While we dodged a bullet, there are more problems on the horizon that have nothing to do with the AHCA. I was aware of these as individual problems but ran across an article by Ed Dolan (also known as Fabius Maximus) that summarized the core aspects of the problems with the future of American health care along with graphics that did a good job of making the difficulties clear. This post is a summary, but it would be well worth your while to review the article carefully. It is the best description of why single-payor should be the outcome we pursue right now.
- No “single payor” system is truly single payor. They all involve the integration of various programs and insurance/reinsurance frameworks to ensure universal access.
- In the US, healthcare is 1/6 of the economy. It is childish and dangerous to believe you can tinker with it without economic consequences.
- The sources that fund healthcare involves every single economic entity at every level of society. Again, tinkering with it changes everyone and every organized component of our society.
- Two-thirds of the health costs for the US are from 10% of the people. Who these people are shifts a lot over time, involving a substantial number of people in single catastrophic episodes that generate huge medical costs.
- Guaranteed issue of health insurance generates unintended premium consequences that are starting to show up in the ACA. If we don’t do something about that, the system as it is now will degrade. It may degrade much faster if the current administration decides they can solve their political problem by tinkering with health insurance.
- There are also problems with employer-based insurance. The biggest one is that increasing health costs effectively stall wage increases. Stalled wages undermine the ability of people to cover any health costs. And so on.
Time to start talking about a rational single-payor system.