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Good article Jeff.
As I've said for years in this forum, the health care system will always under-provide and over-cost as long as health insurance is employer-based and group-oriented. What the Swiss have is all individual policies provided by a market economy. I think a very relevant question about the US system is, then, "how do we get from where we are to something with the characteristics of the Swiss system?"
This goes back to policy goals in the New Deal and the emphasis on employees as opposed to farmers or small business. Employers were given corporate tax-deductibility of health premiums for workers. Private sector unions encouraged this paradigm because, essentially, it allowed employees to obtain health insurance with before-tax dollars.
Looked at with today's numbers, self-employed persons pay 15.3% of their income for Social Security and Medicare. Employees pay 7.65%. If the self-employed wish to purchase health insurance on the individual market they must pay using after-tax dollars. Employees generally get health insurance through their employers at little or no cost to them.
To change, employees would have to pay income tax on the health care premiums that their employers now pay. Let's say that is $ 18,000 for a family. Wages should go up 18k and the employee should buy insurance in the individual market for that amount. When making this move, it would make sense for all persons to pay the 15.3% rate for SS and Medicare, because having multiple rates that favor employees over farmers or small business makes no sense.
I just don't see that as un-doable in terms of the math. And I think most higher income earners would have no problem paying some more so that the indigent can have insurance.
The Swiss assume that individuals will make reasonable choices (as indeed they have in actual fact) but the progressives in the US will never, under any circumstances, allow individual choice. It will always come back to the Hillary question, "... But what if they make the wrong choice?" The whole progressive movement of the last 125 years has been about having bureaucratic experts make the "right choices". They would no more allow choice in health insurance than they will allow choice in education. Won't happen. There is a vast bureaucratic swamp "feeding" off the health care delivery system, and these "stakeholders" have a lot to lose if we were to go to the Swiss system.
As I've said for years in this forum, the health care system will always under-provide and over-cost as long as health insurance is employer-based and group-oriented. What the Swiss have is all individual policies provided by a market economy. I think a very relevant question about the US system is, then, "how do we get from where we are to something with the characteristics of the Swiss system?"
This goes back to policy goals in the New Deal and the emphasis on employees as opposed to farmers or small business. Employers were given corporate tax-deductibility of health premiums for workers. Private sector unions encouraged this paradigm because, essentially, it allowed employees to obtain health insurance with before-tax dollars.
Looked at with today's numbers, self-employed persons pay 15.3% of their income for Social Security and Medicare. Employees pay 7.65%. If the self-employed wish to purchase health insurance on the individual market they must pay using after-tax dollars. Employees generally get health insurance through their employers at little or no cost to them.
To change, employees would have to pay income tax on the health care premiums that their employers now pay. Let's say that is $ 18,000 for a family. Wages should go up 18k and the employee should buy insurance in the individual market for that amount. When making this move, it would make sense for all persons to pay the 15.3% rate for SS and Medicare, because having multiple rates that favor employees over farmers or small business makes no sense.
I just don't see that as un-doable in terms of the math. And I think most higher income earners would have no problem paying some more so that the indigent can have insurance.
The Swiss assume that individuals will make reasonable choices (as indeed they have in actual fact) but the progressives in the US will never, under any circumstances, allow individual choice. It will always come back to the Hillary question, "... But what if they make the wrong choice?" The whole progressive movement of the last 125 years has been about having bureaucratic experts make the "right choices". They would no more allow choice in health insurance than they will allow choice in education. Won't happen. There is a vast bureaucratic swamp "feeding" off the health care delivery system, and these "stakeholders" have a lot to lose if we were to go to the Swiss system.
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