Wednesday, June 21, 2006

Universal Healthcare in San Fran

San Francisco looks to be attempting to implement universal healthcare for its citizens. I certainly have mixed feelings about universal healthcare. From a human perspective it certainly would be nice. I used to be quite the proponent for socializing healthcare until I realized that too many people don't play fair to make it work. After all the stories I hear from my sister about abuses of free access to emergency rooms I find it hard to believe that people will make the effort to allow a system of free healthcare to work. (The healthcare industry faces a large number of supply problems without artifically inflating demand.)

San Francisco has further muddied the waters. Their coverage is only for those without private health insurance. So, I wonder, for what reason should I maintain a health insurance plan if I live in SF? If I'm an employer, not only do I pay for my personal health insurance, but I'm to contriubte $1.60/employee hour to the system. Furthermore, what's the tax rate going to be for the citizens to support the estimated $200 million/year budget. Yikes.

I do like that the plan isn't free. Even if you live under the poverty line you'd be expected to pay a $3/month premium. Anyone making under $40K would have to pony up $35 a month. There is a huge difference between free and affordable. There should also be a sliding scale of copays (the article mentions such, but doesn't elaborate). A visit to a doctor or hospital should come with some cost.

If nothing else I'll be interested to see how this plays out. SF could serve as a testbed for the country. I also await the numerous law suits that will arise from the fact that SF will not cover people who work in SF, but don't live there.


Blogger Zathras said...

As the least, one can look at it as an economic experiment. If it works great, if it doesn't, then we've learned something about economics.

You're very correct about wondering about the incentive to maintain private insurance. The only possibility is that the public insurance might be lacking in some issues with respect to private insurance (maybe higher deductibles, higher co-pays, etc.)

I think the legal issue raised is very interesting. The closest analogue I can think of is a city income tax (which I unfortunately have in Lansing), since there is the no taxation without representation issue, but in that case you can make the argument that even out-of-towners who pay the city income tax still partially benefit from the payment (road maintenance, etc.) The best counterargument by the city is that if someone doesn't like it, they can work somewhere else. I think the lawsuits will be interesting.

11:13 AM  

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