I have an idea that might work to help with the health care crisis. I came up with this while in the shower and am still working out the details. This is more of an idea for discussion.
The idea is: What if the government functioned as a health insurance company? Here is how this would work: The government would offer health insurance that was a percentage of a person's income. If, for example, a person earned $250 and their health insurance was 5% of their income, they would pay $12.50, taken directly out of their check, to the government for health insurance. The government could not deny anyone health coverage. The only elegibilty requirements are being able to work legally in the United States.
The percentage of income would vary based on the person's situation. For example, for my mom to get coverage for herself and I, she would pay a higher percentage of her weekly check than she would just to get coverage for herself. The percentages would also be variable on certain high-risk behavior choices, such as smoking. They would not, however, be variable based on pre-existing conditions. Students could also get lower rates while they are in school. The percentages would also be variable based on the coverage a person selects. A very healthy person might decide to take a plan with a higher deductible and a lower percentage. This allows people to choose the plan that suits them, instead of a one size fits all plan.
This program would also eliminate the need for Medicaid programs, which provide medical care for those who have no insurance and cannot afford it. Instead, these people would enroll in the government sponsored program (remember, the government cannot deny you). This would mean that they bring money into the system (through paying a percentage of their income) and allow it to flourish.
In addition to the government sponsored programs, the regular insurance companies would be allowed to function as normal. This means that people who are already satisfied with their insurance, or who make a lot of money (so the percentage thing would make government insurance more expensive) would be allowed to keep their plans. This keeps competition in the market and eliminates a government monopoly of health care.
I believe this program is a good compromise for several reasons:
1) It ensures that every American is eligible for health insurance. With this plan, yes your taxes will increase. But they would with universal health care too.
2) It allows Americans who do not want universal health care to choose a private insurance company and keeps competition in the market.
3) By using an income proportional system, it makes health care affordable for the poor. Many poor people do not make the same amount of money every week and this would allow them to pay less when they make less and not have to worry about losing their health coverage.
4) The plan would allow people to chose their plan (and percentage), leaving them with choices.
5) The plan does not force one person to pay for the coverage of another or the decisions of another.
And now, a rebuttal to the most obvious criticisms that will probably come up:
Doesn't this screw over the poor people too? What if they can't afford to pay a part of their check for health care and go without?
With any form of government-sponsored health care, there is no way around an increase in taxes. None. Nada. You have to pay for health care anyway, whether through a private insurer, this program or the cross your fingers and hope for the best program. Either way you are going to have to pay. I feel that health care is like food: a necessity, but something you have to pay for.
Wow, this seems like a money-losing program?
It is. I can guarantee that this is a money-losing program. I'm not trying to hide or deny that. It falls under the category of welfare. Welfare programs cost money, but exist to help society. This program eliminates the need for programs such as Medicaid, which could help save the government money.
This still means that the rich get better coverage!
What else is new? The rich will always get better coverage, even if we have universal health care. If we have universal health care, they will bribe people to get to the front of the line or simply choose to pay for better care from somebody else. We can't make everyone equal. But this will make us closer.
Won't this raise everybody else's taxes too?
It might. But by eliminating programs like Medicaid and replacing them with this, the program will lose money, but it should lose about the same amount of money as the current system. So taxes may rise, or may not rise.
Doesn't this take choice away from the poor people?
Not really. Right now, the poor people's choices are go without health care, go to a free clinic or enroll in government programs such as Medicaid. This will allow people to choose a plan (sponsored by the government), thus allowing more choice. And it doesn't force anyone to get rid of private insurance either!
In conclusion, that's my idea. It's a spark. It's just an idea, and I want it picked apart and discussed, trashed and torn. I want it to inspire people to think. I'm not saying that it's perfect. It's just something I came up with in the shower and I want your opinion. So pick it apart and criticize it. Ask questions.
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4 comments:
Wow, Vicky, that's a pretty good plan for just thinking it up in one evening!
Two things I can see - what I mentioned before, that it will decrease real wages (what people bring home -- disposable income), but also...what if someone is not working?
And...(as always with me)...where will the rest of the money to cover it come from?
I think a huge problem right now is the way that insurance companies have people by the...neck. And bills are obnoxiously high - I'll try to find the email my mom sent a few days ago on ER visits (she works as a medical coder in a hospital - the coding is what tells insurance companies what happened). It was something about how that single Tylenol you get from a nurse can raise the price you pay on the bill by hundreds of dollars.
I'm interested to see what others think. :) And you've really thought through some of the questions people would have, too. Very well thought out.
Thanks!
As for your questions:
The real wages of people will decrease with this plan, yes. But real wages would decrease with universal health care too, so it's a wash. And the program is voluntary; you can choose to go without coverage.
I liken health care to food. You have to have food to live, but you have to pay for it as well. Just like shelter and clean water. There really is no such thing as a free lunch. No matter how you look at it, you have to pay for health care! (and, really, you should.)
As for "where will we get the money?" a lot of it will come from the revenue generated by taking percentages of people's checks. This is being run like a business; basically a business that the government subsidizes (but is still part of the government). The rest of this will come from the welfare budget and will replace Medicare/Medicaid. It may result in an increase in taxes, but I'm not sure. This program brings in revenue, unlike other welfare programs. But if this is something that people want, then they might not mind the tax increases.
As for people not working, this is a really good question. This money can be taken out of any form of income (ie. transfer payments). You can also choose to purchase a plan that allows you to keep coverage when unemployed for a certain amount of time. Or the government could offer pay-for-coverage plans where you pay for it as necessary (for example, if a woman were to take time off to raise a kid) The plans could also cover unemployment due to disability.
I think we could also enact legislation to prevent some of the gross fleecing in medical treatment. For example, with the Tylenol, patients could bring in their own OTC drugs (in the original packaging, never been opened) and use them. This makes life at the hospital easier (and cheaper) for everyone involved. There are ways to cut costs, and that makes almost everyone happy except hospitals. Patients and insurance companies (well, really patients, because insurance companies pass the exorbitant costs on to them) don't want to pay hundreds of dollars for a little Tylenol.
I like your idea vicky and I think you have it right that with anything the rich will always find a way to use money to get better coverage, choises or service and there is no way around this. (which is not necessarily a bad thing) Anyway, this idea seems like a good combination of the two sides. While I'm still not sure if I'm really up for having some of my taxes go to others health care that they could do without a very limited amount of coverage could be good.
I actually like this plan. True it would be a money losing program but unlike other government programs their's no cap to say that "you make too much for this" or that "you're too much of a liability". The proportional "taxing" idea is a great one. And giving people the option to decide how much coverage they need is a real plus. It allows consumers to make their own choice about what they need to feel secure.
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