Kandahar's Universal Health Care Plan

Kandahar · Mar 13, 2009

I've been working on this for a couple weeks now. My basic idea is to have three government plans, of varying levels of coverage, along with private health insurers. My plan also provides vouchers to the poor so they can afford their premiums, and it eliminates the incentives for employers to provide health insurance so that individuals could buy affordable plans on their own if they didn't like the federal plans.

What do you think?

UNIVERSALITY
1. It shall be illegal for any public or private health insurance plan to discriminate, deny coverage, and/or charge different premiums based on gender, age, race, sexual orientation, genetic profile, or pre-existing conditions.
2. Federal Health Vouchers shall be made available for individuals with incomes below $20,000 who request them, to purchase a public or private health insurance plan, using the following formula to determine the per-month stipend: ($1,000 / Income) * $750. Vouchers shall not exceed $75 per month for individuals. The voucher shall be paid directly to the health insurer.
3. Federal Health Vouchers shall be made available for families with incomes below $32,000 who request them, to purchase a public or private health insurance plan, using the following formula to determine the per-month stipend: ($1,000 / Income) * $2,250. Vouchers shall not exceed $225 per month for families. The voucher shall be paid directly to the health insurer.
4. All persons residing within the United States or its territories shall be required to have health insurance for themselves and all of their dependents. Failure to comply with this provision shall result in the offender and/or his or her dependents being retroactively registered for the US Green Plan. The offender’s wages may be garnished to pay back premiums.
5. Foreigners in the United States on a temporary work visa or student visa, or foreigners who are in the United States for no more than three months, shall be automatically covered under the Green Plan unless they have health insurance of their own. It shall be illegal for foreigners to travel to the United States specifically to use the Green Plan.

FEDERAL PLANS
6. The federal government shall offer the following health insurance plans to all US citizens and permanent residents, beginning on January 1, 2011:
a. Green Plan (Individual/Family) - $40/$120 Premium per Month. $2,000/$4,000 Annual Deductible. $6,000/$12,000 Annual Maximum. 60% of hospital services. 60% of newborn care. 80% of physician visits. 70% all other services. $100 co-pay for emergency care. $30 co-pay for urgent care. $20 co-pay for physician care.
b. Blue Plan (Individual/Family) - $100/$300 Premium per Month. $500/$1,500 Annual Deductible. $3,000/$9,000 Annual Maximum. 80% of hospital services. 80% of newborn care. 90% of physician visits. 80% all other services. $100 co-pay for emergency care. $20 co-pay for urgent care. $10 co-pay for physician care.
c. Red Plan (Individual/Family) - $120/$360 Premium per Month. $250/$750 Annual Deductible. $1,250/$3,750 Annual Maximum. 90% of hospital services. 90% of newborn care. 100% of physician visits. 90% all other services. $100 co-pay for emergency care. $15 co-pay for urgent care. $10 co-pay for physician care. People receiving Federal Health Vouchers are NOT eligible for the Red Plan, unless they are a current or former member of the Armed Forces with an honorable discharge.
7. Each plan will run for a two year session. No one registered with a government plan may cancel the plan and/or switch to another plan until the end of the session. Anyone who signs up for a plan in the middle of a session may not cancel until they have participated for a full session.

COST CONTROL
8. Any person who files a false or frivolous medical malpractice lawsuits shall pay the court costs and legal fees for both parties, and be fined up to 25% of the compensation which they sought.
9. No medical malpractice lawsuit shall award more than $5 million for a wrongful death. No medical malpractice lawsuit shall award more than $750,000 for pain and suffering. There shall be no maximum on compensation for medical bills resulting from a medical malpractice lawsuit.
10. The federal government hereby establishes the Federal Malpractice Database. Any medical professional who has been found liable for medical malpractice on more than one occasion shall have the details and circumstances of the cases published in the Federal Malpractice Database, which shall be publicly available to all consumers.
11. The federal government hereby authorizes the Department of Health and Human Services to establish best methods and practices, including a National Health Database through which doctors may access patients’ medical records if the patient signs a release. No information from the National Health Database may ever be sold or made public, except with the consent of the patient. No information from the National Health Database shall ever be turned over to law enforcement, except with the consent of the patient or under court subpoena. Violators of this policy are subject to a $500,000 fine, up to six years in federal prison, and the permanent revocation of all medical licenses.

PAYING FOR IT ALL
12. In Fiscal Year 2011, 20% of employer-paid health insurance premiums shall be taxed on the employee’s income and payroll taxes as ordinary income. In FY2012, 40%. In FY2013, 60%. In FY2014, 80%. In FY2015 and every year thereafter, 100% of employer-paid health insurance premiums shall be taxed on the employee’s income and payroll taxes as ordinary income.
13. In FY2012 and every year thereafter, all income over $3.5 million shall be taxed at a rate of 42%.
14. In FY2011 and every year thereafter, all out-of-pocket health expenses (excluding cosmetic surgery) and all health insurance premiums which are paid by the consumer and/or the consumer’s dependent shall be tax deductible.

