Semi-Weekly Discussion Thread - December 16, 2024

[u/tuesday_mod]

INTRODUCTION

/r/tuesday is a political discussion sub for the right side of the political spectrum - from the center to the traditional/standard right (but not alt-right!) However, we're going for a big tent approach and welcome anyone with nuanced and non-standard views. We encourage dissents and discourse as long as it is accompanied with facts and evidence and is done in good faith and in a polite and respectful manner.

PURPOSE OF THE DISCUSSION THREAD

Like in r/neoliberal and r/neoconnwo, you can talk about anything you want in the Discussion Thread. So, socialize with other people, talk about politics and conservatism, tell us about your day, shitpost or literally anything under the sun. In the DT, rules such as "stay on topic" and "no Shitposting/Memes/Politician-focused comments" don't apply.

It is my hope that we can foster a sense of community through the Discussion Thread.

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The list of previous effort posts can be found here

Previous Discussion Thread

[u/Bullet_Jesus]

Considering the discourse; what are peoples ideas for healthcare reform in this country? Are there any other countries that have systems that you think we could draw inspiration from? What are peoples thoughts on national solutions vs regional ones and their feasibility?

[u/Mexatt → u/Bullet_Jesus]

Universal free market in insurance, subscription, mutual, or whatever the hell healthcare funding and delivery mechanism free people choose.

Barring that, Universal HSAs up to a particular dollar figure then universal catastrophic insurance above that, with a separate program for chronic incurables. Income based top-ups for the HSAs. I think Singapore does something like this.

Barring that, a broken Beveridge system where regional governmental organizations own public hospitals which service the poor free of charge and ramp up the dollar cost based on income to a point where people above a certain threshold pay full cost (and maybe even people above another threshold pay an even higher cost, to subsidize the system) to encourage them to go to private healthcare providers using their private insurance. This is kind of like wedding the normal Scandinavian Beveridge system with the Australian Medicare.

[u/Bullet_Jesus → u/Mexatt]

Universal free market? Wouldn't that require getting all the states on board with harmonizing their regulatory codes?

I've heard mixed things about the Singapore system, it seems efficient but I've heard that there are some issues with health outcomes.

I'm surprised to see advocacy for public providers. Then again though I'm confused how this broken Beveridge system operates. If it is designed to get the wealthy to go to private healthcare on private insurance how will it acquire the wealthy users that are supposed to subsidize the system for the poor?

[u/Mexatt → u/Bullet_Jesus]

Universal free market? Wouldn't that require getting all the states on board with harmonizing their regulatory codes?

Yep. One of the biggest problems with something like insurance (although, really, finance in general) in American history has been fragmentation of regulatory regime, often including widespread adoption of bad models and narrow or sectional adoption of good ones. These days we have uniform model law organizations like the ULC to provide harmonized model laws, so it's less of a problem, but harmonization can important for sustaining a common market. See: the EU, in general.

I've heard mixed things about the Singapore system, it seems efficient but I've heard that there are some issues with health outcomes.

Can't get significantly worse than the US, now, right?

I'm surprised to see advocacy for public providers. Then again though I'm confused how this broken Beveridge system operates. If it is designed to get the wealthy to go to private healthcare on private insurance how will it acquire the wealthy users that are supposed to subsidize the system for the poor?

The idea is they would be owned, operated, and funded either by states or some sort of more local, regional public organizations via taxes. But, if someone wealthy wanted to go to one, they'd both get care and be contributing to the system by being charged through the nose for the care. Take a bit of the financial burden off of taxpayers.

[u/Bullet_Jesus → u/Mexatt]

harmonization can important for sustaining a common market

I can actually really get behind this. The US has come a long way since federalization was established and healthcare has changed a lot too. I can understand that the states still have a place for more regionalized industries and for social issues but some issues are becoming increasinly national and require national solutions.

I don't see how this harmonization can be feasibly achieved though. Any federal solution would require opt-in from the states, and when was the last time all 50 states agreed on anything? Feasibly you could create quite a big bloc with just a few states but the best market is the biggest one.

The idea is they would be owned, operated, and funded either by states or some sort of more local, regional public organizations via taxes

As so everyone is already bought in, the poor are subsidized, the middle break even and the wealthy pay for a service they are not likely to use.

I like it, though I expect it to be a real political battle to implement.