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Minus Tier 3, this is almost exactly the system that Germany has. Having lived here for over 4 years and seen myself and my family members go through the medical system many times over, I can say it works absolutely phenomenally. You can also get insurance boosters. Like if you want a little more coush, you can buy a cheap add on insurance to supplement the UHC.I originally posted this nearly 30 months ago and updated it last year. I've mentioned it to a few posters recently, who liked it... and I got a bit of support across the political spectrum when I originally posted it. So, here is my plan:
Heath care would be broken up into a three-tiered program:
1) Tier 1: Government subsidized health care. Plans paid for and monitored by the government. These plans would be universal and would be paid for via taxes of folks who "opted in" to this plan. It would be "one size fits all" with no variation on the plan itself. Any treatment deemed medically necessary by the treating physician would be covered. No elective, non-necessary or experimental procedures would be, however.
2) Tier 2: Private insurance, Similar to what we have now with some notable exceptions. No utilization review, Insurance companies no longer have the right to deny coverage for any reason, as long as the benefit is available. Only the treating medical professional can decide whether a treatment is appropriate or not. Strict government regulations aimed at streamlining the paperwork aspect, including mandatory centralization both of billing locations and of billing and other forms. Failure to comply with these regulations, suspend the company's ability to do business.
Folks who go this route, automatically "opt out" of the government plan and are not due to pay the taxes that subsidize that plan.
Borrowing from HarryGuerilla, plans are developed on an "ala carte" basis. You want coverage for catastrophic illness only? No problem. How about physicals and x-rays, only? Easy peasy. What about the works, except for obstetrics? Good to go. This kind of choice will allow for folks to get precisely the kind of coverage they want, rather than getting coverage for things they do not.
3) Tier 3: Private Pay. Complete out of pocket, pay for service plan. No insurance whatsoever. "Opt out" of government plan and related government taxes in total effect.
Additional parts to this.
1) Under no circumstances are illegal aliens covered under any health plan, government or private.
2) If you opt out of the government plan, and you do not have catastrophic coverage under your private plan, under no circumstances will the government subsidize your care. If a doctor chooses to see you, unsure of your ability to pay for the service, even with a catastrophic illness, even if it is a child, it is then on the doctor to collect fees. The government will NOT subsidize in any way, nor is any doctor or hospital required to provide any charity care. You make a choice, you need to live with it.
3) Bankruptcies will NOT eliminate medical costs. They must be paid in full, no matter what.
4) TORT reform with reasonable caps on any suing for malpractice.
5) The ability to sue an insurance company for not paying for services that are in a patient's benefit package. Yes, this happens more often than you think, currently.
6) I love the "apprentice" program that has been suggested in this thread, and am incorporating it in my plan. As one who has trained and supervised many professionals, I would like to see this expanded. Getting appropriate experience is one of the major challenges to entering this field.
7) Denial for pre-existing conditions is eliminated in both the government and the private insurance plans.
8) Preventative care is covered fully by both the government and private insurance plans. No co-pays whatsoever. Tax breaks could be given to insurance companies and doctors who encourage preventative care, and to citizens who engage in this.
9) Reduction of the time period that pharmaceutical companies hold patents on medications, preventing generics from being produced. My thought would be no more than 5 years.
One thing of note. #6... the apprentice plan was actually suggested by LaMidRighter... and now again in the Welfare thread by reefedjib. It was a good idea then, and still a good idea, now. As you can also see, my "plans" tend to be tiered, with different levels of control and freedom, attempting to cater to all sides of the political spectrum, socio-economic levels, but with allowing for the least amount of manipulation.
So, go to it. Thoughts? Feedback? Suggestions? Additions?
So, go to it. Thoughts? Feedback? Suggestions? Additions?
2) Tier 2: Private insurance, Similar to what we have now with some notable exceptions. No utilization review, Insurance companies no longer have the right to deny coverage for any reason, as long as the benefit is available. Only the treating medical professional can decide whether a treatment is appropriate or not. Strict government regulations aimed at streamlining the paperwork aspect, including mandatory centralization both of billing locations and of billing and other forms. Failure to comply with these regulations, suspend the company's ability to do business.
Folks who go this route, automatically "opt out" of the government plan and are not due to pay the taxes that subsidize that plan.
3) Tier 3: Private Pay. Complete out of pocket, pay for service plan. No insurance whatsoever. "Opt out" of government plan and related government taxes in total effect.
5) The ability to sue an insurance company for not paying for services that are in a patient's benefit package. Yes, this happens more often than you think, currently.
7) Denial for pre-existing conditions is eliminated in both the government and the private insurance plans.
So, go to it. Thoughts? Feedback? Suggestions? Additions?
I want to see a law, mandating that prices or approximated prices, by the attending physicians and facilities be posted for all patients and for as many procedures, medicines, etc, as possible.
