David LaFerney

sinfest.net

Better to laugh than to cry - Thanks to Tatsuya Ishida at sinfest.net

photo credit: David Boyle in DC

I know that no one cares what I think about universal health care.  Nonetheless, this is a relatively simple plan which would work, is compatible with our current system, and is not “Socialized Medicine” - but is not one that has been proposed as far as I know.  The health care issues that I think most Americans want to see addressed are:

• Universal coverage for all Americans
• A fair and affordable method of funding
• Cost controls for both insurance and the cost of health care itself

The Plan

1. Mandate that every American be covered by a standard universal minimum policy.
2. Allow the individual insurance companies to charge whatever they want, but they have to charge each of their customers the same price for coverage.

That’s it in a nutshell, and here’s why it would work:

• A huge market for health insurance would result, and every insurance company in the world would want a piece of the pie.
• Market competition between the insurance companies would keep the cost of coverage fair.
• Everyone would be covered - Just as they are now, but within the system.
• Improved prevention and wellness care (regular checkups, and early detection) could lower overall expenses while actually improving our health if they were a mandated part of the plan.
• There would no longer be the issue of individuals who do without insurance (not contributing to the pool) for years while they are healthy and who then want coverage when they develop health issues.
• The insurance companies could still sell luxury private insurance packages to individuals, companies, or employers who wanted them as long as everyone was covered by the basic plan first - admittedly this market would probably be greatly reduced.
• We already have universal health care to a certain extent, but as it is the uninsured don’t contribute to the cost, and many people don’t have adequate wellness and preventative care coverage.
• American businesses could be more competitive in the world market place because they would no longer be on the hook for most of working Americans health care insurance.
• Portable coverage would mean that workers would no longer become indentured to their jobs just because their employer covers their families insurance - resulting in increased entrepreneurship and career mobility.
• The loss of a job because of market downturns would be less catastrophic for families if they don’t automatically lose access to affordable health care insurance.

The details of the mandated insurance - coverage, deductable, etc - are almost immaterial to the larger plan, but I hope that it would include a heavy emphasis upon wellness and prevention. Personally I wouldn’t have a problem with charging extra to people who voluntarily endanger their health by smoking or by being motorcycle daredevils for example, but that would open up a whole can of worms of complexity and probably isn’t a good idea.

Who Would Pay for it?

All of us - preferably as individuals, but for those who actually can not afford it, then the cost would have to be subsidized by the rest of us just like it is now.  If employers wanted to pay for coverage for their employees then there would be no reason not to - as long as they paid the same cost per insured as everyone else.

Who Would Lose?

Probably no one would really lose in the long run, but several groups would scream bloody murder:

The healthy uninsured - This group consisting largly of the working poor, and younger people in the job market who currently don’t pay anything for health insurance, but who can still get treatment when they need it  - because the rest of us pay the tab for their emergencies.

The Insurance Companies - They probably wouldn’t like it because they could no longer cherry pick the market for the most profitable groups to sell “discounted” insurance packages to while charging deterrent prices to individuals, and denying coverage to the people who have pre existing conditions. I’m sure that “Industry Experts” would assure us that this idea would be so expensive that America would dry up and blow away - But they would be liers when they did.

Small government conservatives, libertarians, anarchists and the politicians who pander to these groups. These people won’t be happy with any plan other than  - “If you can’t afford to go to the doctor then you probably deserve to be sick” - The companion plan to the “If you can’t afford to retire, then work until you die” retirement package.

Otherwise most everyone else would be better off.

How Would this Plan Control Costs?

As we all know, if one walks into an emergency room you will get health care even if you have no way to pay for it - Thus we already have a poor and inefficient system of universal health care.  My plan would spread the cost to everyone who has income, and would improve efficiency by improving wellness and preventative care and getting non emergencies out of the emergency room - the most expensive health care venue that there is.

Insurance plan cost control - Competition between insurance companies for market share would control insurance prices in good old Capitalist supply and demand fashion.

Health care cost - By itself this plan would not control the cost of health care, but improved wellness care and early detection would probably improve over all efficiency by making us healthier and reducing the need for heroic measures to treat preventable diseases.

Health care cost could be further controled by giving consumers a vested interest in avoiding unneeded doctor visits and elective procedures - One way of doing this would be health care savings accounts which could be used for co pays and deductibles, and which would roll over from year to year, and would actually belong to the consumer.  The idea would be that deposits to individual accounts would be made contiuously by everyone with income but if the ballance is depleted then those costs would have to be paid for out of pocket by the consumer.  The problem with health care savings accounts as they are is that they have to be used up annually or the money is forfeited - what genius came up with that?  If we had healthcare savings accounts that could accumulate over time some people would become virtually self insured.  But that is another issue.