DECENTRALIZING TRAGIC CHOICES - POOLING HEALTH RISKS WITH HEALTH UNIONS

Pooling health risks through insurance has led to cost explosion becau se centralized third-party payers cannot deny even cost ineffective tr eatment for life-and-death cases without arousing a sense of tragedy a nd inviting legal challenges. If the same total health budget is distr ibuted equally on a per capita basis, funding decisions for treatment can then be voted on in a decentralized manner. Because unfunded treat ment would be a result of majority choice and not bureaucratic decisio n, both a sense of tragedy and legal challenges can be avoided. Health unions that serve as fund-raising agencies and consumer advocates can coordinate such voting.