I completely agree with you. A smaller, mostly homogenous population that is fitness oriented is going to be healthier than we are and will be able to control costs better.
Still, I believe we are steadily marching towards single payer for a couple of reasons:
1) The very nature of employment, now. Most folks don’t stay with one employer and it’s accompanying guaranteed healthcare. Employment is more tenuous; people don’t feel like they have financial security let along any level of health insurance security. You know that if you lose your programming job tomorrow, you have a 401k and $23,000 in the bank and two kids to provide for. The “middle class” just doesn’t feel that sense of safety that they felt after WWII. Don’t underestimate the desire for parents to make sure their kids have healthcare.
2) The cost of caring for the elderly. Without sharing costs with the young and healthy, it is going to be cost prohibitive (”going to be?”) to continue to care for the elderly. And let’s face it: we are not going to throw grandma under the bus.
I know there are a lot of ideas floating around to get around problem two, but I still think it will be a major contributor towards single payer. The elderly are costly to care for, and without the strong arm of the government, there is no reason for health insurance companies to accept them.
One thing I do agree on is that we are going to have to figure out how to decouple health insurance from employment, and relieve companies of the burden of managing employees’ health insurance.
Consider that when they offshore, they don’t have to worry about the guy in Mumbai’s health insurance.
You SURE do know how to get on my good side! ;-)
The elderly are costly to care for, and without the strong arm of the government, there is no reason for health insurance companies to accept them.
No question... the government already IS in charge of the elderly. We're surely not going to change that.
But, even the government COULD apply the principles of a high deductible plant to Medicare. Offer older people MONEY each year.. that, if they DON'T spend on health care, they CAN use on other things. Then, I believe you will have fewer elder scheduling monthly visits to their Doctor, just so they have some place to go and someone to talk to. My wife worked for a private practive physician. They had a NUMBER of such patients.