The government has been reasonably good at determining use with respect to services. Consider just a few examples of government equity principles:
- Veterans who serve longer or have more severe injuries get more extensive treatment from the VA
- People who make more money pay more taxes (ostensibly!)
- Businesses like trucking who use the roads more frequently pay use and gas taxes that charge for that use
- Families with multiple kids in college get increased college financial aid
- Families on social service benefits receive more based on the number of children in the household
Overall, Federal and State governments have determined ways to equitably charge for use or deliver benefits. It appears that on this issue the universal healthcare system breaks down. No one has discussed the idea that people might actually need to pay for over-use. Or that the average coverage might only benefit people who are healthy to moderately sick. I realize the whole point of major medical insurance is the catastrophic illnesses that can bankrupt a family: cancer, heart surgery, severe auto accidents with long rehab, etc. However, the government must develop a way to relate equity to use or non-use. That might be through tax credits for non-use, payment for overuse, or a medical savings account that could be used for services, products, or even refunds.
The creation of a system which has no constraints on use is a foolish endeavor. Honestly, this is one reason the current healthcare system is so inefficient. People with $5 co-pay insurance plans go to the doctor for any minor issue because there is no financial incentive not to. Instead of incentivizing good health practices we simply incentivized more doctor’s office visits.
People in this country love free. Reward people financially for being healthy and maybe more people will work towards good health. Policy makers should remember that we are a capitalistic mixed economy that is fairly equitable based on use. For universal healthcare to succeed it needs to be built on the same principles as other government services.