Simple Rules for Health Care Reform

1. Prohibit Health Insurance Providers from engaging in anti-competitive practices.

2.. Prohibit Health Insurance Providers from denying health care insurance to individuals with pre-existing conditions.

3. Prohibit Health Insurance Providers from placing caps on annual and lifetime benefits.

4. Establish a mandatory Medical Loss Ratio of no less than 85%.

5. Establish a National Health Insurance Regulatory Commission with the responsibility of ensuring providers adhere by above tenants. This commission shall also field consumer complaints/tips about violations of these provisions. This commission shall also investigate waste, fraud, and abuse in public health plans (Medicare, Medicaid, CHIP, VA, etc).

6. Establish a National Health Insurance Clearinghouse with the following responsibilities:

-Identifying various levels of health insurance benefit packages, and establishing maximum premiums/deductibles/co-pays  for each level, while taking regional factors into consideration. This commission shall certify plans that meet these standards. While insurers do not have to adhere by these standards, individuals may not use governmental subsidies to purchase non-certified policies.

-Collecting and providing electronically to the public, information about all health insurance plans that have been certified.

7. Allow Medicare to freely negotiate with all domestic insurance providers, pharmaceutical businesses, and medical equipment/supply businesses. Increase Medicaid and Medicare reimbursement rates to no less than 60% of average private insurance payments for identical billable procedures.

8.  Incentivize individuals studying to be, and serving as Primary Care Physicians or other non-specialty medical providers through a loan forgiveness option tied to service in clinics/hospitals in undeserved areas.

9. Cap medical malpractice lawsuits to $X million in the most egregious life-threatening instances. This shall represent the uppermost class of suits, a schedule  of other classes of suits shall be established with corresponding maximum liability levels. (Levels/ Amounts TBD by the National Health Insurance Regulatory Commission).

10. Mandate that all children under the age of 18 have health insurance coverage. Increase eligibility for the Children’s Health Insurance Program (CHIP) to 350% of the Federal Poverty Level (FPL). The penalty for non-compliance shall be 100% of the cost of the least expensive eligible health care plan in the individual’s market area. Such taxes shall be directed to a National Health Trust Fund.

11. Incentivize the purchase of health insurance plans by establishing a refundable health care tax credit of $1,000 per individual, $2,000 for couples. Individuals must have maintained eligible coverage for at least 9 months out of the year to be eligible for the credit.

12. Prohibit employers from dropping, without reasonable cause, health insurance benefits for their employees. The penalty for such unjustified actions shall be 100% of the cost savings achieved by the business by dropping the insurance. Such taxes shall be directed to a National Health Trust Fund.

13. Incentivize employer health care insurance benefit plans, by establishing a business health care tax credit of up to $1,000 per employee.

14. Tax employers with at least 50 employers who do not provide health care insurance to their employees 10% of payroll. Such taxes shall be directed to a National Health Trust Fund.

15. Tax individuals making more than $250,000 5% of gross income, and households making over $500,000, 5% of gross income.  All other individuals above 350% of the FPL will pay a 1% tax on gross income. Such taxes shall be directed to a National Health Trust Fund.

16. All tax collections in the National Health trust Fund shall be used to provide a) Subsidies to households making between 350 & 500% of the FPL to purchase certified health care plans & b) payments to providers for uncompensated care provided to uninsured individuals.

-kd-

Other types of reform are necessary as well, including some sort of regulation on Pharmaceutical companies. This list is just a basic beginning for reform, accepting that single-payer health-care’s time has not yet arrived. In addition, % and #’s I provided above where just numbers I threw out there, of course it would require a more thoughtful and deliberative process to hash out such details.

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12 Responses

  1. I like number 10 and 12 but I don’t see it happening anytime soon especially in the middle of a never-ending crisis. Or is it something in the air in the U.S. ? (I’m not American)

    This being said, I find your blog surprisingly entertaining given its theme! Deft pen and thought-provoking style.

    Let me bookmark the “Healthcare Reform for Idiots”; loving the that catchy picture!

  2. hey- thanks for the feedback & compliment 🙂

    What country are you from?

  3. Canada! The healthcare system here is far better than yours but we are still trying to redefine our identity because the American influence is so huge! One can hardly tell the difference between Canadian and U.S. shows.

  4. your health care system isnt better than ours! it is evil and socialistic and people by the millions die everyday for want of medical care. also, at least 50% of your population tries to illegally enter our country every year for access to our dirt cheap and plentiful medical care.

    😛 thats what they tell people here, and sadly, many believe it

    don’t worry about your identity, people in the u.s. would never confuse you for us or vice versa 😀

    plus, you are “winning” the gold count in the olympics lol

  5. Now that’s funny! When people challenge Canada’s healthcare system, they are told to compare with the States and they stop whining. Same thing with the economy. I think Canada found its “ugly friend”!

    And I personally don’t see any difference between English Canadian and U.S. shows. Maybe because I’m french and I think that in general English people like to show off (no offense)! But the Canadian identity is a serious issue and public channels have even launched a massive campaign called Local TV Matters, PARTLY because US shows are dominating the airplay and it’s killing the Canadian broadcast industry. They can’t afford to produce TV shows when everybody else is hung up on Uncle Sam’s soap operas.

