Austin wrote this:
https://twitter.com/afrakt/status/400338128281407488
about this post. Basically, he’s looking for a response to Reihan and Avik’s proposal that we couple concierge care with a catastrophic plan for Medicaid.
I think this misses a huge part of care. Physician time shouldn’t be minimized. But this plan would involve a huge deductible for everything else. So how would preventive care get paid for? Things like colonoscopies, mammograms, and laboratory panels aren’t cheap. How would maternity care get paid for? One third of births occur on Medicaid.
Would we expect people below the poverty line to have thousands of dollars to pay for deductibles for this stuff? Cause they won’t have it. A baby will bankrupt them. They’ll avoid necessary care because they can’t pay the deductible. And if you start adding in preventive care and maternity care and deductibles they can afford back into the plans, you’ve got… traditional Medicaid.
There’s a reason things are the way they are. If it were easy to “innovate” our way out of this, we would have done it already.
