22 January 2008

Single-Payer nuts and bolts

It's one thing to see that single-payer makes sense. Kind of like seeing that the marketplace makes sense, for most goods, or that universal education makes sense, or socialized policing.

It's quite another thing to actually research and dream up the specifics of the best possible American single-payer system.

That's why you have people like George Swan, staunch Republican, fiscal and social conservative, who is outraged at the affront to his family and fiscal values embedded in our current system -- which he describes as 3PMP, third party multi-payer.

Regarding ERISA challenges to a single state enacting universal, single-payer health care, George writes:

"I have written many times the obvious decision for insurers from out of state, those "paying higher prices than average due to cost shifting (see Lewin's vivid graphic in his "Healthcare Spending in Colorado" draft at the 208 Commission website).

"If you're an insurer, and it is possible to obtain healthcare in Colorado 30% less than prices in other states, you'd send your beneficiaries to Colorado, wouldn't you? If ERISA policy-holders and 3rd party multi-payers (3PMP) could get single payer rates in Colorado, due to standard pricing practices (whereby everyone knows what services actually cost), they'd realize a 30% windfall savings (varies, depending on area/providers/carrier/etc). 3PMPs could lower their premiums and pocket increased profits. This is why Blue Cross of South Carolina has developed an agreement for beneficiaries to travel overseas for surgery!

This is why you'd levy a 30% surcharge to out of state (and ERISA-protected) carriers. The surcharge would be adjusted by the Board of Directors, based on data, simply to equalize the charges to non-single-payer carriers. You could even develop a marketing strategy to sell surplus capacity, to become a net importer of medical services!"

Health care tourism, right here in a single-payer Colorado. We'd get a jump on other, slower states.

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