Goobieman · Mar 13, 2009

I vote no.

The federal government should not be involved in health care, except in a regulatory mannner (prusiant to its power to regulate interstate commerce). It certainly has no buisness in PROVIDING health care to the population in general.

WI Crippler · Mar 13, 2009

I've been working on this for a couple weeks now. My basic idea is to have three government plans, of varying levels of coverage, along with private health insurers. My plan also provides vouchers to the poor so they can afford their premiums, and it eliminates the incentives for employers to provide health insurance so that individuals could buy affordable plans on their own if they didn't like the federal plans.

What do you think?

I'll just point out some of the problems I see, and we'll assume I either agree with, or am nuetral about the topics I don't cover.

UNIVERSALITY
1. It shall be illegal for any public or private health insurance plan to discriminate, deny coverage, and/or charge different premiums based on gender, age, race, sexual orientation, genetic profile, or pre-existing conditions.

No way this could work, at least for the private sector. Different premiums are charged on some of these groupings, because analysis would show that being in certain groups or attaining certin thresholds such as age, leads to an increase in the use of health insurance over others. Insurance is a pooled risk, and it needs to be determined what pool you are a part of, so that you are paying your fair markert share of the risk you are transferring to the insurance company. I don't have much issue with you saying they cannot deny coverage based on those criteria, but to then tell them they cannot increase the premium amounts based on things like age and pre-existing conditions, you would bankrupt the private market faster than you could blink.

4.All persons residing within the United States or its territories shall be required to have health insurance for themselves and all of their dependents. Failure to comply with this provision shall result in the offender and/or his or her dependents being retroactively registered for the US Green Plan. The offender’s wages may be garnished to pay back premiums.

Health insurance should not be mandatory. Some people simply aren't going to bother with getting insurance. The ones that want it, will get it via one of your plans. Trying to enforce this would be an unnecessary bueracracy.

FEDERAL PLANS
6. The federal government shall offer the following health insurance plans to all US citizens and permanent residents, beginning on January 1, 2011:
a. Green Plan (Individual/Family) - $40/$120 Premium per Month. $2,000/$4,000 Annual Deductible. $6,000/$12,000 Annual Maximum. 60% of hospital services. 60% of newborn care. 80% of physician visits. 70% all other services. $100 co-pay for emergency care. $30 co-pay for urgent care. $20 co-pay for physician care.
b. Blue Plan (Individual/Family) - $100/$300 Premium per Month. $500/$1,500 Annual Deductible. $3,000/$9,000 Annual Maximum. 80% of hospital services. 80% of newborn care. 90% of physician visits. 80% all other services. $100 co-pay for emergency care. $20 co-pay for urgent care. $10 co-pay for physician care.
c. Red Plan (Individual/Family) - $120/$360 Premium per Month. $250/$750 Annual Deductible. $1,250/$3,750 Annual Maximum. 90% of hospital services. 90% of newborn care. 100% of physician visits. 90% all other services. $100 co-pay for emergency care. $15 co-pay for urgent care. $10 co-pay for physician care. People receiving Federal Health Vouchers are NOT eligible for the Red Plan, unless they are a current or former member of the Armed Forces with an honorable discharge.
7. Each plan will run for a two year session. No one registered with a government plan may cancel the plan and/or switch to another plan until the end of the session. Anyone who signs up for a plan in the middle of a session may not cancel until they have participated for a full session.

I am unsure as to what your threshholds for each plan would be. Or are all three offered regardless of income level? I'm sorry, but the green plan looks flat out horrible. Anybody who was purchasing that plan as a bare minimum
, would have horrible coverage that ends up costing them more money out of pocket. I realize its a quasi-market crafted set of plans (less premium=less coverage), but I feel the green plan falls well short of being feasible. My other question would be that having set premiums in dollar amounts like this, regardless of any underwriting, it would become unfeasible for the government to maintain those rates over time.

And for number 7, anybody should be able to opt out of their insurance at any time, for any reasoon. Thats how the private market works. There is no reason to keep people on the government subsidized plans, if they can afford to move off them.

COST CONTROL

10.The federal government hereby establishes the Federal Malpractice Database. Any medical professional who has been found liable for medical malpractice on more than one occasion shall have the details and circumstances of the cases published in the Federal Malpractice Database, which shall be publicly available to all consumers.

Disagree. The states liscence healthcare practioners, and thereby have the responsibility of overseeing the ethical conduct of said healthcare providers. If the states choose to do this, fine. It doesn't need to be done at the federal level.

