healthcare reform

[flaja]

The Republican proposal to give tax credits for people that buy their own health insurance won’t work for the simple fact that working class (and not a small number of middle class) people that cannot afford health insurance now likely aren’t making enough to have any taxable income in the first place. Giving people who don’t pay taxes tax credits so they can buy health insurance is just socialized medicine under another name.

Any proposal involving medical savings accounts won’t work due to market forces. Where I live you can get medical savings accounts at a credit union, but the accounts are paying less than 4% in interest. Putting money in one of these accounts means that you are just barely breaking even with the government’s official inflation rate. But the real inflation rate (when you consider food and energy) is likely at least double the official rate, and the yearly inflation rate for the healthcare industry is something around 20%. A medical savings account is a losing proposition.

So what can we do?

First of all we must remember that any healthcare system must:

1. Preserve competition among providers for insurance policies, healthcare products and healthcare services in order to lower prices.
2. Preserve the profit motive to fund R&D of new medical products.

But these market forces have contributed (at least in part) to the problem that millions of American cannot afford adequate healthcare. Inadequate healthcare coverage is a problem that neither private individuals, nor private enterprise can deal with. The government will have to eventually become involved. This will mean that the government must have new sources of revenue while we must also reevaluate our existing spending priorities.

Taxes to consider:
Television sets
Cable and satellite TV services (based on the number of channels and number of receivers)
CD/MP3/IPOD players
DVD players
Video cassette recorders
Video cassette players
Pre-recorded video tapes
Digital video recorders
Pre-recorded CDs, DVDs, cassette tapes and MP3 recordings
Entertainment themed software
Computers
Video game systems
Video game disks, cartridges et cetera
Automobiles for personal use (proportional to the number of autos owned by a household)
Tobacco products (in addition to whatever taxes now exist)
Alcohol products (in addition to whatever taxes now exist)
Packaged process foods based on calories
Restaurant foods based on calories
Payroll tax on people who are not enrolled in the healthcare system
Internet service providers not used exclusively for business
Progressive tariff on products imported from the People’s Republic of China based on the amount of products imported, i.e., the more you import the higher your tariff rate
Corporate stock owned by non-U.S. citizens or companies not owned by U.S. citizens
Real estate owned by non-U.S. citizens or companies not owned by U.S. citizens
Credit card debt
Consumer finance loans
Sale of contracts for the future sale of gold, silver, crude petroleum, refined petroleum products, agricultural products based on the value of the contracts
Sale of corporate stock that has been owned for less than 1 year


Requirements:
Impose price limitations on all medical products that are otherwise sold over-the-counter (adhesive bandages that Wal-Mart can sell for a penny a piece shouldn’t cost $5 just because it is sold by a hospital or doctor).

End all subsidies, insurance programs and disaster aid to tobacco farmers.

Create a nutrition education program for grades 1-8.

Fund daily PE programs for grades 1-8.

Revamp the school lunch program to avoid high-calorie/low nutrition meals.

Ban advertising of prescription medications.

Prohibit the sale of soft drinks at all public schools.

Restrict the products that can be purchased by food stamps to insure that recipients maintain a nutritious diet.

Basic plan:
The plan will provide 3 levels of coverage.

Basic coverage will be offered everyone and will include a yearly health assessment examination and routine vaccinations as well as coverage for minor incidental medical needs (illness and injury). Anyone who is enrolled in the basic coverage plan will be required to enroll in the chronic and catastrophic plans as well.

The chronic coverage plan will include things like pregnancy, diabetes and hypertension.

The catastrophic coverage plan will cover things like cancer, heart disease and paralysis.

How the plan works:
Doctors and insurance companies will create a standardized set of health assessment criteria that will determine a person’s overall health and the likelihood that he will need certain types and amounts of medical care during the next year based on the person’s age, gender, family history, lifestyle et cetera. A person’s health assessment will be expressed as a numerical score.

Each year all interested insurance companies will submit bids for premiums to cover each possible health assessment score for each level of coverage (routine, chronic and catastrophic). The bids for each health assessment score will be averaged to determine the national average.

Persons who are enrolled in the plan will receive a voucher equal to the average premium for an insurance policy to provide routine health care. Each enrolled person will use the voucher to purchase a routine health care insurance policy from one of the participating insurance companies. If the person purchases a policy that cost more than the national average, he must pay the difference. If he purchases a policy that cost less than the national average, he may apply the difference towards his purchase price for the chronic health care insurance policy that he must buy.

Each year’s health assessment score will be converted to a percent chance that he will need chronic medical care during the next year. Each enrolled person will receive a voucher equal to: [100% of the average premium] – [(percent chance of need) x (100% of average premium)]. This way the more burden a person puts on the healthcare system the more he pays in insurance premium. Each enrolled person must use the voucher to purchase a chronic health care insurance policy from one of the participating insurance companies. If the person purchases a policy that cost more than the national average, he must pay the difference. If he purchases a policy that cost less than the national average, he may apply the difference towards his purchase price for the catastrophic health care insurance policy that he must buy.

Each year’s health assessment score will be converted to a percent chance that he will need catastrophic medical care during the next year. Each enrolled person will receive a voucher equal to: [100% of the average premium] – [(percent chance of need) x (100% of average premium)]. Each enrolled person must use the voucher to purchase a catastrophic health care insurance policy from one of the participating insurance companies. If the person purchases a policy that cost more than the national average, he must pay the difference. If he purchases a policy that cost less than the national average, he may apply the difference towards alternative treatments or lifestyle modification programs.

Each year a national average cost will be calculated for medical products and services (doctors’ visits, lab work, hospitalization, prescription medications, diagnostic tests and procedures, medical supplies). These averages must be published and provided to each person who is enrolled in the program. Persons who are enrolled in the program may obtain medical services and products from any participating provider. Insurance companies will pay the average cost. If the person uses a provider whose price is greater than the average, the person must pay the difference. If the person uses a provider whose price is lower than the average, he will receive a voucher for the difference that he may apply to his out-of-pocket costs for medical products and services or apply them to alternative treatments or lifestyle modification programs or apply towards the next year’s insurance premiums.