Back again, this time with a few suggestions on how to make the national health insurance system better. It is already good, but I am thinking “better.”
1. Consolidate the systems. As I understand this, there are basically three systems now: one for government employees and other people who work at large organizations, another for everybody else under 75, and then another for people 75 and older. First, the only reason for the 75+ grouping is that it is assumed these people cost more, the under-75s don’t want to pay it, so we separate them off. But in the hope everyone will get that old, and in the realization that these people paid their premiums even when they were not costing the system much if anything (which is the way insurance works), there is no good reason to cordon them off when they start costing the system money. Then there is the other division, which is essentially one of who pays the premiums. Big organizations pay half the premiums for their low-risk people. Gig workers, for example, pay the full premium themselves. But that is an irrelevant distinction. The system should not care who pays the premium and should instead work to expand the pool. Include everyone. Make it truly one national system with the same premiums and the same coverage for everyone regardless of age, employment status, or other factors.
2. Similarly, the 75+ group now has three co-pay ranks: 10%, 20%, and 30%. Once the systems are consolidated, everyone should also have the same co-pay stages depending upon income.
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4. And finally, expand coverage to include such prevention measures as health check-ups and vaccinations. It is a truism that prevention is cheaper than treatment. So expanding coverage to include prevention will end up saving the system money. (I am just thinking of things doctors/hospitals do and not your fitness gym, jogging shoes, otc vitamin pills, or the like.)
I think these tweaks would make the system better and end up costing everyone less on average, but mine is an ordinary-voter perspective and I would be interested in hearing what experts and other people think, if you care to comment.