Another Method to Achieve Universal Health Insurance

[dtotire]

I have written an essay for another method of Universal Health Insurance, that would be more achievable than a single-payer plan. I am non-comittal on the final form.
This is it:


Conservatives generally oppose single-payer health insurance, but some would support the same health insurance plan that is provided for Congress and Federal employees. Under this plan, you can choose from an number of fee-for-service plans or HMOs. Employees pay a certain amount, and the Government picks up the rest. Under the Blue Cross standard family plan, the employee pays $314.47 monthly, and the Government pays $713.48 For the California HealthNet HMO, the employee pays $221.45 for the family plan, and the Government pays $664.35. Single payers pay considerably less. Rates for the plans and brochures can be found on the internet.

These plans all differ in their co-payments and deductables. The providers cannot turn down anyone who enrolls, which is a plus. I believe that the insurance companies would not object to this type of universal Health Insurance, and it could be passed easily.

If we adopt this method, everyone would be required to enroll in a plan, and families and individuals below a certain income would not have to pay anything. (Perhaps the states could help out.) The insurance providers would have to be more strictly regulated by the Government, and profits should be limited. (In Germany, the providers are non-profit.)

To fund this method,or any other method, we should adopt a dedicated consumption tax. such as a value-added tax. The advantage of a consumption tax is that it would be rebated on all exports, which would make American businesses more competitive, and create jobs.

A single-payer plan might be more efficient and cost less to administer, but if there is difficulty in passing the required legislations, the Federal plan could be adopted. Insurance companies would still be in business. However, the Doctors who provide service would still have to deal with multiple insurance companies, which is a burden to them.

This is the web site that give the rates:

http://www.opm.gov/insure/health/08rates/2008non_postal_ffs.pdf

[snappyturtle]

1. My mother has SAMBA insurance.....it has been totally great. They had

it while I was growing up and medical care was never a problem. I would love to pay the rates they did. My last insurance (I have none now) was with BCBS and it got to be too much after eight years (ater a divorce) for me to pay especially since I had no claims, good health and a $10,000 DEDUCTIBLE. I shopped around and that was the best at the time. I have since re-married and soon we hope to be in a position to get health insurance again. It's very scary not to have it. I just see no reason, except for the cost of war(!), that the U.S. doesn't have decent health insurance & higher education for everyone. Other countries do it....WHY aren't we?

[Lydia Leftcoast]

2. A value-added tax does NOT mean that the poor "wouldn't have to pay anything"

In fact, it would be regressive, taking up a greater percentage of their income than of a wealthy person's income.

Also, rescinding the VAT on exports would be a form of corporate welfare.

It sounds like a DLC idea for universal health insurance, not universal health care.

[dtotire]

6. VAT

Every country that has a VAT rebates it on their exports, and adds it to everything they import. China, for instance, has a 17% VAT, which their consumers have to pay, but it is rebated on goods they export. If we export something to them, they add 17% to the cost. If we want to compete with them, we have to do the same, otherwise we lose jobs--we have already lost many because of this. We will be able to provide more employment by paying all social programs with a VAT.

[Lydia Leftcoast]

8. It's still regressive

It immediately raises all prices for poor people.

And as far as competing with China goes, we could also lower our minimum wage to $1 a day and compete with China. There's more to life than easing the way for big business, which has gotten virtually ALL the benefits of government policies in the past 30 years.

[dtotire]

12. Food would not be subject to a VAT

That would be the bulk of purchases by the needy. Also, used goods, such as a used car, or clothing or TV's, would not be subject to a VAT. Very little of their purchases would have a VAT. The VAT is used in nearly every country on the planet. In the European Union, the MINIMUM for all countries is 15%, some countries have as high as 25%. I believe their use should be limited for specific social programs. I would oppose their use to pay for defense, or interest on the national debt, and some other programs. These should be paid only by the very wealthy.

[eridani]

3. Insurance companies will oppoae ANY attempt to limit their cherrypicking

It's just as much a no-go as single payer, so why not go with the sheep istead of the lamb? You are caving ing to Rethugs and insurers in advance. What's the point? If you want a kitten, ask for a pony. If you want to sell your used car for $3000, ask for $5000. Never give anything away at the beginning of a negotiation.

[dtotire]

5. cherrypicking

In the current Federal plan, insurance companies MUST accept anyone who enrolls in their plan, regardless of preconditions. That is the way it will be if the Federal plan is extended to everyone.

[eridani]

14. And that is exactly why the insurance companies will refuse to go along with it

They will refuse any reasonable compromine--count on it.

[supernova]

4. It's still insurance which is not acceptable

I want the insurance companies to go the way of the steel industry. They need to be whittled down to a much smaller part of the financial pie that they currently are.

