Can you afford to pay 1500 for a CT scan out of pocket?
The point I was getting at was that the states would need to control the design of the group coverage, negotiate reimbursements but that the overall pool needs to be at the Federal level. See Paul Oneills recent Op-Ed. (He is not a flaming radical by any means.)
I don't agree with his prescription in the whole but many of his ideas mirror the structure of the French system.
See:
Obviously, for those people with little or no income or wealth, society as a whole would have to provide first-dollar coverage. It is only fair that those with more financial means share the burden.
This gives rise to many complex issues. At what income level should people be required to shoulder some and then all of their own insurance needs?
Should there be one insurance pool for the entire population or should there be subnational pools? (I would lean toward a single national pool.) Should people be assessed extra premiums related to age or chronic conditions or drug or alcohol addiction? The answers are not obvious, but they are questions Congress and the presidential candidates are refusing to wrestle with.
at:
http://query.nytimes.com/gst/fullpag...d/Contributors accessed today.
The large national pool will act to constrain health care inflation which is the biggest elephant in the room facing our society.
See Ezra Klein:
By now, you folks well know my obsession with pointing out that Medicare's costs will blow up not because of demographics, but because of the same cost growth afflicting the private sector Here, however, is a nice, colorful chart making the point:
at:
http://ezraklein.typepad.com/blog/charts/index.html