How would minimum basic income free us from a welfare state?
What happens when your $50,000 in medical bills is greater than your $27,000 in annual income (or whatever it happens to be), and you elected not to purchase insurance with your money? Serious question, not meant at a dig against this proposal, because I am genuinely curious as to how it would be handled.
I think they highlighted in there that $3000 of the $10,000 must be spent on healthcare coverage. Sounds like they're deliberately setting out to remove the chance to let people have a healthcare cost sink them.
Yes, I have a similar question. One of the major reasons to have social programs that buy things like health insurance is that governments have a lot more bargaining power than individuals (up to and including the legal authority to set price caps). In the case of healthcare, governments can get the same coverage and care much cheaper per capita than individuals could if they purchased it on their own. Giving individuals a basic income does not give them this bargaining power, so doesn't that mean that either (a) there will still be a need for social welfare programs for things like healthcare, even with the basic income; or (b) the basic income level must be much higher per capita than what the government would spend on these programs? I think I am probably missing something here, so I'd appreciate it if someone would explain this.
Consider the ACA model (even minus the subsidy aspect), which uses (1) purchase mandates, (2) minimum standards, and (3) state exchanges through which private insurance can be purchased.
This applies most of the the large-purchaser effect of a social program, but isn't a traditional social benefit program (sure, the actual ACA, which has subsidies for some purchasers, includes a traditional social benefit program as a component, but there is no reason that the rest couldn't be maintained with similar benefits without the subsidy in a BI system.)
> This applies most of the the large-purchaser effect of a social program...
Does it, though? That's what I'm wondering. Is there any evidence that the model followed by the Affordable Care Act is not significantly more expensive per capita than a single-payer, "Medicare for all" kind of system?
Well, there's the large-purchaser effect when the purchased good is privately-offered health insurance, and the large purchaser effect when the purchased good is actually health care services. Aside from the effects of the non-discrimination requirements which shift costs from the older and less healthy to the young and healthy, the ACA model increases the number of people that can benefit from large-purchaser group rates on insurance -- its almost certainly less efficient than single-payer overall still (as, for that matter is Medicare, which hasn't been single payer for decades, due to Risk HMO / Part C / Medicare Advantage plans, which are actually make it very similar in model to the ACA except with a public option.)
That implies that they're not talking about scrapping the welfare state. That's fine, but it implies that they are not speaking plainly, and it also eliminates the basis for my question.
What happens when your $50,000 in medical bills is greater than your $27,000 in annual income (or whatever it happens to be), and you elected not to purchase insurance with your money? Serious question, not meant at a dig against this proposal, because I am genuinely curious as to how it would be handled.