Health Care - Back to the Basics

Care, Insurance, Doctor-Patient relationships, Malpractice, etc., etc. - in this entire discussion, there is one underlying issue that tends to be glossed over (by choice, or by happenstance : the difference pretty much defines your 'conspiracy theorist' level).

Who is this supposed to benefit?

Deep pause, intake of breath, and sudden realization that the answer isn't that easy.

Some answers are really easy. Take National Security for instance. The direct and immediate beneficiaries are the Citizens. Yes, defense contractors, military-industrial complex, etc, but in the end, it is the Citizens. Not quite convinced? Follow the money - the difference between mercenaries and an army is that one is for hire, and one isn't. As Shlock Mercenary tends to point out every now and then, just because you hired a bunch of mercenaries doesn't mean that they aren't - at the same time - also working for someone else! Follow the money indeed. Do you really want to take the chance that your prized National Defense Apparatus is suborned by the simple task that someone else just Paid More?

But, Health Care? Who should it be for? The Citizens? The Companies? In the end, that is the question that needs to be answered. Once that is defined, the rest can be argued based on whatever political/economic/ideological viewpoints you may tend to have.

If the answer is Companies, then lets all drop the Moral, Ethical, and Social statements. Stop saying 'Everybody should have Health Care', because, that is *not* what we are trying to get at. Instead, stick with what we have, and stop whining about The Cost Of Health Care, because, frankly, You Are Not Paying Enough (Remember, its got nothing to do with you. You aren't paying Enough, because its for the greater good and glory of the Companies)

If the answer is Citizens, then the equations change, but only slightly. Lets frame the question as follows - What is the best way to maximize the Health of each Citizen? There are any number of answers here, and a lot of them would make Free-Marketers really really happy. Not to mention, swell the coffers of a lot of companies in the process. Maybe not the coffers of the Companies that currently offer Health Services, but that is not what we are aiming for, right?

Take Tontines for example. To dumb it down, this works as follows

1. You pay your insurance
2. If you fall ill, you are covered by the insurance
3. If you don't fall ill, you get cash-money back.

Of course, the money back in (3) isn't the money you paid in (1), but there'll be a nice market-based spread there, and you can pick/choose. In fact, there are all sorts of fun market-based thingies buried in this.

1. Insurance companies will now be incented to bring young people into the system. After all, young people don't fall ill,
2. The spread between what young people pay, and the cash-money-back can be pump up the Insurance Company's profits. Some companies will stick to Business As Usual, and just play around with this spread, varying it to maximize the number of young-uns that they attract.
   
3. Some Insurance companies will use this spread to reduce the costs of the Not-So-Young insurance payers. This will bring more of them into the system, thus pumping up profits just as well.
4. The only sure thing here is that the guaranteed money that an insurance company *has* to pay out is when you fall ill. Sooo, the insurance company now doesnt want you to fall ill. It is in their best interest to make sure that you get preventative care . Heck, they might incent you to go to the doctor! Get checkups! Get vaccinated!

Brilliant, right? And nary a subversive fifth-column socialist thought there anywhere. Lots of money to be made by a lot of companies, and Health-Care for all!