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|User Info||Atlanta Appeals Court Crushes Obamacare Argument; entered at 2011-08-13 15:35:05|
"1. Dismantling all of the anti-competitive crap that currently is in Health Care, thereby causing pricing to collapse to that which can actually be paid, as opposed to the leveraged bull**** games played now."|
Health care is going to be expensive no matter what you do. It involves costly and protracted training by the practitioners, high technology, extensive quality systems, hands-on personal delivery of services (no manufacturing "scale up" of efficiencies), risk/liability, etc.
"2. A single-payer system much like Canada has."
It is commonly believed that a universal-payer system is required to provide universal financing of health care. That is not true. On my first post to the Ticker Forums, I described the following health care financing system. It does not suffer from the legal pitfalls of Obama Care, yet accomplishes his desired end goal (universal health care). It also would accomplish many of the goals you seek.
Simple Health Care Financing System
The following is a "thought experiment". I noticed that most people who promote universal health care seem to think that it requires a single-payer (government) to pay for all health care. Below is an alternative system that preserve many aspects of a free market--yet removes the government from the doctor-patient relationship. Some may find this more acceptable than a Canadian single-payer system, for example.
A simple health care plan for the U.S.:
* Each person is required to put 15% of his or her income into a health savings account.
* All health care spending comes from this account.
* If a charge to your health care account is larger than your balance, then your account balance goes negative. This is effectively a federal health care loan.
* When your account balance is negative, 20% of your income is deducted from your income until your account balance is positive again.
* The money in this account is your money. When you die, any positive balance is passed on in your estate. If you have a negative balance, your assets (if any) must first pay off any negative balance in your health care account.
* If you have insufficient assets to pay off your negative balance at death, then the balance is "written off." (see additional points)
* This program replaces all government health care programs, including Medicare and Medicaid. The taxes for these programs would be eliminated.
* Most employers would probably stop offering health insurance as a job benefit. This would free every private employer of this burden and the cost it levies on them. This makes U.S. businesses more competitive.
* The payment for health care services would be immediate and swift using a debit-like card--like using a credit card at Wal-Mart. However, providers would be required to retain records about the transaction for a period of time to allow audits for fraud.
* All of the people who are presently employed in medical offices and hospitals to fight insurance companies could be repurposed into actually providing health care services. An enormous gain in productivity.
* People would largely be spending their own money, and thus, they will be more careful about how it is spent. (With today's third party payment of medical expenses, there is little reason for a person to try to spend less.)
* Doctors might get tired of answering the question "How much does this cost?" but the question will be coming from their patient, right in front of them, rather than some nameless guy at an insurance company.
* Cost shifting already happens when non-insured/indigent go to a hospital for treatment. This plan simply makes it very transparent. These people will carry a negative balance funded by all of us. The hospitals would not have to cost shift, and so their prices should become more reasonable immediately.
* The health savings account would be for legitimate health care spending only. Fraud would be very strictly punished--both on the side of the provider and consumer.
* Health care products and services typically covered by an employer-sponsored plan would be eligible.
* Dependents would be paid for out of their guardian's accounts.
* 15% would be a minimum. You could deduct more if you want.
* The 15/20% is taken from your paycheck pre-tax.
* There would be a maximum account balance per dependent. For example, the maximum account balance might be $200,000 plus $50,000 per dependent. (When this limit is reached, no salary deduction would be required.)
* Funds would be deposited in FDIC/NCUA insured bank accounts. You would get to pick the institution. I would likely pick a local credit union.
* I think we should probably include in this plan a sales tax on medical care and services to pay for indigent care (those who die with negative balance). This tax should cover whatever our generation is predicted to cost in indigent care. It might be 3-5%??
* Private health insurance would be largely eliminated. However, insurance companies might provide "negative balance" insurance. That is, when you die with a negative balance, the insurance would payoff your balance. This would avoid an asset sale when a spouse dies first, for example.