11.The federal government hereby authorizes the Department of Health and Human Services to establish best methods and practices, including a National Health Database through which doctors may access patients’ medical records if the patient signs a release. No information from the National Health Database may ever be sold or made public, except with the consent of the patient. No information from the National Health Database shall ever be turned over to law enforcement, except with the consent of the patient or under court subpoena. Violators of this policy are subject to a $500,000 fine, up to six years in federal prison, and the permanent revocation of all medical licenses.

Again, I disagree that the H&HS should determine the best practices. Thats what doctors and nurses get paid to do. Thats why they go to years of school, interships etc...We don't need a bueracracy in D.C. determining treatment.
I understand that private insurers kind of do this already, but they have liscenced professionals on hand to dispute treatment. They are also liscenced by the states, and thus it is incumbent upon the state legislatures to determine the power of health insurers doing business in their state. Having the Federal government essentially replace, or replicate one of the major problems in the healthcare industry(IMO) is not a solution, but just more problems and more bueracracy.

Edit: Forgot to add this

12. In Fiscal Year 2011, 20% of employer-paid health insurance premiums shall be taxed on the employee’s income and payroll taxes as ordinary income. In FY2012, 40%. In FY2013, 60%. In FY2014, 80%. In FY2015 and every year thereafter, 100% of employer-paid health insurance premiums shall be taxed on the employee’s income and payroll taxes as ordinary income.

I don't support this. You shouldn't tax the people who are on private group health insurance plans, to pay for individuals that are on the government plans. Don't penalize people who choose the private market.

DarkWizard12 · Mar 13, 2009

Kandahar said:
I've been working on this for a couple weeks now. My basic idea is to have three government plans, of varying levels of coverage, along with private health insurers. My plan also provides vouchers to the poor so they can afford their premiums, and it eliminates the incentives for employers to provide health insurance so that individuals could buy affordable plans on their own if they didn't like the federal plans.

What do you think?

UNIVERSALITY
1. It shall be illegal for any public or private health insurance plan to discriminate, deny coverage, and/or charge different premiums based on gender, age, race, sexual orientation, genetic profile, or pre-existing conditions.
2. Federal Health Vouchers shall be made available for individuals with incomes below $20,000 who request them, to purchase a public or private health insurance plan, using the following formula to determine the per-month stipend: ($1,000 / Income) * $750. Vouchers shall not exceed $75 per month for individuals. The voucher shall be paid directly to the health insurer.
3. Federal Health Vouchers shall be made available for families with incomes below $32,000 who request them, to purchase a public or private health insurance plan, using the following formula to determine the per-month stipend: ($1,000 / Income) * $2,250. Vouchers shall not exceed $225 per month for families. The voucher shall be paid directly to the health insurer.
4. All persons residing within the United States or its territories shall be required to have health insurance for themselves and all of their dependents. Failure to comply with this provision shall result in the offender and/or his or her dependents being retroactively registered for the US Green Plan. The offender’s wages may be garnished to pay back premiums.
5. Foreigners in the United States on a temporary work visa or student visa, or foreigners who are in the United States for no more than three months, shall be automatically covered under the Green Plan unless they have health insurance of their own. It shall be illegal for foreigners to travel to the United States specifically to use the Green Plan.

FEDERAL PLANS
6. The federal government shall offer the following health insurance plans to all US citizens and permanent residents, beginning on January 1, 2011:
a. Green Plan (Individual/Family) - $40/$120 Premium per Month. $2,000/$4,000 Annual Deductible. $6,000/$12,000 Annual Maximum. 60% of hospital services. 60% of newborn care. 80% of physician visits. 70% all other services. $100 co-pay for emergency care. $30 co-pay for urgent care. $20 co-pay for physician care.
b. Blue Plan (Individual/Family) - $100/$300 Premium per Month. $500/$1,500 Annual Deductible. $3,000/$9,000 Annual Maximum. 80% of hospital services. 80% of newborn care. 90% of physician visits. 80% all other services. $100 co-pay for emergency care. $20 co-pay for urgent care. $10 co-pay for physician care.
c. Red Plan (Individual/Family) - $120/$360 Premium per Month. $250/$750 Annual Deductible. $1,250/$3,750 Annual Maximum. 90% of hospital services. 90% of newborn care. 100% of physician visits. 90% all other services. $100 co-pay for emergency care. $15 co-pay for urgent care. $10 co-pay for physician care. People receiving Federal Health Vouchers are NOT eligible for the Red Plan, unless they are a current or former member of the Armed Forces with an honorable discharge.
7. Each plan will run for a two year session. No one registered with a government plan may cancel the plan and/or switch to another plan until the end of the session. Anyone who signs up for a plan in the middle of a session may not cancel until they have participated for a full session.

