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Claim HMOS - HMO subsidy as Medicare reform

Category: Politics:US Politics JUDGED at 0
Judge:306, SMWinnie
due date:1998/09/22

The Claim

Simon's HMO subsidy program is adopted as Medicare reform

In an oped piece entitled A Modest Proposal for Medicare Reformers in the Wall Street Journal of September 22, 1995 (page A12) Julian Simon proposes an outright subsidy on HMOs as the fundamental means of Medicare reform. That is, there shall be no price controls on medical care delivery but the Federal Government shall subsidize ``high need'' patient contracts in the marketplace. He poses four conditions:

  1. Prepare a list of people (or households) who meet Congress' criteria for enrollment.
  2. Obtain a medical history for each person.
  3. Publicly inform all health insurers and qualified health providers - especially those in each local area, but not limited ot them - that there will be an auction of the contracts in which each of these people will be considered separately
  4. Assemble all potential bidders to the auction hall or electronically.
Simon states that the major virtues of this system are that
  • it requires absolutely no changes in any other part of the health-care system, though other changes could be applied
  • government activity is limited to doing what the federal government does bets -- writing checks
  • no bureaucratic allocation of resources is involved, reducing potential chicanery and corruption
  • the plan can be applied to Medicare or any other group for whom the government wishes to acquire responsibility for their health care
  • the costs of this system are straightforwrd: merely the sum of the checks that the government writes. Other systems' costs are unevaluatable and have huge indirect costs
  • the auction system prevents providers from running away from high-risk low income patients by making it worth while to stay and provide care
Additionally he points out that this system of nonlinear pricing has effectively been put in place in the airline industry since he proposed it in 1966. Thereby rationalizing the problems with timeliness in the supply and demand of air travel.

Judge's Statement

I will judge based on the intent of this claim, if I perceive such intent to be obvious. If such intent is ambiguous I will judge on the basis of the precise wording. If both are ambiguous, I will look for a solution which follows IF/FX precedent insofar as such precedent is apparent to me and applicable to the claim. I will seek the guidance of the claim's owner/author in interpreting the claim. It's his or her question - s/he ought to get the answer sought. If I believe this claim to have met a YES or NO condition, and if I believe judgement will be controversial, I will post a prospective judgement to fx-discuss and forestall entering the judgement for a comment period to be announced in the post.

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