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January 30, 2012

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Tung Yin

"[T]he federal government could give everyone a voucher that would be worth the full cost of the lowest-priced health care plan on the market. People could purchase more expensive plans, but they would have to pay the difference in cost between their plans and the low-cost plan."

I understand the point that programs have more popular support when they have a broad base of beneficiaries, but I have a hard time seeing how it could be more efficient to tax me enough to provide benefits for the poor *and* for the voucher for me, and then give me the voucher back. I mean, I suppose there could be some efficiencies of scale, but more likely the extra transactions costs and government bureaucracy would eat away at those efficiencies and more.

David Orentlicher

If I'm understanding your point correctly, I think it's hard to predict efficiencies with health care systems. Medicare taxes you enough to provide benefits for the poor and for you after age 65, and it operates with lower administrative costs than does the combination of private insurance and Medicaid for persons under age 65. But even if a universal voucher sacrificed efficiency over a more ideal alternative, the advantages of a universal system (e.g., ensuring access to coverage) would compensate for the loss of efficiency.

Tung Yin

Hmm, but is it accurate to say that Medicare taxes me "enough"? Considering the massive unfunded liability in Medicare, it seems that Medicare does not come close to taxing enough to pay for what it's promising.

junior prof

Race-to-the-bottom plans are likely to fail (in terms of health care coverage) for many reasons that have been well documented by responses to previous pro-voucher arguments. One way to prevent sub-standard care (or, every time some treatment is needed, fighting with the insurance company over what is medically necessary) is to REQUIRE than all members of Congress (and their families) be enrolled in the proposed "bottom" or "base-line" plan. If it's good enough for the American people, it should be good enough for the lawmakers.

Pamela Averill

For the increasing number of elderly Americans that needs special care, the government must give attention in all health care providers. They should know if they can still afford the expenses with tax for the health care services.

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