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 The Bill To Permanently Fix Health Care For All
Joeykins 4 posts, incept 2017-04-03
2017-04-04 12:17:02

Quote:
No it won't because in the implementation section you will see that any provider that bills more than 50% of its dollar volume via Treasury is instantly subject to audit.

You're suggesting a bureaucratic function to enforce "fair" prices. While it would certainly serve to police egregious cases of fraud, I doubt that you could move me from the opinion that it would provide a kind of subsidy that would tend to increase prices. I get that it is your concession to the critical problem of how to care for the indigent. I acknowledge that there are choices to be made among imperfect solutions. Rather than forecast the impact of any particular solution, allow me to propose some other approaches:

1. Directly address issues of the source of poverty. Most solutions are reactive. There are things to do to improve the lot of the poor, many of which are done to some extent. A neglected topic is to understand and fix why so much wealth is diverted to the financial sector. This category, in my opinion, is the most fruitful long-term. As interesting as it could be, I'm sure we can agree that it's no quick fix.

2. Encourage informal institutions to care for the indigent. Again, this is certainly not a quick fix. If we don't actually care about the poor, this approach results in some of them dying. In the long-run, it would be the cheapest if we survive the resulting class wars. (I'm speaking tongue-in-cheek; in the long-run I really do wish that we could move this direction.)

3. If a top-down government mandate must be made, how about this: back-stop funding is to be provided by the smallest government entity possible. Cities and municipalities must demonstrate financial inability to provide the back-stop before appealing to counties. Counties must do the same before appealing to states. And you get the same deal with states appealing to the federal government.

#3 could be effectively accomplished by restructuring Medicaid to require states to adopt this bottom-up approach in order to receive any funding at all. States that prefer to do a state-level top-down back-stop or no back-stop at all, of course, could simply fail to qualify for federal funding. However they're established, I believe that institutions will be more effective to control costs and needs when they are as close as possible to the people that they serve.

Regarding some of the considerations to why you insist that solutions must be imposed at the federal level, I need to continue to educate myself and will listen. I don't doubt that there are points at which the federal government must cooperate and/or acquiesce to achieve fully consistent solutions. But I still believe that the best solutions come from the bottom-up. Fortunately, there is nothing to stop me from putting my efforts into those local solutions while you continue your voice aimed at the top.
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