Richard Rainey

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  Richard commented on the article | almost 3 years ago

  Uwe Reinhardt's Un-level Playing Field

  Here's how you achieve universal, affordable and portable healthcare in the USA and satisfy both democrats and republicans, capitalist and socialist. without raising taxes or spending 650 billion dollars more over the next 10 years.
  
  You would fund the system by using several different sources The first source of funding would come from federal and state Medicaid funds, these funds would form the common underlying  financial basis for this new system. Each person in the system would get an equal credit in their HSA account from those funds.. The next source for the system would be all the private insurance premiums paid by employers(and self-employers) these premiums would be credited to the HSA account of that company's employee. The third source would come from an hourly wage fee (25 cents per). A fourth source would come from a small monthly fee for life insurance and catastrophic illnesses($20). A fifth source would come from the consumer himself, repaying the system over a long repayment schedule for billings that exceed hisHSA credits.
            These five sources would finance a "single-payer pool" system which would pay medical bills up-front(not to be confused with a single-payer system where government pays all, since they're not). In this system everybody covered by the system (18 to 64 with their children under 18, universal, medicare will continue to cover those over 65) would start with equal credits from their share of the Medicaid funds used (about $1,350 worth), hourly-wage works (18 to 64) would add another $500 dollars in credits totheir HSA account($1,850 total). Others who are covered through private premiums would have that premium amount credited to their account on top of the Medicaid basis of $1,350 dollars in credits.
          These credits would be allowed to accrue year to year allowing the healthy to build their accounts as others use what's in the pool that year. The young and healthy would be able to build-up their HSA accounts early in life while the older members of the system would be repaying the "pool" via life insurance and the repayment schedule.
          By using the Medicaid funds in this manner each dollar of those funds will be used more efficiently and with much better overall effectiveness than has been done in the past. By putting all the private premiums in the "pool" those that don't use their credits won't lose them like they do now. What good was that premium for the payer when the covered person didn't use the funds. By using the funds thisway this strategy finacially helps both the healthy and unhealthy at the same time.
           This strategy will actually make the healthcare system a true free-market economy with the consumer directly in charge of every dollar that is spent in the system. The consumer, now that he is paying directly(albeit over time), can pick his own doctors and hospitals. The doctors and hospitals can list their prices out on the competitive market
  By using this strategy we could expand coverage for optical, dental and other comprehensive medical needs.
           This strategy allows for a lot of new paradigms in healthcare to be explored.