Jonathan,
As I read the argument, he is not failing to account for the difference in health care costs, but he is claiming that the lower costs may in fact be a result of the other system (Theo is this correct?).
I think it does bring up a chicken-and-egg problem, though. Are the costs lower because of the system, or is the system possible because of the low costs?
More significantly, I remain confused as to what happens when, say, a smoker gets lung cancer at age 40. He has some savings in the fund, which will be quickly exhausted. He did not eat his vegetables, so to speak, so he is not 'deserving' of care from the public till. At this point he is denied care? He uses his personal savings until he is bankrupt and then simply dies at home? If people are to be incentivized, we have to be prepared to show toughness towards people who do not behave as we would like, or the incentives are a myth. (Of course, we deny people care all the time because they have no insurance now).
The pamphlet you provided is very instructive. It describes medisave as a 'compulsory savings plan' and medishield as "a low cost medical insurance plan" (you call it "a communal fund for catastrophic costs" and recommend that it be mandatory). I am not sure how the resulting system is very different than, say, Hillary Clinton's plan that everyone be required to purchase health insurance, combined with some sort of flexible spending plan like those widely available in the US.
-- AndrewCase - 05 Mar 2009 |