses, and give suggestions for discussion. Feel free to tie to your exam question on Justice and Health Care. (I suggest that you discuss via email first and then post your joint response).
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This is a combined post from both Megan and Luke:
ReplyDeleteIn this article, DeGrazia discusses his views on how American healthcare is a "terrible mess." He goes on to develop a case for merging single-player finance with managed competition as a means for delivering healthcare. DeGrazia believes that a political compromise of these two concepts will provide the most morally acceptable model, will be the most cost effective answer, and will offer the most advantages and the least disadvantages.
This reform falls into six categories of proposals, that can be combined in different ways. The first category is Market Reforms. The idea of this is to encourage consumers to stay with the same insurer longer and therefore lower administrative cost and lead to lower premiums. The next proposal is Tax Credits, in which people who owe no income tax would receive a government payment for insurance. The third proposal is Individual Mandates. This proposal would legally require adults without insurance to purchase it. The next is Employer Mandates that requires employers to either provide insurance or pay a fund to cover insurance for their employees. Next is the Incremental Expansion of Existing public Sector Programs. This would enlarge programs until universal coverage is achieved. Lastly, the Managed Competition would cause different insurance plans to compete foe enrollees among federal workers.
All of these proposals work together to achieve four main goals: universal coverage, control and lower costs, maintain or enhance patient freedom while also reducing bureaucratic hassle, and keep current quality of care.
Strengths
-Provides, or makes an effort towards, universal coverage
-Lowers the cost of healthcare
-Doesn't compromise quality of service or patients rights
-Simplifies the process which makes things easier for patients, doctors and insurance company and lowering costs
-No billing of patients
-Eliminates out of pocket costs for covered services
-No premiums or deductibles
-Standardizes coverage to prevent adverse selection
-Eliminates the profit based insurance companies which encourages them to provide better care since they aren't losing profit by providing less care
-Takes the money that would be profits and either puts it back into the system to provide better healthcare or eases the financial burden on the government
Weaknesses
-Reduces the job force of the insurance industry, in an effort to reduce spending, raising unemployment
-Patients could abuse the system by going to the doctor more than necessary since it doesn't cost them to go (or costs very little if there is a copay)
-Raises income taxes
-Little to no differences between insurance plans making it harder for the patient to pick and choose one that might benefit them more
-Could make wait time longer in doctors offices as a result of universal coverage and lack of financial incentive to not go
-Taxes will be proportional to income, so wealthier people will be paying a whole lot more for the same coverage as a much less well off person
-The working Americans would be paying for the non-working Americans healthcare, which is only a negative in regards to the part of that group that should be working but aren't
-If unemployment were to rise, the loss in revenue from income tax to pay for the healthcare would either have to be covered by the government, or by raising the income taxes for the employed, putting them in greater financial stress
Discussion Questions
-How will this effect the deficit?
-Should plans, rates, and services all be the same for every provider? If so, whats the point in having more than one and how is that creating competition?
-Would this be good or bad for our economic situation? On one hand, the citizens are saving a lot of money, but on the other hand, the government is spending a lot more.
-Should everyone have the same coverage?
-Should patients be required to pay a copayment?
-How would businesses that can provide healthcare for their employees fit into this system?