The Two Tiered Health System
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I've spoken about this before, but it does work. We've done it in Louisiana before.
The tiers consist of public and private hospitals. The public hospitals offer care based on a sliding scale...Anybody making less than 300% of poverty level receives free care. For example, a family of four could make around $40k/yr and pay nothing. A family making more money would be billed on a sliding scale - the more you make, the higher percentage you owe. Public hospitals would still bill Meducaid, Medicare or private insurance, while adhering to billing guidelines for the patient. A large percentage of the physicians will be residents.
Typical patient profile is indigent, but we had a decent percentage of Medicare patients. They used the facilities, since their income levels usually meant no bill.
Private hospitals concentrate on attracting the patients with insurance or patients with higher incomes. Facilities were usually a little nicer and not quite as spartan. Services were usually broader. Billing is traditional. Wait times for elective procedures will be minimal. Past EMTALA, they will have the right to refuse service in some cases, if the patient does not have the ability to pay.
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Sure but make the sliding scale more realistic. Based on current, over-inflated medical procedure pricing, that $40k should be more like $400k
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Sure but make the sliding scale more realistic. Based on current, over-inflated medical procedure pricing, that $40k should be more like $400k
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Sure but make the sliding scale more realistic. Based on current, over-inflated medical procedure pricing, that $40k should be more like $400k
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@mark said in The Two Tiered Health System:
Sure but make the sliding scale more realistic. Based on current, over-inflated medical procedure pricing, that $40k should be more like $400k
Yeah that would cover over 99% of the population.
@Loki said in The Two Tiered Health System:
@mark said in The Two Tiered Health System:
Sure but make the sliding scale more realistic. Based on current, over-inflated medical procedure pricing, that $40k should be more like $400k
Yeah that would cover over 99% of the population.
https://www.gobanking.com/average-person-income-around-world/
The average per capita income worldwide is $10,298, according to the World Bank
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Yeah, $400k was a bit of a stretch. Start the scale at $85k and increase it, to a cap of about $225k. And then, perform annual COL adjustments.
We are not living in the 1970s.
@mark said in The Two Tiered Health System:
Yeah, $400k was a bit of a stretch. Start the scale at $85k and increase it, to a cap of about $225k. And then, perform annual COL adjustments.
We are not living in the 1970s.
Still unsustainable.
The goal is to provide adequate medical care to as many people as possible and still not break the bank.
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The other wrinkle here is that some large lower paying companies have made arrangements to offer health insurance to their workers. Costco, Starbucks, Walmart.... if we make the ceiling too high they will have no incentive to continue doing so. It's not a killer, but it certainly needs to be considered. What we are after is no one goes without healthcare.
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The other wrinkle here is that some large lower paying companies have made arrangements to offer health insurance to their workers. Costco, Starbucks, Walmart.... if we make the ceiling too high they will have no incentive to continue doing so. It's not a killer, but it certainly needs to be considered. What we are after is no one goes without healthcare.
@Mik said in The Two Tiered Health System:
The other wrinkle here is that some large lower paying companies have made arrangements to offer health insurance to their workers. Costco, Starbucks, Walmart.... if we make the ceiling too high they will have no incentive to continue doing so.
It's past time to decouple healthcare from employment.
Forget two- or three- or four-tiered healthcare system. Just go straight to single payer universal healthcare and be done with it.
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@Mik said in The Two Tiered Health System:
The other wrinkle here is that some large lower paying companies have made arrangements to offer health insurance to their workers. Costco, Starbucks, Walmart.... if we make the ceiling too high they will have no incentive to continue doing so.
It's past time to decouple healthcare from employment.
Forget two- or three- or four-tiered healthcare system. Just go straight to single payer universal healthcare and be done with it.
@Axtremus said in The Two Tiered Health System:
@Mik said in The Two Tiered Health System:
The other wrinkle here is that some large lower paying companies have made arrangements to offer health insurance to their workers. Costco, Starbucks, Walmart.... if we make the ceiling too high they will have no incentive to continue doing so.
It's past time to decouple healthcare from employment.
Forget two- or three- or four-tiered healthcare system. Just go straight to single payer universal healthcare and be done with it.
There goes the subsidizers of healthcare. Employers pay so much more than Medicare and Medicaid. So you argue think of the administrative cost savings, well that wouldn’t touch the difference.
Good luck with it.
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@Mik said in The Two Tiered Health System:
The other wrinkle here is that some large lower paying companies have made arrangements to offer health insurance to their workers. Costco, Starbucks, Walmart.... if we make the ceiling too high they will have no incentive to continue doing so.
It's past time to decouple healthcare from employment.
Forget two- or three- or four-tiered healthcare system. Just go straight to single payer universal healthcare and be done with it.
@Axtremus said in The Two Tiered Health System:
@Mik said in The Two Tiered Health System:
The other wrinkle here is that some large lower paying companies have made arrangements to offer health insurance to their workers. Costco, Starbucks, Walmart.... if we make the ceiling too high they will have no incentive to continue doing so.
It's past time to decouple healthcare from employment.
Forget two- or three- or four-tiered healthcare system. Just go straight to single payer universal healthcare and be done with it.
That is a great idea if the goal is higher cost and lower quality for everyone.
But it makes a swell virtue signal.
Now that obamacare pays for insurance for anyone that doesn't have insurance and can't afford it there is no reason for single payer.
Except, higher cost and lower quality and the virtue signal.
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Taiwan has a single payer healthcare. Seems to work pretty well. I have not had to use too much, but I know growing up as a poor family, it helped us and continues to help my mother.
(NOTE: I know taiwan is very different from the US. Population (25 million vs. 300 million, cultural differences, etc.)
Some points on Taiwan healthcare
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the government spends only one percent of its health care budget on administration. In US, insurers spend 12 percent of their revenue on administration. And, administrative costs account for 25 percent of hospitals’ budgets.
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Patients’ medical records are all on one system. Taiwan uses a national electronic health records database.
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health insurance premium payments take the form of payroll contributions (5.17 percent of income)
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Progressive income taxes and additional taxes on lottery tickets and tobacco also help fund the Taiwanese health care system. And, the Taiwanese government imposes a copay of about $12 whenever people use the medical system, unless they are low-income. Taiwanese with greater incomes can buy private insurance to pay for services their public system does not pay for.
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Taiwan spends six percent of GDP on health care, as compared to 17.7 percent in the US.
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