COST CONTROL
8. Any person who files a false or frivolous medical malpractice lawsuits shall pay the court costs and legal fees for both parties, and be fined up to 25% of the compensation which they sought.
9. No medical malpractice lawsuit shall award more than $5 million for a wrongful death. No medical malpractice lawsuit shall award more than $750,000 for pain and suffering. There shall be no maximum on compensation for medical bills resulting from a medical malpractice lawsuit.
10. The federal government hereby establishes the Federal Malpractice Database. Any medical professional who has been found liable for medical malpractice on more than one occasion shall have the details and circumstances of the cases published in the Federal Malpractice Database, which shall be publicly available to all consumers.
11. The federal government hereby authorizes the Department of Health and Human Services to establish best methods and practices, including a National Health Database through which doctors may access patients’ medical records if the patient signs a release. No information from the National Health Database may ever be sold or made public, except with the consent of the patient. No information from the National Health Database shall ever be turned over to law enforcement, except with the consent of the patient or under court subpoena. Violators of this policy are subject to a $500,000 fine, up to six years in federal prison, and the permanent revocation of all medical licenses.

PAYING FOR IT ALL
12. In Fiscal Year 2011, 20% of employer-paid health insurance premiums shall be taxed on the employee’s income and payroll taxes as ordinary income. In FY2012, 40%. In FY2013, 60%. In FY2014, 80%. In FY2015 and every year thereafter, 100% of employer-paid health insurance premiums shall be taxed on the employee’s income and payroll taxes as ordinary income.
13. In FY2012 and every year thereafter, all income over $3.5 million shall be taxed at a rate of 42%.
14. In FY2011 and every year thereafter, all out-of-pocket health expenses (excluding cosmetic surgery) and all health insurance premiums which are paid by the consumer and/or the consumer’s dependent shall be tax deductible.

Well, I have some general problems with the details, but first, what would be the cost? What would be the ballpark figure?

Scarecrow Akhbar · Mar 13, 2009

Here's my Universal Health Care Plan, for comparison:

You have a body?

You pay to take care of it.

DeeJayH · Mar 13, 2009

subscribe 123456+

TOJ · Mar 13, 2009

Don't have any unpaid taxes do ya? I expect Obama will be calling any minute to have you head up the effort. :rofl

Kandahar · Mar 13, 2009

WI Crippler said:
No way this could work, at least for the private sector. Different premiums are charged on some of these groupings, because analysis would show that being in certain groups or attaining certin thresholds such as age, leads to an increase in the use of health insurance over others. Insurance is a pooled risk, and it needs to be determined what pool you are a part of, so that you are paying your fair markert share of the risk you are transferring to the insurance company. I don't have much issue with you saying they cannot deny coverage based on those criteria, but to then tell them they cannot increase the premium amounts based on things like age and pre-existing conditions, you would bankrupt the private market faster than you could blink.

I agree that insurance is about pooling risk, which is exactly why I think it should be illegal to discriminate based on these things. Your "fair market share of the risk" is very subjective...it's not as though people CHOOSE to be 70 years old and have diabetes and cancer.

It wouldn't bankrupt the private market so much as shift some of the cost from high-risk patients to low-risk patients. Which is absolutely necessary, as people cannot afford expensive medical procedures on their own.

This is part of the reason I included the mandatory-health-insurance provision. I recognize that if discrimination is illegal, insurance companies will be flooded with high-risk applicants with few low-risk applicants to balance it out. This problem would be eliminated if it were mandatory.

WI Crippler said:
Health insurance should not be mandatory. Some people simply aren't going to bother with getting insurance. The ones that want it, will get it via one of your plans. Trying to enforce this would be an unnecessary bueracracy.

If they don't get health insurance, then they'll eventually show up at the ER and present the government with a much higher bill, than if it had just been nipped in the bud when the problem was small.

WI Crippler said:
I am unsure as to what your threshholds for each plan would be. Or are all three offered regardless of income level? I'm sorry, but the green plan looks flat out horrible. Anybody who was purchasing that plan as a bare minimum
, would have horrible coverage that ends up costing them more money out of pocket. I realize its a quasi-market crafted set of plans (less premium=less coverage), but I feel the green plan falls well short of being feasible. My other question would be that having set premiums in dollar amounts like this, regardless of any underwriting, it would become unfeasible for the government to maintain those rates over time.

Basically, the Green Plan is designed to provide "catastrophic" insurance only. For 20-somethings who aren't at much risk and don't have a lot of money for premiums, or for very wealthy people who are willing to self-insure to a large degree. I agree that it would be horrible for a middle-class family or an older person.

As for the premiums and benefits, there's no reason that the government couldn't alter them. These were just my ideas for three distinct levels of coverage. Obviously the exact details could be changed. Congress could adjust the premiums/benefits each year.

WI Crippler said:
And for number 7, anybody should be able to opt out of their insurance at any time, for any reasoon. Thats how the private market works. There is no reason to keep people on the government subsidized plans, if they can afford to move off them.

I included this provision more for cost-control than anything else. Forbidding people from cancelling their plan before the end of the session would prevent people from joining in June 2011, having some expensive one-time procedure in July 2011, and cancelling the plan in August 2011. Most private insurers have similar provisions.

