|
Preface as to how I see single-payer: For US, would cost 1T$/year, we now pay 2.5T$/year. That leaves 1.5T$/year to become savings if we go to single-payer eliminating insurance companies altogether. And, this would be self-insurance -- no middle men.
T = trillion
Dillon's bill seems to stop shy of self-insurance and still includes insurance companies(unnecessary as I deem them to be). It does, however, intend to make a single-payer of insurance companies for all under State of Michigan employ.
(The US government, I would think does this. As a US government employee you have a list of companies, plans and prices to pick from having various costs for various areas within government.)
The gain comes from two areas: 1. One payer, one arbiter, less costly redundancy for insurers and state departments and a larger pool leads to a lower price. 2. Fewer choices, such as teachers with a gold system might have to settle for a silver system with, perhaps, higher co-pays and deductibles.
So, I see this as a mixed bag. If a worker sees their benefit falls, and it will cost them more, then they wish to negotiate for a higher salary. This amount in not included in either raising or lowering the projected cost of a health plan.
That is: if teachers suddenly get a $1,000/year deductible, they would want to argue for an extra thousand a year salary, even more so after taxes they would have the thousand to pay for their health. The plan might show savings in health care, but might not actually save any money -- and might actually lose ground.
The pooling effect should still produce a net savings.
The notion of careful monitoring saving money, seems a joke. First, that's what you pay the insurance companies to do. Will Dillon offer redundancy? Problem is, insurance companies, like all companies, exist to make a profit and only offer as much service as is needed to make it look like they offer a service. Money is number one.
Sorry to go on so long.
|