If anyone has a critique of these I will forward them to the Healthre list
whence it came> CHeers, Ken Hanly
In my approach to universal health care,
www.his.com/robertb/hlthplan.htm I require that there be a mandatory MSA
for workers in the same sense as Social Security is mandatory.
Some have questioned this mandatory requirement. In looking over the
writeup I noticed that I do not explain why I feel that it is a
requirement that the MSA be mandatory; so here is an explanation. I
would appreciate any comments from the list as to why the MSA should or
should not be mandatory.
Bob Blandford
Alexandria, VA
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Why MSA Feature Should be Mandatory
The MSA needs to be mandatory because it is desired that the voucher +
MSA, together with strongly regulated catastrophic insurance, as much as
possible take the place of comprehensive insurance, whether private,
medicare, or medicaid.
If the MSA is not mandatory, employers will be much more tempted to
grant comprehensive insurance as a benefit to their employees, in order
that the employees need not draw down their voucher. On the other hand,
if the MSA is mandatory, most employers and employees will feel that
comprehensive insurance is not necessary. Employers in that case, if
they decide to provide any health benefit, will be inclined to
contribute extra money to the employees with the proviso that it go into
the MSA.
It is important that comprehensive insurance not dominate; if it did,
then the health market would be suppressed, because third party payments
would continue to distort the market. If many employers, especially
employers of the middle and upper-middle classes, offered comprehensive
insurance; then that paradigm would be seen to be standard and
desirable. So advocates for the poor would continue to argue that the
poor also should have comprehensive insurance. If, on the other hand,
the middle-class get MSA-support from their employers; then the Federal
government will be urged to give the same benefit to the poor; enhancing
the market.
Also, these middle-class people are the ones who will seek out the
lowest prices and thus make the market. They also are the people who
will make the best use of the information sent back from the federal
government to those who use the voucher and MSA to pay bills, thus
enhancing market efficiency. (This information feedback is a feature of
my approach).
I do discuss in the existing writeup that a mandatory MSA is not as
radical as it may seem in light of the fact that taxes for Social
Security and medicare are mandatory and progressive, and that it is
mandatory to pay the taxes which support medicaid. So mandatory MSA is
less confiscatory than many other taxes; at least the money goes
exclusively for the good of the taxed person.
Of course the general, progressive taxes nonetheless pay for the
lifetime voucher, yearly use-or-lose voucher, and strongly rationed
safety net which are features of my approach.
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