WI Crippler said:
Disagree. The states liscence healthcare practioners, and thereby have the responsibility of overseeing the ethical conduct of said healthcare providers. If the states choose to do this, fine. It doesn't need to be done at the federal level.

That's fair enough. I'm not entirely sure how medical licensing works (like if an Ohio Medical License is valid in the other 49 states), but if the states have complete control over who can operate in their states, then I'd agree that this provision could be nixed.

WI Crippler said:
Again, I disagree that the H&HS should determine the best practices. Thats what doctors and nurses get paid to do. Thats why they go to years of school, interships etc...We don't need a bueracracy in D.C. determining treatment.

I'm not referring to the DHHS publishing guidelines that say "If the patient has Disease X, give them Treatment Y." I agree that the doctors and nurses should do that. I was referring more to the clerical aspect of medicine. If Cigna requires Form A and C, and Anthem requires Form B and D, and Medicare requires forms A, C, and D, then the system is really not efficient. If the federal government simply mandated a common standard, then a lot of these inefficiencies in the system would be eliminated. One of the biggest problems in our system is that isn't really a system at all, but a patchwork of hospitals and insurers each with different policies. An obscene proportion of medical costs go toward paper-pushing. If we had some national standards, that could largely be eliminated or at least mitigated.

WI Crippler said:
I understand that private insurers kind of do this already, but they have liscenced professionals on hand to dispute treatment.

The DHHS has licensed professionals on hand as well.

WI Crippler said:
I don't support this. You shouldn't tax the people who are on private group health insurance plans, to pay for individuals that are on the government plans. Don't penalize people who choose the private market.

This really isn't so much a penalty as the removal of a subsidy. There's not really any reason that employer-paid medical benefits SHOULDN'T be taxed as ordinary income. People are still getting something of monetary value in exchange for their employment. Eliminating this subsidy wouldn't really favor government plans over private plans...it would favor individual plans over employer plans.

The idea of this isn't necessarily to get everyone's on the government dime. It's to break the tie between employment and health insurance. Under the current system, people have very few options for affordable health insurance if they aren't employed, because individual plans are unbelievably expensive.

WI Crippler · Mar 13, 2009

Kandahar said:
Under the current system, people have very few options for affordable health insurance if they aren't employed, because individual plans are unbelievably expensive.

I'll get to the rest of your post tonight when I have time, but I wanted to point out this part. The reason its so expensive for individual plans, is because thats the market cost for those plans. Employer or group health insurance where the employer pays a portion of the costs, is one way to effectively reduce the premium the individual pays. Having the government basically replace the "employer" paying a portion of costs(which is what you are doing), isn't necessarily going to reduce the market price of insurance which the government will have to pay.

Other things you have brought up could help reduce healthcare costs, and I'll get into that later tonight when I have time.

WillRockwell · Mar 13, 2009

Goobieman said:
I vote no.

The federal government should not be involved in health care, except in a regulatory mannner (prusiant to its power to regulate interstate commerce). It certainly has no buisness in PROVIDING health care to the population in general.

If the federal government should not provide for the health of its citizens, why should it provide for their safety? Why have fire departments, police or military? Isn't the whole point of government to improve the lives of citizens?

DeeJayH · Mar 13, 2009

WillRockwell said:
If the federal government should not provide for the health of its citizens, why should it provide for their safety? Why have fire departments, police or military? Isn't the whole point of government to improve the lives of citizens?

YouTube - Rockwell - Somebody's Watching Me

WI Crippler · Mar 13, 2009

WillRockwell said:
Isn't the whole point of government to improve the lives of citizens?

No.

Ten character limit.

American · Mar 13, 2009

WillRockwell said:
If the federal government should not provide for the health of its citizens, why should it provide for their safety? Why have fire departments, police or military? Isn't the whole point of government to improve the lives of citizens?

Are you American? That's a serious question, because you really don't seem to understand what America is all about. The purpose of the military is to protect the union. The purpose of police is to enforce the law. Believe it or not, fire departments were first started to save property. But regardless, you don't understand much about a free people and why the United States came about in the first place. If you want government control you can got to almost every other place on Earth, we are very different. That's what sets us apart and why more people want to come here than any other country on Earth. I suggest you pay close attention, and begin reading more about our Founders.

WI Crippler · Mar 13, 2009

I agree that insurance is about pooling risk, which is exactly why I think it should be illegal to discriminate based on these things. Your "fair market share of the risk" is very subjective...it's not as though people CHOOSE to be 70 years old and have diabetes and cancer.

It wouldn't bankrupt the private market so much as shift some of the cost from high-risk patients to low-risk patients. Which is absolutely necessary, as people cannot afford expensive medical procedures on their own.

