Comment by georgeplusplus | Hacker News Reader

Comment by georgeplusplus | Hacker News Reader

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>> Well, they can't deny emergency care to a human being who is about to die/in critical condition, can they? So lets start on that common ground

Let’s first find our common ground. If you are a doctor and a patient comes to you, and the doctor refuses on the grounds he will not be paid enough, you think you have the right to compel this doctor to perform the service anyway?

The emergency care example you give is an extreme and shouldnt be used as the basis for all other policy. I would say a doctor who chose the job as an emergency care provider acknowledges your stance when he took the job, to provide service to matter what, not because it is a right but a contractual obligation.

I think the "what right do you have" or "can you force someone" phrasing is adversarial and can't drive a conversation.

Lets instead look at distilling the universal access idea to its essence, we need

  1) A capital pool to fund the program
  2) A legislative framework that
    2.1) Lays out the products and services and the pricing of those
    2.2) Allows for price negotiation based on geography and other market driven criteria
    2.3) Drafts fines for inappropriate behavior - excessive billing, using unapproved medication, etc
    2.4) Defines licensing terms for a provider to bill the government

Now #1 is no different from any other regular insurance, you collect individual payments at the federal level. #2 would also be federal legislation. #2.4 would be similar to how medicare-certified hospitals operate.

Now the question really becomes - why would any provider not take this deal? Certainly, there could be several reasons, and those can be addressed on a case by case basis. But the point I want to make is, we can start small, maybe we only tackle preventative care at first.

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