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November 16, 2009


I think you're on the right track, though I'll admit I'm not well-versed enough in the legality or the politics of the business to know if the above suggestions would be sufficient changes that would ultimately provide affordable coverage to everyone who wants it. My concern is that the high-risk individuals, or those with existing conditions -- AKA the people who most need insurance -- will always be left uncovered unless someone mandates that they be protected, and at a realistic rate.

Also, wouls drug companies continue to produce drugs if they COULDN'T make a killing on the sale price? Altruism is beautiful, but I'm cynical enough to suspect most drug execs would immediately convert their operations into genetic food factories (or something else more exceedingly profitable) instead.

One perso interviewed at the impromptu New Orleans health clinic MSNBC organized was a nurse who said he can't get enough hours at either of his two jobs to make him eligible for health insurance. I dig irony, so I'm sure you'll agree that a nurse who works to keep insured Americans safe but can't get insurance himself is ultra-ironic. But that kind of irony shouldn't even be possible.

Apologies on my typos above. I was typing with one finger. Long story. (And no, it's not injury-related, nor would it have been avoided if I were insured.)

Hey Justin, thanks for the comment.

The above plan is a MASSIVE change as compared to the current plans - not less by any means. That's why no one wants it - it's very dangerous to their interests.

High risk people are far better off under this system. They would be outed (by means of not getting tested) as higher risk, but remember the risk premium is based on how much the treatment cost is. The real sayings they experience is on the tech and labor side. If meds/tech are 5% (conservative) of their current cost, it doesn't matter if you have 10 times the risk - it's still only 50% of the previous cost. Labor is similar as well - with no monopoly, medical tourism, and expert systems, we can reduce the costs of labor drastically.

Incentive for drug companies is pretty much a non-issue. R&D would continue from the universities - as it does today. FDA approval is subsidized, so they have far less commercialization costs. Not all products have to have massive margins to succeed. Look at all commodities: corn, oil, etc. have very little profit for anyone - it's close to perfect competition. The same would happen to pill makers - they'd specialize in eliminating cost to gain market advantage - like most manufacturers do today.

I think you're mistaking the free market for altruism. We already give NSF/NIH funding to solve common good issues like finding cures for diseases. All drug companies do is solve the issue by monopoly - I want to solve it via competition. With less restriction, we'd have a lot of novel health companies. This issue is that everyone can't see past the present to see how a different system would work. In their risk averse state - they don't solve anything.

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