I recall being in Canada a few years ago and the newspaper front page headline warned that 900,000 Ontarians had no primary care physician, despite having the right to one under the Canadian system. In other words, it was almost as if they were uninsured, meaning they had to get urgent care from hospital ERs.
Now, we find in this New York Times article that the meltdown continues and increasing numbers look to private care for the medical needs–even though such care has been illegal.
I recall mentioning in a speech I gave in Canada the day that story came out, that Americans want the Canadian system and many Canadians were beginning to want the American approach. This seems to be continuing.
This isn’t my area of expertise. But perhaps the best approach would be a national blend of private/public health care financing: Have the government pick up catastrophic costs beyond a certain point, which would reduce insurance premiums. Permit national private insurance coverage rather than state by state, to expand the coverage pool. Have a Medicare type coverage for all legal residents and citizens, but keep the package limited to necessary care that would offer partial coverage. Allow private insurance or private pay to fill the gap. Stop cherry picking by requiring insurance companies to subsidize coverage for people with significant pre-existing conditions. Permit high deductibles supplemented by medical savings accounts to avoid over utilization. Permit certified physician’s assistants to do the routine work.
This much seems sure to me: Our current system is breaking. National health coverage, Canada or UK style doesn’t work. We need to be imaginative if we are to avoid health care rationing, which is discrimination by a polite name.