Tax-penalties to make health care affordable

Well, I disagree with your interest in incentives. It's better to allow people to structure their own choices as much as possible. There are problems with health care and insurance right now that drive up prices and undermine the natural economic incentive for living healthy, which is saving money on health care.

If everyone has to pay for everyone else that avoids doing what they can to prevent utilization, that removes the economic incentive for staying healthy. The challenge is how to allow healthy people to only insure health care for others who do due diligence to prevent health problems without allowing others who shirk due diligence to create bills that others have to pay. It is a huge challenge.

If everyone would just self-pay for health care, you would still have hospitals and providers pricing their services in ways that maximize their revenues from the most common treatments, even if those treatments and services could be provided at a lower cost.

Somehow the industry has to be disciplined to not exploit the vulnerable position of sick/injured people in need, who have little choice but to seek care. Unless there are numerous local urgent care centers that are able to provide all needed services/treatments without sending people to emergency rooms, then emergency rooms have a relative monopoly position, which allows them to charge exorbitant fees, which in turn allows the hospital administrators to use their ER as a cash cow, along with whatever other services and treatments they provide that people have no alternative to seek elsewhere at a lower price.

Good points here as well.

I especially like this;

"Somehow the industry has to be disciplined to not exploit the vulnerable position of sick/injured people in need, who have little choice but to seek care. Unless there are numerous local urgent care centers that are able to provide all needed services/treatments without sending people to emergency rooms, then emergency rooms have a relative monopoly position, which allows them to charge exorbitant fees, which in turn allows the hospital administrators to use their ER as a cash cow, along with whatever other services and treatments they provide that people have no alternative to seek elsewhere at a lower price."

Yes! Healthcare does not sit well with commercial interests. The vast majority of western countries understand this and have public health systems. America is the odd one out.
And there is this perception that the private sector is always more efficient than the public sector. And there are no shortage of examples of inefficient public operations. However, i have noticed that the public sector in recent years has been starting to smarten up and improve its game.

Ultimately I perceive the efforts to make private health work as flogging a dead horse, its something that can never possibly work long term with an aging population.

Even public sector institutions can be and are used like businesses by the people involved. Many public budgets are manipulated politically to provide various forms of funding to contractors, for example. School systems and their students work together to make schools in more expensive neighborhoods better and less expensive neighborhoods worse, to get people to buy into the most expensive houses/apartments possible. There are all sorts of ways that public institutions can be used to manipulate private business and public healthcare would surely be no exception.

What is needed is true ethics and self-discipline on the part of everyone involved, so they don't manipulate whatever system they are using in the service of money-making, but such self-discipline is lacking and impossible to achieve through external regulation. People have to want to behave ethically for the greater good.


Ethical people could choose to teach/train others for low cost and then work for modest wages to provide care services, but there are a number of factors that would be needed to support that, including limiting liability and insurance costs, patients taking responsibility to do as much as possible for themselves, people not trying to manipulate the system to create more jobs, GDP growth, etc.

It would be extremely difficult for everyone to cooperate to provide care at affordable prices without attempting to manipulate each other in ways that trigger lawsuits, etc. to get more money out of whatever pot of money they can tap into.