Share Your Ideas for an ObamaCare Replacement Plan

MedicareUS Healthcare plan 1.0

Outlined here is my version of a compromise healthcare plan for the Unites States.

The objective is to provide all citizens with affordable healthcare while preserving a market of healthcare insurance offerings from private insurance companies.

The basics of the plan laid out will use a combination of a form of expanded Medicare-for-all (MedicareUS), HSA accounts, high deductible plans, and additional coverage provided by private insurance.

A) Everyone pays into MedicareUS through payroll deductions or self-employed gross income based on percentage of income, and number of those covered in the household by head-of-household.
1. Raise individual’s MedicareUS tax to 4%. with additional .25% per non-working person in household.
2. Keep employers rate at 1.45%.

B) Everyone receives a Health Saving Account. (do away with the FSA).

C) Everyone will receive High-deductible insurance coverage paid through the single payer of MedicareUS.
This will include at no out of pocket.
1. A yearly physical health wellness visit
2. A yearly mental health wellness visit
3. Vaccinations for children under 18
4. Pre-natal and childbirth care

D) Your yearly deductible is based on a 6 month average of your total gross income.
▪ So say a person makes $35,000 a year, their personal deductible could be $350 for the entire year; and a person making $350,000 could have a deductible of $35,000 a year. This simple sliding deductible does away with a layer of bureaucracy and bean counting that would involve any type of tax credit scheme. (The deductible demonstrated are just examples and the actually viable deductibles would have to be worked out).

E) HSA accounts would be available for all with a larger max-cap than today. These are funded by payroll deductions or through direct payments by individuals. (Individuals below a certain threshold or with disabilities may even get federal money as a kick-starter in some form of a tax credit, or as a replacement of Medicaid).
1. Parents could roll over a (?)% portion of their HSA account to children (under 18) every year.
2. Unused money in an individuals HSA account upon death would be rolled over into MedicareUS.

F) Employers would be able to offer additional coverage plans (business tax deductible) to employees as part of incentive packages with no restriction or penalty to cover the portion of care that fall under their MedicareUS deductible.

talking points:
Health Insurance is not Health Care.
(1) As a civilized society we are obligated to provide for the needy. This includes health care for those who cannot (truly) afford it. The federal government should provide Medicaid, via taxpayer dollars, for any who truly need health care and cannot afford it. However, health care does not include everything covered by the typical health insurance plan. Minimum essential health care needs to be carefully defined – vaccinations, cancer screenings, blood pressure checks, blood sugar tests. I also think that the taxpayer should pay for programs to quit smoking, quit drinking, quit drugs, lose weight, with the proviso that the recipient must reimburse the funds if he/she relapses. Congress can argue long and hard about what services should be covered and what should not be covered.
(2) every individual should have the right to buy catastrophic care insurance
(3) every individual should have the right to live uninsured
(4) all policies should be catastrophic care only. From talking point 1 above, if you cannot afford to pay for your own family’s minimum essential health care, you should qualify for Medicaid.
(5) all policies should be individual policies only (why should it matter how large my employer is in determining my insurance premium)
(6) all policies should be available nationwide (why should it matter which state I live in, let alone which city/county, in determining my insurance premium)
(7) since the “risk pool” for the insurance company will then consist of EVERY insured individual, the insurance company should have all the data they need to determine premiums, and pre-existing as well as new conditions will be covered to be paid by ALL who purchase insurance.
(8) all diseases and conditions should be covered – no “well” care should be covered. As in point 1 above, if you cannot afford minimum essential “well” care you should get Medicaid.

First expanded medicaid is a terrible idea because it places more burden on the Federal government instead of the states and does nothing to control costs. I believe a better way is to look at states whom refused to expand medicaid and look at what has proven to be successful. A perfect example and the only example I can provide is Wisconsin whom has built a model program which contains costs and provides better services.
However I feel that even state medicaid recipients should have to pay something even if only $25 per visit.
Now to cost control, regulations with ACA are proving to be counter productive and have eliminated choices for competition. Competition and intelligent incentives for doctors to become independent and to mandate open pricing for procedures so the consumer can at least be informed is very important. Co-Operatives should be encouraged and health insurance companies or anyone but the direct consumer should not be allowed to sue the Co-Op. We see Co-Ops being extremely effective within the companies that share the burden such as Puritans or Medi Share, Liberty and Christian Health Sharing. All of these plans take care of their members for less then $600 per month for a family. Two of the companies mentioned have special programs offering 1 million in coverage and one of those offers unlimited sharing.
I just checked into family care for our family through ACA and the projection for next year is a little over $2,000 per month.
Combine the ability of co-ops and private direct care doctors like Dr. Umber or in my city the Joyful Doc and you have unlimited access to a doctor for $50 to $75 per month as an adult and $10 to $25 for each child. The bottom line is true competition and responsibility is by far the best route to a successful healthcare system. Anything else does not control costs which is a disaster like single payer. The more the government is involved and regulating the worse it is for citizens.