The Republicans were unable to pass a health insurance reform law. And although the ACA is not as bad off as they claim, it has flaws which will seriously impede its effectiveness in the future. One of the provisions in the Republican plan was to 'allow' buyers to 'choose' the type of coverage they wanted; or not require sellers (insurance providers) to provide a fixed set of benefits (like mental health or maternity care).
There was no or little talk of rationing during the recent debate over health care. But make no mistake, medical should be rationed. Resources are not unlimited so keeping very ill people alive at the expense of the wellbeing of many younger, healthy people is absurd. The question is how to set limits? A few years ago, there was an essay and study published about how Doctors' end-of-life decision making for themselves differed from the decisions of patients. This might be the best guide to determine the limits of basic medical care. Survey doctors for how the degree and extent of treatment they would pursue if they had a given diagnosis. Use 90-95% coverage of these limits to define the benefits of a basic universal health care plan; ideally, a system where patients never deal with billing paperwork - the billing system alone of the American healthcare system is extraordinarily expensive. Private insurers can offer anything above and beyond basic coverage.
Like the U.S. tax system, the U.S. health insurance system is deliberately complicated to generate the need for 'specialists' to maneuver the system. The beneficiaries are the 'specialists' themselves and their employers (who profit from their work). Consumers pay in time and stress and dollars due to misunderstanding and errors. A single payer system would lift a major burden from consumers.
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