What is wrong with simplicity?
The educated person may tell you how to run the world. The common person may tell you how the world works. In this statement there is arrogance on both sides. The educated thinking that they know the best way to accomplish the goals of running a nation. And the arrogance of the common person that lives under the rules set by the educated. However, ignores them for convenience and stubbornness. “I will continue to do what has worked for me”. I am sure you have seen this process at work. When a supervisor or outside contractor comes in and change a process at work. And the targets of the change set about to work against the system proposed. And most of the time, the common person does know what the hell they are doing.
This process was repeated on a National level as the Democratic party rolled out a comprehensive health care initiative. With even the leading proponents admitting they didn’t know what was in it. This lead to the common person thinking on this in terms of common sense. How can a plan that takes into account thousands of variables be made into a one size fits all model? The simple answer is it cannot. Common sense also leads us to believe that you cannot control cost without connecting the consumer to the price of the product.
Health insurance has become a health maintenance plan in recent years. That has lead to the escalation of prices as the average consumer disconnected the plans overall price with services provided. If it was covered under your plan, you did not ask how much this test cost, or if it is necessary. Same with prescriptions. The only thing the consumer asked was how much is my copay. We forget that health care also has a sales component attached to it. This may shock some of you but, people like to make money, even doctors and hospitals. Not all test are necessary, and there could be cheaper alternatives in prescriptions. How was a comprehensive National Health Care going to solve this? It can’t without exercising the collective will of the government. That means everyone won't get what they want.
The simple solution I would have proposed is this. all citizen would be required to have a plan, and all American citizens would have the opportunity to buy a simple Health insurance plan, provided by government. You could opt out of this plan if you so choose. However, all citizen would have to be covered by a plan. This plan would be a simple Health insurance where the first $1000 is out of pocket unless qualified for medicaid or medicare. From there it would be 50/50 coverage until you have reached $10,000.00 then like all catastrophic plans it would cover the rest. Your deductibles would reset every year, just like a normal plan. However, this would be a baseline government plan, that you could buy regardless of pre-existing conditions. The only caveat to this is, if you did not have a plan before use of this insurance, you would be fined based on rate and time for the lapse in coverage. So, if you went three years prior to event, you would be fined and charged for them three years of non coverage. This may not be enforceable in a lot of cases where the person has no assets. However, it would encourage everyone to buy and maintain a plan while it is reasonable.
Then a plans could be set up more like insurance of our parents and grandparents. That is a plan based on desired coverage, with HSA(health saving accounts) set up early in life. These HSA could use pre tax funds, and set up at time of birth if desired. The marketplace will probably develop around the concept similar to Whole life. In which, a portion of payment would automatically be placed in your HSA. Of course, the larger your HSA the larger your deductible and the cheaper your plan could become. To encourage competition, you can transfer at any time specified contractually into any similar plan with the same or higher deductibles without pre screening or pre-existing coverage limitations. However, if you choose to go down in deductibles or increase coverage then you can be pre screened for pre-existing coverages. Moreover, your coverage can not be taken away for any reason except, a reasonable time frame for non-payment. The HSA would have no ceiling, and monies left can be passed on after death. Theoretically, a long term contributor to a HSA could be self insured and provide for their own long term care. This would also mean the long term reduced need for Medicare. This could be created for the individual by creating a cradle to grave policy plan at an early age. Also, employer coverage will go away. This creates a more stable insurance that does not precipitate the need to remain working for the same employer all your life. The HSA could also be used to maintain your insurance in times of financial duress.
Granted, this not an automatic fix. It would take a few years until the any real savings were seen from this system. However, it would be a quicker return then the single payer system we are looking at now.
It will take some educated people to work out the details, which comes to the wisdom part of the statement mention in the beginning of this article. The plan does not have to be complex and confusing to the common man. All complicating the issue does is create distrust and confusion.
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