This is part of the reason I included the mandatory-health-insurance provision. I recognize that if discrimination is illegal, insurance companies will be flooded with high-risk applicants with few low-risk applicants to balance it out. This problem would be eliminated if it were mandatory.

First of all, at age 70, you've got medicare already, so lets not concern ourselves too greatly with the elderly, although Medicare could use reform as well. Obviously nobody "chooses" to get cancer. If, in your scenario, the government is requiring that insurers not only accept these patients and their pre-existing conditions, then I only see two options that are viable. Have insurers be allowed to charge the extra premium they need to remain in business, or have the insurers determine the premium difference, and the government susidizes that difference back to the insurer.

To your bolded, by making insurance mandatory, you are making high-risk applicants flood the insurers, whether they be the private market or the government, in your scenario.

As I said in a different thread, the underwriting is not that discriminatory for a health insurance plan in the first place. Age, sex, pre-existing conditions, line of work, and family memebers is all thats really used in a single, non-group, policy. The only thing that may get people turned away, is the pre-existing conditions and usually an insurer will offer to cover the person, as long as the pre-existing is excluded. All the other information, is simply underwriting information used to determine premium amounts. People aren't denied coverage, because they are female or black. I believe that all things being equal, a female pays slightly less than a male for insurance. I am unaware of any racial difference(assuming health is equal) since race isn't used as underwriting criteria(as far as I know).

If they don't get health insurance, then they'll eventually show up at the ER and present the government with a much higher bill, than if it had just been nipped in the bud when the problem was small.

Actually, they present the hospitals, and by proxy, the people who do have health insurance, with the burden of their cost, not the government.

I included this provision more for cost-control than anything else. Forbidding people from cancelling their plan before the end of the session would prevent people from joining in June 2011, having some expensive one-time procedure in July 2011, and cancelling the plan in August 2011. Most private insurers have similar provisions.

I see your point. Although I don't really agree with your plan in principle, if something to this effect were instituted I would rather see an annual contract, vs. a bi-annual contract.

That's fair enough. I'm not entirely sure how medical licensing works (like if an Ohio Medical License is valid in the other 49 states), but if the states have complete control over who can operate in their states, then I'd agree that this provision could be nixed.

Alot of states sign compacts with each other, recognizing the liscences from other states as valid or equivalent requiring no extra training or CE courses. But you still have to apply for a state liscence to the state you are practicing healthcare in. My wife, an RN, has had to get a new state liscence each time we have moved(SC,WI,NC). She could not work in WI, with a SC liscence. But she did not need to attend any extra training due to the compact between those particular states.

I'm not referring to the DHHS publishing guidelines that say "If the patient has Disease X, give them Treatment Y." I agree that the doctors and nurses should do that. I was referring more to the clerical aspect of medicine. If Cigna requires Form A and C, and Anthem requires Form B and D, and Medicare requires forms A, C, and D, then the system is really not efficient. If the federal government simply mandated a common standard, then a lot of these inefficiencies in the system would be eliminated. One of the biggest problems in our system is that isn't really a system at all, but a patchwork of hospitals and insurers each with different policies. An obscene proportion of medical costs go toward paper-pushing. If we had some national standards, that could largely be eliminated or at least mitigated.

Alright, thats not as bad as what I thought you were saying. Still, I would be against the creation of a national patient database, which I think you mentioned. However, so long as state legislatures are writing the insurance laws, this won't be feasible(the nationalized paperwork scenario) IMO. I think there is some validity in trimming the paperwork to be more efficient, but I am leery that the federal government could mandate efficient paperwork in the first place. That would be a hypocrisy of the highest standard. However, it would be beneficial if states adopted your idea regarding the paperwork, prehaps as with state liscensure, adopting a "compact" of standards. What works for Wisconsin and Minnesota, may not work for Claifornia and Arizona.

This really isn't so much a penalty as the removal of a subsidy. There's not really any reason that employer-paid medical benefits SHOULDN'T be taxed as ordinary income. People are still getting something of monetary value in exchange for their employment. Eliminating this subsidy wouldn't really favor government plans over private plans...it would favor individual plans over employer plans.

The idea of this isn't necessarily to get everyone's on the government dime. It's to break the tie between employment and health insurance. Under the current system, people have very few options for affordable health insurance if they aren't employed, because individual plans are unbelievably expensive.

Breaking the tie between employment and insurance isn't going to bring costs down for individual plans. The price for an individual plan is not tied to the price of group health insurance. The price of the individual plan is the market price. The employer tie to health insurance does keep cost down for the employed individual, usually because the employer is paying part of the premium. If you added together the employer contribution and the individual contribution and compared it against an individual plan, the difference between a group plan and individual plan is not all that great. Especially for smaller businesses.

Health insurance costs paid by the employer, aren't tax deductible for the individual in the first place, because it is not a part of income. It seems that way on the surface, but the employer does not deduct from somebodys check, the employer participation in health insurance. So it shouldn't be taxed as income, because it is never received as such. When companies file their taxes, health insurance expense is seperate from payroll.

