Flame — HabitableZone

Flame » in reply to Actually, I doubt they'll take my advice

An interesting idea.
TB — (archived)

On one hand, almost all professionals who do some kind of "repairs" for a living are paid by the procedure. On the other hand, there are certainly professionals who do that kind of work for a steady salary (a serviceman contracted to, say, a hotel.)

Of course, this could produce an incentive to do fewer procedures. Some salesmen work on commissions. Others work on salaries. Many have combinations of both (your "bonus" concept?)

All forms of health insurance, government or private, have to have some kind of governor on payments. If we've decided it isn't going to be market forces (something that's becoming true even in the private insurance industry) we will have to use rationing. All health care systems around the world are dealing with trying to hold down costs in the face of the inevitable ever-increasing demands for "free" goods (in recent years, much of this has been in drugs and medicines). Most are simply restricting services or imposing price controls.

There will always be some bureaucracy needed to make sure health care money is being well-spent. I'm not convinced that a government bureaucracy is going to be better at it, or wind up cheaper, than a private system. The core premise of those advocating government medical care is that the government can do it cheaper and more efficiently, while providing the same care.

I may be cynical, but I have seen no other category, no other government-run function, where this has been true.

You make a good point that Medicare-type coverage for younger groups will not be as expensive per person. I have studied Canada's system in great depth, and while their average health care spending per capita is around $5,000 (Canadian), it's only $3700 per person between infancy and the age of 64. It goes up drastically for seniors: $5,369 for
age group 65 to 69, $7,382 for 70 to 74, $9,987 for 75 to 79 and $17,121 (!) for age
80 and older.

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