Overall Healthcare Solution is Simpler Than You'd Think! Just stop setting the 2 sides against each other....

 Since a large majority of Americans think government should provide health care insurance for all --

 In Searchlight’s polling, most respondents — 66 percent — said the government should provide health care to all Americans, regardless of age or income.  -- Opinion | This Is Why So Many Voters Hate Both Parties - The New York Times

and the main challenge to all healthcare in the world is simply that to provide what people reasonably want as good healthcare this has to include newer treatments (once proven)  which cost a lot more than old treatments, so that the needed new (better) treatments then cause overall costs to go up and up....

 -- which this blog has explained (accurately) as unavoidable due to an unchangeable fact:  that if someone's life is at stake, then price is no object  -- people will mostly choose to pay as much as it takes to save their lives (or at least try to do so)... 

-- and that's why the free market doesn't/cannot limit overall total costs in health care well (while it can limit costs for older standard treatments though, such as by using robotics and health care aides and such as technicians, it cannot control the cost of newly developed treatments that are still under patent)

-- While on the other hand, trying to limit the endlessly rising costs by switching to government run healthcare, which could potentially control costs powerfully, has the well understood other costs of:

•  1) stifling innovation, 
•  
•  2) resulting in long waits for some newer (or even sometimes older) key services.....

This is the well understood quandary as explained on this blog before...

But...

Looking at the big picture once you've accepted these facts makes it possible to think in new ways -- and a broad solution becomes obvious at some point, once you've understood and accepted the realities.

The great majority of Americans would like it if government would provide healthcare for all that wouldn't break the bank but also would encourage and allow continual innovation and better new treatments to continue to arrive, with private incentive to make new treatments....

A seeming impossible both/and goal....

But that's where to rethink.

"Why not do both/and."

It's a societal discussion flaw we can remove here, the mistake of opposing sides -- where so many have argued one side or the other without realizing both are best not as tolerated side systems.

Instead, think on it in a new way -- that both public and private are needed as primary, main systems.

Both.  (not one huge and the other small/marginal, but both large, primary, and thriving)

So, let's look at how that would work.

Both Systems Solution:

Here's a way:

A Medicare for All system (where private supplemental insurance is allowed as already is normal) that covers (wait for the new part at the end here....) only (as already standard in Medicare) proven treatments which are medically necessary....and....includes dental and vision coverage....and....sets prices by negotiation with individual hospitals and small associations (not giant monopoly like associations of course, so some new law is needed to control networking (healthcare associations) that makes a local monopoly (say over 70% of provider capacity (number of doctors could do) in defined areas where population is over 50,000) -- that has to be made illegal, and of course that means funding investigators to audit to check for such illegal local monopoly)...and...

...also carefully limit regulation on the private sector to include only key basic regulation such as fraud prevention (laws and enforcement), requirement of clear language and summaries of coverage, and (government audited) language about a treatment's rate of effectiveness -- then let the pure free market handle all the rest. 

  Under the private system would then be all the new treatments not yet included in the Medicare for All system -- where the Medicare for All systems would only cover new treatments that have proven themselves over a 7 (or 9 or 11) year period, to give time for competitors to come up with versions of that new treatment type and time enough for all the free market gains to happen.

So that private free market innovation can continue apace... in a major, large system way.

But at the same time, all basic well proven healthcare will be price fixed and under Government insurance.  Fully.

Both systems being full fledged, neither in a minor role.

We'd likely see that a high portion of all healthcare visits (most are lower cost) such as perhaps over 85% being under the Medicare for All system. (all the most routine and basic health care visits along with a wide variety of highly standardized well proven treatments (such as joint replacements, etc.).   

No one would need to die merely for lacking well proven and long standard healthcare -- proven and effective long existing treatments.  

Looking over time for what works well, a Medicare for All system could also include public clinics (as is common in many areas) for certain classes of visits, and law could also be included as needed to prevent the private sector from extending monopolies on drugs and treatments more than 20 years old, though it's reasonable to carefully consider when the clock starts ticking on such a timeline.

So: we'd have then also a large scale and widely used system of private supplemental insurance that is purchased privately with private dollars oriented to the latest (and of course relatively more expensive) treatments.

We need to simply stop thinking we should choose or prefer one system over the other. 

We can have both types of systems operating well, both the public and the private, without thinking we'd have to make one side (public vs private) operate poorly or at a disadvantage.

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This is also politically doable, as it's not hugely different from the current Medicare system, and if it happened that there was too much fear or opposition to extending Medicare for All, it's pragmatic to be able to phase it in in a way that is more palatable to various sectors like insurers, hospitals, and private practices.

Phasing in Medicare for All:

If needed, phasing in slowly would make this much easier for insurers and providers to plan and transition over time.

So, for instance, a very slow transition (if needed to be politically viable) -- First lower the entry age into Medicare to 55 for 5 years. And then lower the entry age by 3 years every 5 years.

OR: (a perhaps better speed) -- First lower the entry age into Medicare to age 50 for 4 years. And then lower the entry age by 5 years every 4 years.

OR: (perhaps even just as politically viable) -- First lower the entry age into Medicare to age 45 for 3 years. And then lower the entry age by 5 years every 3 years.

OR: Set up a full transition All At Once (all ages) to be implemented all at once 4 or 5 (or 7) years after passage -- giving plenty of lead time.  This time gives insurers and health care providers time to plan and get ready, and will reduce their political objections.