I’m sorry, I can’t stop laughing.

Nevertheless, this is pretty much how the Swiss healthcare system works and it’s considered one of the best in the world. Here.

Sorry about the format, stupid pdf:

Insurers, which under the Health Insurance Law must register with and are monitored by the Federal Social Insurance Office (itself subordinate to the Federal Department of the Interior), are obliged to accept all applicants, thereby avoiding cream-skimming. The insured may change insurer twice per year.

Choice of Insurer: Both registered health insurance funds and private insurers are permitted to provide the compulsory
basic insurance. There are 93 registered insurance funds offering compulsory basic insurance in 2002. In 1993 there
were 207, in 1977, there were 615, in 1945, 1,151. There doubtless will be further insurer mergers. These companies,
whose membership varies in size in 2000 from 256 (Krankenkasse Unitas, Binn), to 1,129,479 (Helsana Versicherung,
Zurich), may be federal, regional (e.g. KK der Region, Goms), religious (e.g. Christlich-Soziale de Schweiz
Versicherung) or occupationally based (e.g. Betriebskrankenkasse der Chocoladefabriken Lindt + Sprungli).18,19,20 All
are run on a not-for-profit basis though under the new CBSI law this is no longer a requirement.21 Insurers group
together in Cantonal and Federal Associations to negotiate fees with service providers, represent the interests of
members, compile statistics and so forth.22 This long-standing group negotiation is likened by many to a cartel.23
Basic Benefits Package: ‘Basic’ is a real misnomer here as it implies that significant elements of healthcare must be
purchased in addition. This is not the case, indeed Zweifel among others likens the Swiss ‘basic’ package to a luxury
one in the US or Germany.24 The health insurance law defines the scope of the benefits package under compulsory
insurance. Benefits are standardised throughout the federation. The package which covers the cost of medical treatment
in the canton of residency, includes inpatient and outpatient care, care for the elderly and physically and mentally
handicapped, unlimited stays in nursing homes and hospitals, diagnosis, and so forth. Since 1999, alternative and
complementary medicine benefits are also included.25 Services covered must meet criteria of clinical effectiveness,
appropriateness and cost-effectiveness. However, these tests have only been applied to potential additions to the package, not those already included.

Premiums: Swiss premiums, which are federally regulated but not fixed, are independent of income. They are
community rated, that is, the same for every person taking out a policy with a given company in a given area,
regardless of individual risk rating. Premiums, which vary from insurer to insurer, may vary by 50% from canton to
canton, and are payable directly to the insurer on a monthly basis. The insured shop around for best premium rates.
Prior to 1996, premiums were risk-related, thus some with high risk found health insurance unaffordable.30 The cost of
insurance is now roughly £1500 per person annually.31 Patients may also opt for bonus options for no claims (as in the
German private insurance market).

So: from a time-allocation point of view, worth reading?

Coupled in that way, it may reduce unemployment (while addressing risk aversion constraints for labor) and by framing division as a visible share of surplus issue may help egalitarianism.

There was an interesting discussion years ago in the Boston Review with Herbert A. Simon, Emma Rothschild, Edmund S. Phelps, Brian Barry, Elizabeth Anderson, Ronald Dore, Fred Block, Robert E. Goodin, Claus Offe and others responding to Van Parjis.

Murray’s book may indeed have been ‘one of the…most influential written about the American welfare state,’ but that simply testifies to the appalling degree of ignorance on such matters in this country. That you would judge it ‘one of the best…ever written about the American welfare state’ assures me your grasp of the relevant literature is weak at best.

Goodin well took care of Murray’s arguments (and like-minded New Rightists) in the book cited above. In any case, commencing with ‘1950’ hardly amounts to an historical examination of the rationale of the welfare state: see, for example, Michael B. Katz, In The Shadow Of The Poorhouse: A Social History of Welfare in America (New York: Basic Books, 1986). See too Theda Skocpol’s Protecting Soldiers and Mothers: The Political Origins of Social Policy in the United States (Cambridge, MA: Belknap Press of Harvard University Press, 1992).

You might also benefit from intimate acquaintance with Robert E. Goodin, Bruce Headey, Ruud Muffels, and Henk-Jan Dirven, eds., The Real Worlds of Welfare Capitalism (Cambridge, UK: Cambridge University Press, 1999).

All good wishes,
Patrick

Politically, it will not happen, and it would have to be airtight to consider dismantling SS.

I would say:
Do it in addition to SS.
Universal healthcare (including children) seperate from this scheme.

I now read Patrick O’Donnell with a hermeneutics of suspicion.

If we mean you received $x this year, saved y, then you are taxed on x-y (and the corollary, that if y is negative, then you pay the consumption tax on what you took out of your savings) then yes. That was The Economist’s plan from the mid 1980s.

Progressivity? Meh. Although I do think it outrageous that the poor pay income tax at all. Should start around the median income. If we can’t get enough from those over that to pay for the State then shrink the State.