They are taking insurance premiums from patients and not paying out claims. They take malpractice premiums from MDs and tell them it's because of high malpractice costs. Bullshit. They want to recoup bad investment/management losses. In this way they have interfered wrongly and obtrusively in the doctor/patient relationship, turning it into an adversarial one when that is most certainly undesirable.

I like what they do in the UK. Insurance companies are reduced to selling policies to upgrade (but not replace nor interfere with) what their NHS provides.

We really do need to get away from the for-profit insurance model in healthcare altogether.

And my real issue with your proposal is if that is enacted just as you say, we will stop there because too many people will be "sorta" satisfied that we "did something about healthcare." And too many decisionmakers will be pleased that insurance companies will still be able to keep the big buck rolling in, unabated. Afterall, when we are "required to" buy health insurance, what's to stop the insurance companies from becoming even more of a monopoly than they are now? What's to stop them from jacking up premiums even further? What's to stop them from not paying claims because, willy-nilly the treatment "isn't 'usual and customary.' "

[dtotire]

7. The Insurance Companies will be strictly regulated

as they are in the current Federal system. Their profits can be limited, or they can be made non-profit, as they are in Germany. They will still have to compete with each other for their business.

I suggest you review the FRONTLINE program from some months ago, which shows how health care is provided in five other countries: Britain, Germany, Japan, Switzerland, and Taiwan. I believe the French system is similar to Germany.

This program from PBS shows how health care is provided in five other countries:

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/

You should also review the interviews with the experts on the different systems.

[Lydia Leftcoast]

9. Insurance companies that operate in Minnesota are required to be non-profit, BUT

that doesn't stop them from cherrypicking, raising rates arbitrarily above the rate of inflation, and forcing customers to choose between either unaffordable monthly premiums or deductibles that are high enough that most people never reach them, and they still look for any excuse they can to deny coverage. They do this while giving their executives 7-figure salaries. They're technically non-profit,but they seem to spend their extras on executive compensation rather than improving services to customers.

They're slime. They need to be put out of business or completely restructured.

[supernova]

10. You are relying on the insurance cos

to accept limitations on their powers and money-making capacity with good grace. You are either very naive or you work in the medical insurance industry.

No such capitulation will happen, I can assure you. That's why they need to be put out of our misery. They may, MAY come back many years from now, in very limited form, edit: but for right now, they and their crony enablers do need to be removed from the public discussion about how to overhaul the healthcare system.

[dtotire]

11. Read how it's done in other countries

This program from PBS shows how health care is provided in five other countries:

http://www.pbs.org/wgbh/pages/frontline/sickaroundthewo... /

You should also review the interviews with the experts on the different systems.

This is from the interview with the expert on the German system:


The German health care system is unique in its attempt to combine competition among sickness funds on the one hand and a universal coverage plan on the other hand. Most health care systems are either one or the other, so you either have private insurance and competition but not everyone is covered for everything, or you have a single-payer system. So the ideal types are like the American system on the one hand or the Scandinavian or U.K. systems on the other end.
Germany tries to combine the advantages. Everyone is covered; all sickness funds have to provide a comprehensive benefit package; ... and there is nevertheless competition for price and quality between the sickness funds. ...

Are there then rankings ... by size or number of members and stuff like that?

Yes, there is ranking for contribution rate, so the cheaper sickness funds good quality can both advertise their better quality plus their lower contribution rates and therefore gaining members. We had about 240 sickness funds a couple of months ago; we are now down to 213, I think. In two or three years, only 50 or so will survive.



Adopting the Federal system (with some modifications) would make our health care system similar to Germany.
The German system has been adopted in many other countries in Western Europe.

That link didn't work. Try this one:


http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/

[supernova]

13. I've already seen the FRONTLINE

program and yes it was a very well done program.

AND, what I'm telling you is that none of that will happen here WITHOUT A FIGHT. If you think just watching a FRONTLINE episode will cause the Insurance companies to crumble into ethical submission, well I've got a swamp in Arizona to sell you.

Again, I don't want an insurance scheme, I want Universal health CARE, with no insurance premiums and no paperwork. Anything less than that will be unsatisfactory.

edit: Do you have any substance to add to this thread besides pacifying yourself with a documentary?

[nightrain]

15. nice try... good that people are looking at options because

what we've got now is a total mess.

That said.... My experience tells me that insurance companies are a major part of the problem, and I don't consider that their participation in a national health service or payment plan is needed or desirable.

If we can find (borrow) the money for these travesties in Iraq and Afghanistan, and elsewhere, then surely providing real healthcare for the nation would not be impossible either.

The costs to individuals and families MUST be reasonable and entirely affordable, not in the several hundreds extra a month. Regular people cannot afford that!

Keep working on solutions that don't involve insurers and all the ancillary profiteers.