    Mind you to me Canada and U.S. are two brothers with a love-hate relationship! And who cares how well Canada did in the olympics, you won the hockey game on our own soil. SHAME…

  6. It seems like a simple issue doesn’t it? Let’s change HC so that everyone is treated fairly and everyone is covered. There’s plenty of forces against it, let’s hope that Obama can at least get some solid foundations created so that they can be improved on later.

  7. Fighting for equality in healthcare is a ridiculous notion. Your proposed “fixes” would create a gross economic inequality replacing one “injustice” for another.

    For example, Caterpillar recently came out and said that the health reform that was passed will cost the company $100,000,000 in the first year alone. How will they make up for that loss of revenue? Cutting jobs, which then puts more people on unemployment requiring bigger and bigger chunks to be paid by the rich. The rich then have less money, creating less jobs, creating even more need for income to cover health costs…it is a perpetual cycle.

    The fact is that everyone does not deserve health care. They either earn it or they don’t. The federal government has no right to force it upon anybody or any business. People assume that it is ok to screw others as long as the others are rich, but that thought process makes you no better than a common racist. Worse even, since you are discriminating against people for their accomplishments and hard work. I would say that to most, their pride in their accomplishments in life means more to them in life than the color of their skin.

  8. Chris, your comments make me sad. So many people, presumably yourself included, fight to defend the status quo of our current healthcare system. Sadly, most of these people don’t realize how broken our system is until they loose their job, or someone in their family becomes seriously ill.

    I’ve been fighting for a better health care system for about 4 years, and I’m getting tired of running into close minded people like you.

    Your assertion that I am discriminating against people for their accomplishments and hard work would be laughable if I thought you were capable of a more complex understanding of how our tax system works, and what it means to be a contributing member of society.

    I in no way suggest that we “screw people who are rich”. I suggest that those in our society who are most able to contribute to the common good do so- hardly a radical notion, and in fact is accepted doctrine the world over.

    I wonder, if I am no better than the common racist for suggesting that we insure our children, our poor, our disabled and elderly, what you are for stating “everyone does not deserve health care”?

    I suppose your partner, your parents, your family, your children deserve health care no? So who exactly are these people who don’t deserve it?

  9. My family is in no way entitled to health care. Nor am I. In fact, I was laid off for two months over the summer, then again starting 1 December 2009 until now. Never did I presume that it was somebody else’s duty to provide for me. It is mine and mine alone.

    To take from the rich and give to the poor may be accepted by the world populace, but that does not make it right. In fact, if you believe freedom to be a basic human right, you cannot support that policy.

  10. Oh wow this is a heated debate! I’m extremely surprised by your replies Chris. Not that I don’t agree but you brought to light some aspects that I hadn’t considered.

    I’m not a specialist but I know that the healthcare reform has been in the air even in the Clinton era. Why have people wanted a change for so long?

    Losing your job and – by extension health care – is not something that most people are looking forward too.
    I know it means more money for insurance companies. Of course not all employers will be able to sustain the costs but you can’t make an omelette without breaking eggs. And who has the right to say who deserves health care or not? What criteria should you base your judgement upon?

    The first moves will be extremely painful. But what could be worse than not being able to afford medical care? You might as well try something else even if it’s gonna hurt at first. I’m not saying that this is a perfect plan but you might as well take it as a draft, something that will be refined after lessons learned.

    About “the rich” that have to pay more… you might as well say that taxes are unfair because the more you make money, the more you have to pay.

    • Taxes are unfair when they are only levied differently for different portions of the populace.

      Article 1, Section 8 of the constitution says this:

      “The Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States”

      Even in the 16th amendment, which allows for a federal income tax, the difference in rate is not even mentioned. I argue that taxing people at different percentages is not only wrong, but unconstitutional.

      I am not saying that a family that makes 30K should pay the same amount as a family that makes 500K, but they should pay the same percentage. If you want to pass a bill, you don’t steal the money from the people who will never use it to support the people will never pay for it.

  11. The full reality of U.S.’s health care system came to fore, when some American women (in some international women’s forums that I particpated in past few years), was that some people hang onto their jobs even though they absolutley hate their jobs…because they need the health insurance benefits.

    Also some U.S. couples stay together instead of divorcing, because 1 partner has health insurance through their employer. Truly sad.

    That is TRULY a sad state of affairs if a national health care system has such impact on a person’s life beyond their health.

    I am aware of a person’s relative in the U.S., who’s terminal illness costed them over $200,000 in medical bills.

    Then since I am a cyclist, I’m shocked to hear the medical bills of some the U.S. cyclists who get hurt. And these are not racers. Just unforeseen falls, etc.

    I can’t even fathom the thought of exercising regularily, etc. and not have health insurance. But many Americans do.

    Just to give to your readership about how Canada’s health care system can work, depending on where one lives in Canada. My father who has prostate cancer, is being treated…no limits.

    Before that he rarely used the health care system. aside from his cancer, he has no cardiovascualr, respiratory problems @83. So now he is seeing cancer specialist at Canada’s leading research hospital in Toronto. He has lived in Toronto for past 15 yrs. He only got cancer….in past 3 yrs.

    He is a low-income senior. Restaurant cook his whole life, with 6 children and housewife, my mother.

    He is getting top care. He has been a taxpayer in Canada…so this is the level of care he is getting.

    And I’m glad he doesn’t have to pay thousands of dollars to get it. No point grumbling…over this folks. He contributed back to the economy in spades plus 6 productive children.

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