That would be good, but physicians aren't "charging what they want". There is usually a contract agreed upon between physicians and companies, or in the case of government, a set rate for services. It should be posted, I agree. Usually charges are discussed with patients who are out of pocket payers.
I originally posted this nearly 30 months ago and updated it last year. I've mentioned it to a few posters recently, who liked it... and I got a bit of support across the political spectrum when I originally posted it. So, here is my plan:
Heath care would be broken up into a three-tiered program:
1) Tier 1: Government subsidized health care. Plans paid for and monitored by the government. These plans would be universal and would be paid for via taxes of folks who "opted in" to this plan. It would be "one size fits all" with no variation on the plan itself. Any treatment deemed medically necessary by the treating physician would be covered. No elective, non-necessary or experimental procedures would be, however.
2) Tier 2: Private insurance, Similar to what we have now with some notable exceptions. No utilization review, Insurance companies no longer have the right to deny coverage for any reason, as long as the benefit is available. Only the treating medical professional can decide whether a treatment is appropriate or not. Strict government regulations aimed at streamlining the paperwork aspect, including mandatory centralization both of billing locations and of billing and other forms. Failure to comply with these regulations, suspend the company's ability to do business.
Folks who go this route, automatically "opt out" of the government plan and are not due to pay the taxes that subsidize that plan.
Borrowing from HarryGuerilla, plans are developed on an "ala carte" basis. You want coverage for catastrophic illness only? No problem. How about physicals and x-rays, only? Easy peasy. What about the works, except for obstetrics? Good to go. This kind of choice will allow for folks to get precisely the kind of coverage they want, rather than getting coverage for things they do not.
3) Tier 3: Private Pay. Complete out of pocket, pay for service plan. No insurance whatsoever. "Opt out" of government plan and related government taxes in total effect.
Additional parts to this.
1) Under no circumstances are illegal aliens covered under any health plan, government or private.
2) If you opt out of the government plan, and you do not have catastrophic coverage under your private plan, under no circumstances will the government subsidize your care. If a doctor chooses to see you, unsure of your ability to pay for the service, even with a catastrophic illness, even if it is a child, it is then on the doctor to collect fees. The government will NOT subsidize in any way, nor is any doctor or hospital required to provide any charity care. You make a choice, you need to live with it.
3) Bankruptcies will NOT eliminate medical costs. They must be paid in full, no matter what.
4) TORT reform with reasonable caps on any suing for malpractice.
5) The ability to sue an insurance company for not paying for services that are in a patient's benefit package. Yes, this happens more often than you think, currently.
6) I love the "apprentice" program that has been suggested in this thread, and am incorporating it in my plan. As one who has trained and supervised many professionals, I would like to see this expanded. Getting appropriate experience is one of the major challenges to entering this field.
7) Denial for pre-existing conditions is eliminated in both the government and the private insurance plans.
8) Preventative care is covered fully by both the government and private insurance plans. No co-pays whatsoever. Tax breaks could be given to insurance companies and doctors who encourage preventative care, and to citizens who engage in this.
9) Reduction of the time period that pharmaceutical companies hold patents on medications, preventing generics from being produced. My thought would be no more than 5 years.
One thing of note. #6... the apprentice plan was actually suggested by LaMidRighter... and now again in the Welfare thread by reefedjib. It was a good idea then, and still a good idea, now. As you can also see, my "plans" tend to be tiered, with different levels of control and freedom, attempting to cater to all sides of the political spectrum, socio-economic levels, but with allowing for the least amount of manipulation.
So, go to it. Thoughts? Feedback? Suggestions? Additions?
Math is not your friend here. You used an "arbitrary number" and a flat tax rate of about the same as Medicare (which is WAY underfunded) yet is only available to those at age 65 (or disabled). Considering that the average Medicaid patient now costs we the sheeple about $7,000 per year (that program now covers about 20% of the US population).
Medicare Tax and the Unearned Income Medicare Contribution Tax
https://www.cms.gov/Research-Statis...arialStudies/downloads/MedicaidReport2011.pdf
CC, my main concern with your plan would be opting out of the Medicare taxes. Such a system would probably be unsustainable and would create a problem of socializing the losses of the insurance companies. I think the solution might involve an Obamacare mandate with a variable tax rate based on insurance status for higher income earners. i.e a 2% base rate and a 1.8% for people earning over $65,000 who don't have private insurance (figures mine and not in any way actuarial based.) This would help to keep the insurance companies happy.The Good Captain Said Stuff....
Using current Medicaid data as a forecast for an at large plan isn't a good idea. That high number is skewed because Medicaid is also responsible for the long term care of elderly patients who are more expensive. As well poor subsets that are Medicaid other clients are more likely to have poor health and thus cost more, skewing that figure again. To blanket cover a population would have a lower figure. I don't have the numbers for an actual figure.
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