The problem with this approach is that preventative care is the best care. It might cost someone $100/month to take some pills -- or cost the state $10k+ when they have a life-threatening episode of whatever ails them. If the price of the preventative care is too expensive, and there's light at the end of the tunnel (so long as you survive your critical episode, I guess), then there's an incentive to just wait it out until it gets so bad it's free.
I live in New Zealand, and I have Ulcerative Colitis. We have a public/private system somewhere along the lines you propose (although a little more forgiving), and are really quite lucky:
* There's a strong tendency for doctors to work both publicly and privately. They'll put in time at the public facilities, but those facilities are generally pretty highly loaded -- turnarounds can be slow. If you've got the money, you can see most privately (that's generally not overly expensive).
* Thanks to a Government agency known as Pharmac, we bulk buy all our drugs -- so, I pay $5/prescription (prescriptions can last up to 3 months), instead of $120+/prescription. For someone with a chronic condition like myself, this is fantastic. It also works out cheaper for the Government too: we have the market power to negotiate much better deals from pharma companies.
* If you do get into a critical state, the public system will provide care. Alternatively, if you've got insurance, you can go private (but private care for critical stuff -- where surgery/non-Pharmac drugs are required -- is generally prohibitively expensive).
* Elective/preventative care is also available publicly. This means you're in a queue ("we'll get around to it sometime in the next year"), but does mean you're able to maintain a higher quality of life.
Medicine is hard: reconciling care with expenses is a moral quagmire. There are absolutely inefficiencies in the NZ system, but I've come to really respect it.
I live in New Zealand, and I have Ulcerative Colitis. We have a public/private system somewhere along the lines you propose (although a little more forgiving), and are really quite lucky:
* There's a strong tendency for doctors to work both publicly and privately. They'll put in time at the public facilities, but those facilities are generally pretty highly loaded -- turnarounds can be slow. If you've got the money, you can see most privately (that's generally not overly expensive).
* Thanks to a Government agency known as Pharmac, we bulk buy all our drugs -- so, I pay $5/prescription (prescriptions can last up to 3 months), instead of $120+/prescription. For someone with a chronic condition like myself, this is fantastic. It also works out cheaper for the Government too: we have the market power to negotiate much better deals from pharma companies.
* If you do get into a critical state, the public system will provide care. Alternatively, if you've got insurance, you can go private (but private care for critical stuff -- where surgery/non-Pharmac drugs are required -- is generally prohibitively expensive).
* Elective/preventative care is also available publicly. This means you're in a queue ("we'll get around to it sometime in the next year"), but does mean you're able to maintain a higher quality of life.
Medicine is hard: reconciling care with expenses is a moral quagmire. There are absolutely inefficiencies in the NZ system, but I've come to really respect it.