- I think that people should be responsible for their own health care including funding.
- I think the proportion of people needing reasonable funding at some stage in their life means the concept of sharing risk via insurance for most illness is meaningless.
- I think if people do not take care of their health, they will likely still get care and others will advocate for them; but there will be costs that someone has to cover.
The third point is important because the situation occurring as the result of people making bad decisions will be used to argue for socialised government in the name of caring.
I think the Singaporean system, or a model based on it, is worth considering.
Here is some reading on the Singaporean system as it is.
- International Health Systems: Singapore
- The Singapore Model
- The Singapore health system—achieving positive health outcomes with low expenditure
- All workers are to pay 5% of their income into an individual, managed, low-risk health account.
- There is a tax cut of the same amount so individuals have the same take home pay.
- Employers are not required to give any money toward their employees account, nor can unions force this issue. This prevents people being locked into jobs because of the health benefits.
- The money is yours, it cannot be taken by the government, it can be passed on in a will at death to other healthcare accounts, hospitals or medical research; or possibly as cash to the beneficiaries of the will.
- Compulsory insurance is paid from the account to cover rare, unexpected, high-cost events (eg. kidney failure requiring life long dialysis).
- You can use your account to pay healthcare costs. The potential healthcare and the costs are determined by government; that is, both what you can get medically and the maximum amount you can pay. It would include doctor, nurse, hospital visits, etc. It would include prescription and immunisation costs. It would cover dental care.
- You can only cover your own and your dependants healthcare costs.
- You can purchase a higher level of care, or medical services outside normal practice, but this is unable to come from your healthcare account.
- All provision is by private providers who can charge what they will, though adequate competition should keep costs down.
There are problems. It does not deal to those who are not employed. It does not deal well with congenital conditions. It does not cover visitors to the country such as tourists. And it does not offer a solution as to how a different system can be transitioned to this. But with medical costs increasing rapidly because of new and better diagnostic and treatment modalities, it is impossible for governments to sustain future expenditures. And when individuals see how much an intervention really does cost, then they may consider whether the benefit is worth it.