Post Apocalyptic Healthcare
I believe healthcare is headed for a major crises. There is a split in the road with one direction going East and one going West. To the East we have a return to market based healthcare, where you pay your doctor directly and have inexpensive insurance for catastrophic events like cancer, heart attacks, car accidents etc. To the West we have total socialized medicine where the government will pay doctors to care for the population. I'm sorry to say that only one of these options is really viable.
We already have several forms of socialized medicine that care for around a third of the population. Medicare, and Medicaid services had around 110 million people use their services in 2015. The Medicare budget is $672 billion, and Medicaid is $565.5 billion. A combined budget of $1,237,500,000,000. This is a huge slice of the $3.8 trillion dollar total budget, around 1/3. National debt sits at $20.8 trillion dollars as I write this. According to US DEBT CLOCK, spread amongst tax payers this debt amounts to $172,000 per taxpayer. It is quite clear to anyone who has looked, that the United States will eventually hit a debt wall that will create a downward economic spiral. It happens like this: First other countries will stop buying our bonds which fund the deficit in budgets, we will miss debt deadlines and get out credit downgraded, the downgrade will lead to high interest rates on our debt, leading to more missed debt deadlines, missing a deadline leads to bigger and bigger deficits growing our debt at an incredible pace, this leads to massive inflation, as a result our money becomes worthless. I appreciate that the socialized medical programs take care of some of the most vulnerable in society. However, if the debt is not addressed there will be no health services for them. Some politicians suggest Medicare for all, but this is not looking at reality. Such a scheme would make healthcare spending encompass the entirety of the current US federal budget. We are already running close to a trillion dollar in deficit every year. We would need to raise overall tax collections by 25% ,or cut the budget by 25%, just to cover what we are currently spending every year. That would be a monumental task. How monumental? President Calvin Coolidge was the last US president to have a surplus every year and run an overall surplus for his term in office, and he served from 1924-1929. It's been almost a 100 years since we last had a responsible spending government. The Medicare for all scheme would double the national budget and likely come with even larger deficits year after year. This is virtually guaranteeing the economic collapse. What doctor is going to work for pennies on the dollar when that happens?
The road less traveled, but vastly more sustainable, is a system in which a patient pays their doctor directly. Many of the issues in our current system disappear when people engage face-to-face and the patient is not separated from payment. Wait times will go down. Patients who are made to wait too long will leave and take their money with them VS getting locked into select clinics because they take your insurance. Customer service will improve. When you hold the money everyone has to be on their best behavior and if a doctor is rude he will lose patients and get more disputed payments VS your insurance paying for your visit whether you enjoyed it or not. Costs will go down. Looking in someones face and asking for money is cost controlling in itself and it also allows for on the spot negotiation of prices VS your faceless insurance company paying high prices and charging you higher premiums. Doctors are not heartless. If a bill is too large for you to pay a sympathetic doctor will understand and come down in price a lot VS you owe a percentage of costs through insurance no matter the price. Keep your doctor. Most insurance is tied to your workplace. When you leave work, you will lose your coverage, and probably your doctor. That means you have to explain your whole medical history to a new doctor VS having a doctor your whole life, that you picked, that knows and cares for your wellbeing. Chronic disease will be addressed. A doctor who gets paid through insurance gets the money whether your are getting better or worse under their care VS paying a doctor directly and possibly withholding funds or changing doctors if that doctor is allowing your health to collapse. There are many more situations, but you get the point.
On one road we face a future with economic collapse and unknown negative outcomes and the other road we can embrace markets and let our money bring about a golden age in healthcare. The choice is really up to you. I know which road I'm picking.