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In reply to the discussion: The Urban Institute's Attack On Single Payer: Ridiculous Assumptions Yield Ridiculous Estimates [View all]ehrnst
(32,640 posts)97. Most countries do it with multi-payer system, some of which use private insurance companies to
manage payments.
Compulsory insurance[edit]
This is usually enforced via legislation requiring residents to purchase insurance, but sometimes the government provides the insurance. Sometimes, there may be a choice of multiple public and private funds providing a standard service (as in Germany) or sometimes just a single public fund (as in Canada). Healthcare in Switzerland and the US Patient Protection and Affordable Care Act are based on compulsory insurance.[26][27]
In some European countries in which private insurance and universal health care coexist, such as Germany, Belgium, and the Netherlands, the problem of adverse selection is overcome by using a risk compensation pool to equalize, as far as possible, the risks between funds. Thus, a fund with a predominantly healthy, younger population has to pay into a compensation pool and a fund with an older and predominantly less healthy population would receive funds from the pool. In this way, sickness funds compete on price, and there is no advantage to eliminate people with higher risks because they are compensated for by means of risk-adjusted capitation payments. Funds are not allowed to pick and choose their policyholders or deny coverage, but they compete mainly on price and service. In some countries, the basic coverage level is set by the government and cannot be modified.[28]
The Republic of Ireland at one time had a "community rating" system by VHI, effectively a single-payer or common risk pool. The government later opened VHI to competition but without a compensation pool. That resulted in foreign insurance companies entering the Irish market and offering cheap health insurance to relatively healthy segments of the market, which then made higher profits at VHI's expense. The government later reintroduced community rating by a pooling arrangement and at least one main major insurance company, BUPA, then withdrew from the Irish market.
This is usually enforced via legislation requiring residents to purchase insurance, but sometimes the government provides the insurance. Sometimes, there may be a choice of multiple public and private funds providing a standard service (as in Germany) or sometimes just a single public fund (as in Canada). Healthcare in Switzerland and the US Patient Protection and Affordable Care Act are based on compulsory insurance.[26][27]
In some European countries in which private insurance and universal health care coexist, such as Germany, Belgium, and the Netherlands, the problem of adverse selection is overcome by using a risk compensation pool to equalize, as far as possible, the risks between funds. Thus, a fund with a predominantly healthy, younger population has to pay into a compensation pool and a fund with an older and predominantly less healthy population would receive funds from the pool. In this way, sickness funds compete on price, and there is no advantage to eliminate people with higher risks because they are compensated for by means of risk-adjusted capitation payments. Funds are not allowed to pick and choose their policyholders or deny coverage, but they compete mainly on price and service. In some countries, the basic coverage level is set by the government and cannot be modified.[28]
The Republic of Ireland at one time had a "community rating" system by VHI, effectively a single-payer or common risk pool. The government later opened VHI to competition but without a compensation pool. That resulted in foreign insurance companies entering the Irish market and offering cheap health insurance to relatively healthy segments of the market, which then made higher profits at VHI's expense. The government later reintroduced community rating by a pooling arrangement and at least one main major insurance company, BUPA, then withdrew from the Irish market.
Tomasky, Michael (March 21, 2010). "Healthcare vote: Barack Obama passes US health reform by narrow margin". Michael Tomasky's blog. London: The Guardian. Retrieved March 23, 2010.
Jump up ^ Roy, Avik. "Switzerland - a case study in consumer driven health care". Forbes.
Jump up ^ Varkevisser, Marco; van der Geest, Stéphanie (2002). "Competition among social health insurers: a case study for the Netherlands, Belgium and Germany" (PDF). Research in Healthcare Financial Management. 7 (1): 6584. Retrieved November 28, 2007.
https://en.wikipedia.org/wiki/Universal_health_care
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The Urban Institute's Attack On Single Payer: Ridiculous Assumptions Yield Ridiculous Estimates [View all]
melman
Sep 2017
OP
That says "industry funders are Cigna and Pfizer", it doesn't say how much. Plus...
George II
Sep 2017
#46
At least yours is reasonably current, not six years old, and has no mention of Cigna or Pfizer...
George II
Sep 2017
#87
Wait...Keynsian ecomomics is now a hall-mark of "the conservative wing of the Democratic party?"
Expecting Rain
Sep 2017
#61
How did you do that? I typed out the breakdown of their funding below (sans last two, got tired!!!)
George II
Sep 2017
#36
If the information being provided is inaccurate, it would sound that way. But...
George II
Sep 2017
#59
But if a corporation touches anything, it becomes impure! Unless it has been blessed of course
Ninsianna
Sep 2017
#113
Your link provides no evidence of significant funding. No dollar amounts, and no corporate donors
pnwmom
Sep 2017
#68
It doesn't sound like Himmelstein is just picking numbers to fit his preference.
dgauss
Sep 2017
#13
The ACA is a renamed "Romney care" that the GOP called Obamacare to play to the racism
guillaumeb
Sep 2017
#45
No, the ACA is the ACA, nicknamed "Obamacare". Has nothing to do with Romneycare except...
George II
Sep 2017
#47
Most countries do it with multi-payer system, some of which use private insurance companies to
ehrnst
Sep 2017
#97
Obama also said that it would not be wise to go directly to Single Payer from our current system
ehrnst
Sep 2017
#98
He did. He also pushed for a public option, which a couple Senators killed.
Warren DeMontague
Sep 2017
#102
I guess that he didn't actually think it was the "only moral, fiscal" solution.
ehrnst
Sep 2017
#104
it's a "rabbit hole" to point out that the ACA has its origins in a Heritage Foundation proposal?
Warren DeMontague
Sep 2017
#89
Do you folks forget that between Reagan and Bush (not sure which, probably the first) were...
George II
Sep 2017
#65
I really don't. It connected the ACA with Presidents Reagan and Bush, which occurred almost....
George II
Sep 2017
#72
When people go see the doctor for checkups and get regular dental care
Warren DeMontague
Sep 2017
#52
And someone who doesn't understand that when you pay for something with cash
Warren DeMontague
Sep 2017
#88
And a Single Payer System isn't going to magically create more health care spending.
Warren DeMontague
Sep 2017
#91
"People do worry about their health and they will use more care if it is free"
Warren DeMontague
Sep 2017
#96
Actually, the increase in the number of people using health care is a cost issue in implementation
ehrnst
Sep 2017
#108