CaptainCourtesy · Mar 14, 2009

Goobieman said:
I vote no.

The federal government should not be involved in health care, except in a regulatory mannner (prusiant to its power to regulate interstate commerce). It certainly has no buisness in PROVIDING health care to the population in general.

Actually, a large portion of Kandahar's plan is about regulation. Only a small portion, from what I see, is about providing health care.

Jerry · Mar 17, 2009

Kandahar said:
I've been working on this for a couple weeks now. My basic idea is to have three government plans, of varying levels of coverage, along with private health insurers. My plan also provides vouchers to the poor so they can afford their premiums, and it eliminates the incentives for employers to provide health insurance so that individuals could buy affordable plans on their own if they didn't like the federal plans.

What do you think?

UNIVERSALITY
1. It shall be illegal for any public or private health insurance plan to discriminate, deny coverage, and/or charge different premiums based on gender, age, race, sexual orientation, genetic profile, or pre-existing conditions.
2. Federal Health Vouchers shall be made available for individuals with incomes below $20,000 who request them, to purchase a public or private health insurance plan, using the following formula to determine the per-month stipend: ($1,000 / Income) * $750. Vouchers shall not exceed $75 per month for individuals. The voucher shall be paid directly to the health insurer.
3. Federal Health Vouchers shall be made available for families with incomes below $32,000 who request them, to purchase a public or private health insurance plan, using the following formula to determine the per-month stipend: ($1,000 / Income) * $2,250. Vouchers shall not exceed $225 per month for families. The voucher shall be paid directly to the health insurer.
4. All persons residing within the United States or its territories shall be required to have health insurance for themselves and all of their dependents. Failure to comply with this provision shall result in the offender and/or his or her dependents being retroactively registered for the US Green Plan. The offender’s wages may be garnished to pay back premiums.
5. Foreigners in the United States on a temporary work visa or student visa, or foreigners who are in the United States for no more than three months, shall be automatically covered under the Green Plan unless they have health insurance of their own. It shall be illegal for foreigners to travel to the United States specifically to use the Green Plan.

FEDERAL PLANS
6. The federal government shall offer the following health insurance plans to all US citizens and permanent residents, beginning on January 1, 2011:
a. Green Plan (Individual/Family) - $40/$120 Premium per Month. $2,000/$4,000 Annual Deductible. $6,000/$12,000 Annual Maximum. 60% of hospital services. 60% of newborn care. 80% of physician visits. 70% all other services. $100 co-pay for emergency care. $30 co-pay for urgent care. $20 co-pay for physician care.
b. Blue Plan (Individual/Family) - $100/$300 Premium per Month. $500/$1,500 Annual Deductible. $3,000/$9,000 Annual Maximum. 80% of hospital services. 80% of newborn care. 90% of physician visits. 80% all other services. $100 co-pay for emergency care. $20 co-pay for urgent care. $10 co-pay for physician care.
c. Red Plan (Individual/Family) - $120/$360 Premium per Month. $250/$750 Annual Deductible. $1,250/$3,750 Annual Maximum. 90% of hospital services. 90% of newborn care. 100% of physician visits. 90% all other services. $100 co-pay for emergency care. $15 co-pay for urgent care. $10 co-pay for physician care. People receiving Federal Health Vouchers are NOT eligible for the Red Plan, unless they are a current or former member of the Armed Forces with an honorable discharge.
7. Each plan will run for a two year session. No one registered with a government plan may cancel the plan and/or switch to another plan until the end of the session. Anyone who signs up for a plan in the middle of a session may not cancel until they have participated for a full session.

COST CONTROL
8. Any person who files a false or frivolous medical malpractice lawsuits shall pay the court costs and legal fees for both parties, and be fined up to 25% of the compensation which they sought.
9. No medical malpractice lawsuit shall award more than $5 million for a wrongful death. No medical malpractice lawsuit shall award more than $750,000 for pain and suffering. There shall be no maximum on compensation for medical bills resulting from a medical malpractice lawsuit.
10. The federal government hereby establishes the Federal Malpractice Database. Any medical professional who has been found liable for medical malpractice on more than one occasion shall have the details and circumstances of the cases published in the Federal Malpractice Database, which shall be publicly available to all consumers.
11. The federal government hereby authorizes the Department of Health and Human Services to establish best methods and practices, including a National Health Database through which doctors may access patients’ medical records if the patient signs a release. No information from the National Health Database may ever be sold or made public, except with the consent of the patient. No information from the National Health Database shall ever be turned over to law enforcement, except with the consent of the patient or under court subpoena. Violators of this policy are subject to a $500,000 fine, up to six years in federal prison, and the permanent revocation of all medical licenses.

