Universal basic health insurance
Patients in America are in trouble. We are the only modern western capitalist country where people go bankrupt due to health care bills. Health care bills cause more Americans to go bankrupt than any other kind of bill.
Oregon is in trouble. We did pass measure 101, but even with this measure, federal funding for the ACA Medicaid expansion is still going to end. Then the 400 000 Oregonians who gained health care will lose it again. Rural hospitals will close. Oregon cannot afford a business-as-usual approach to dealing with Oregon's Medicaid population. Also, the cost of employee benefits, which are driven by health insurance costs, are a significant drag on our city, county and state budgets.
America is in trouble. We spent 16% of our total economic production on health care costs in 2015. The next most expensive health care system by GDP is France, which spends 11%. Germany, Canada, Italy, Japan, Taiwan, Switzerland, Australia, and most other modern western capitalist countries pay even less than that.
We need a rational health care system: a not for profit, no opt out health insurance system run under a lean management strategy by the state government. Admin costs should not be more than 4%. At the moment, admin costs in the private insurance industry are 15%. Medicare admin costs are 3%. This insurance must include everyone: rich, sick, healthy, poor. Yes, some people get sick because they do dumb stuff. But most people get sick because they're unlucky. Nobody wants to be sick. Including everyone doesn't mean that some people can get up to no good and we have to take care of them anyway. Including everyone is how normal insurance makes taking care of problems cheaper for everyone. It means that even if you do everything right and you still get sick and you lose your job and you go broke, you will still get health care.
How will we pay for it - ?
We already pay for it. Healthy workers who pay their taxes are already paying for all of the health care in this country. This includes their own private insurance that they either buy themselves or get through their employer. And through their federal and state taxes they also pay for care for the poor or people who can't work. And we are paying too much for it. The truth is, in America we already have a half baked universal health insurance system.
If we take the profit out of the insurance industry, Oregonians would pay less.
If we standardized care and fees, Oregonians would pay even less than that.
If we eliminated the paperwork involved in billing Oregonians would pay even less again.
If physicians were paid a salary, like I am, Oregonians would pay even still less again.
If we used a Coordinated Care Organization model, we would pay less again.
And care could be delivered in a more rational manner based on public health goals - for instance taking care of your diabetes now instead of having a devastating stroke a year from now because of uncontrolled diabetes. This would also cost less, and keep us healthier for longer.