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0 pointsbryanlarsen9y ago0 comments

"For day-to-day healthcare, that should just be included in "cost of living" calculations. General-purpose welfare programs (or ideally a minimum income) would guarantee that people could afford checkups, birth control, etc."

That sounds reasonable, but is it efficient?

1. It discourages "routine maintenance" -- it's a lot cheaper to go to the dentist annually than to get a root canal every ten, yet there are many who if they only had catastrophic dental insurance would skip the annual.

2. This "cost of living" varies drastically based on age, sex, pre-existing conditions, et cetera. So it couldn't be covered fairly by a single fixed UBI. So you'd need bureaucracy to determine who is eligible for extra coverage

3. Every small doctor's office would need a billing department. In socialized healthcare countries, "billing" is not much more work than filling in a time sheet, and is often done by the doctor themselves.

It's cheaper, more efficient and more fair to cover day-to-day healthcare for everybody than to just cover only catastrophic care.

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6 comments · 3 top-level

echaozh9y ago· 2 in thread

Sure, we Chinese basically cover most of our medical bills, and rely on insurance for treatments of more vital diseases. Actually, people go to hospital more, because cold or other smallish issues cost no more than a good meal.

Clinics do fine. They charge more, and they have the hospitals as a reference for their prices, providing better service for a premium.

janekm9y ago

This creates a big problem though... the hospitals are incentivized to prescribe antibiotics when they are not needed (which they can charge for, the "doctor visit fee" is not remotely enough to cover the hospitals costs) leading to rampant over-prescription of antibiotics (leading to antibiotic-resistant bacteria).

saimiam9y ago

Likewise in India.

jessaustin9y ago· 1 in thread

This is an argument for someone to pay for "day-to-day healthcare", but it's still not clear that someone should be an insurance company.

bryanlarsenOP9y ago

Except for the quoted paragraph, I agree completely with the parent and grandparent comments which make effective arguments that middleman insurance companies should be cut out. Should have made that clear, I guess.

kileywm9y ago

> "1. It discourages "routine maintenance" -- it's a lot cheaper to go to the dentist annually than to get a root canal every ten, yet there are many who if they only had catastrophic dental insurance would skip the annual."

It's not quite fair to say that it discourages, when really it just doesn't encourage routine maintenance.

To that end, it would be interesting if there was a component that encourages routine maintenance. Every undocumented annual checkup results in <some percentage> of the claim being the claimant's financial responsibility.

Similar, I suppose, to an automobile warranty where a lack of documented regular maintenance can be grounds for voiding some portion or all of the warranty. The healthcare parallel being less extreme.

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