We see lots of health policy books — most repeating familiar themes and refrains. This one has something new: Chronic Crisis – Guide and Response to the Healthcare Debate … For Regular People. (Click here for the Amazon page.) It’s by Dr. Selvoy Fillerup, an MD and public health service doc, who undertook his own comparative health policy study and came up with some interesting results.
The familiar debate is single payer all-government financing versus market competition. Fillerup’s thesis, looking at health systems in a dozen nations, is that a blended system makes the most sense — both to achieve universal coverage without rationing and to control costs. That’s not meant as an endorsement of our system by any means. We flunk by any reasonable measure. What are the elements the matter? Here’s his list:
1. Government determines the parameters of a minimum basic benefits policy (MBBP)
2. The same MBBP applies to private (PHI) and government health insurance (GHI)
3. Health insurance is mandatory
4. Health insurance is offered under conditions of: community rating and guaranteed issue
5. There are no barriers to switching between carriers
6. Employees of large corporations much choose PHI
7. All others may choose GHI or PHI
8. GHI covers all vulnerable populations
9. Employers and employees share the cost of health insurance
It’s a challenging notion — the optimal system combines expansive government financing and strong market oversight along with some measure of private health insurance as a counterbalance. Not sure Fillerup’s got it completely right, but his ideas deserve airing and attention.
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