PAYING FOR IT ALL
12. In Fiscal Year 2011, 20% of employer-paid health insurance premiums shall be taxed on the employee’s income and payroll taxes as ordinary income. In FY2012, 40%. In FY2013, 60%. In FY2014, 80%. In FY2015 and every year thereafter, 100% of employer-paid health insurance premiums shall be taxed on the employee’s income and payroll taxes as ordinary income.
13. In FY2012 and every year thereafter, all income over $3.5 million shall be taxed at a rate of 42%.
14. In FY2011 and every year thereafter, all out-of-pocket health expenses (excluding cosmetic surgery) and all health insurance premiums which are paid by the consumer and/or the consumer’s dependent shall be tax deductible.

Jerry's Universal Health Care Plan: Go buy one.

Jerry · Mar 17, 2009

WillRockwell said:
If the federal government should not provide for the health of its citizens, why should it provide for their safety? Why have fire departments, police or military? Isn't the whole point of government to improve the lives of citizens?

That's not the point of government at all.

Goobieman · Mar 17, 2009

WillRockwell said:
If the federal government should not provide for the health of its citizens, why should it provide for their safety? Why have fire departments, police or military? Isn't the whole point of government to improve the lives of citizens?

:shock:

I cannot believe I missed this gem!

Government exists to protect your rights, not provide you the means to exercise them.

Tucker Case · Mar 17, 2009

I'm not in favor of a Universal Health Care plan at all. Nor would I support a Galactic Health Care plan.

I'd keep it in our own solar system. Do you guys have a clue how much it costs for a Vloktrogian to have it's Gimblat removed?!?!? One case of Gimblaticitis and boom! There goes the global economy!

talloulou · Mar 17, 2009

Kandahar said:
UNIVERSALITY
1. It shall be illegal for any public or private health insurance plan to discriminate, deny coverage, and/or charge different premiums based on gender, age, race, sexual orientation, genetic profile, or pre-existing conditions.

Excellent.

2. Federal Health Vouchers shall be made available for individuals with incomes below $20,000 who request them, to purchase a public or private health insurance plan, using the following formula to determine the per-month stipend: ($1,000 / Income) * $750. Vouchers shall not exceed $75 per month for individuals. The voucher shall be paid directly to the health insurer.
3. Federal Health Vouchers shall be made available for families with incomes below $32,000 who request them, to purchase a public or private health insurance plan, using the following formula to determine the per-month stipend: ($1,000 / Income) * $2,250. Vouchers shall not exceed $225 per month for families. The voucher shall be paid directly to the health insurer.

Sounds good.

4. All persons residing within the United States or its territories shall be required to have health insurance for themselves and all of their dependents. Failure to comply with this provision shall result in the offender and/or his or her dependents being retroactively registered for the US Green Plan. The offender’s wages may be garnished to pay back premiums.

Well what if you don't work? Wages can not be garnished in such cases yet person still automatically gets the Green Plan. We're clearly not going to jail folks for not carrying medical insurance so what's to stop all non-working folks from just refusing to pay for any medical plan with the knowledge that they'll automatically be enrolled in one anyway???

5. Foreigners in the United States on a temporary work visa or student visa, or foreigners who are in the United States for no more than three months, shall be automatically covered under the Green Plan unless they have health insurance of their own. It shall be illegal for foreigners to travel to the United States specifically to use the Green Plan.

Absolutely not. I foresee huge issues with this and stipulating that it is illegal for foreigners to travel here to use the Green Plan will do nothing to resolve the issues this would cause.

FEDERAL PLANS
6. The federal government shall offer the following health insurance plans to all US citizens and permanent residents,

and according to above any foreigners....

beginning on January 1, 2011:
a. Green Plan (Individual/Family) - $40/$120 Premium per Month. $2,000/$4,000 Annual Deductible. $6,000/$12,000 Annual Maximum. 60% of hospital services. 60% of newborn care. 80% of physician visits. 70% all other services. $100 co-pay for emergency care. $30 co-pay for urgent care. $20 co-pay for physician care.

This is incredibly close to my current plan that's combined with an HSA account. You don't mention HSA accounts anywhere. You should, they're a fantastic idea. Since the Green plan is the "automatic enrollment" plan and the one that is most likely going to be used to cover poor folks, foreigners, non-working peoples, etc the plan is virtually akin to having no insurance. With a $2000 ind and $4000 family deductible the plan will almost never be used. My family currently has a $3000 yearly deductible. We've never met it. Unless someone in the family is chronically ill or there is a catastrophe the people under the Green plan are going to be expected to just flat out cover most of their medical expenses out of pocket on top of paying their monthly premiums. Unless the government is going to reset dr. fees to make them incredibly low this ins. plan is akin to a poor person having NO insurance but being required by law to pay a monthly premium with forced enrollment.

11. The federal government hereby authorizes the Department of Health and Human Services to establish best methods and practices, including a National Health Database through which doctors may access patients’ medical records if the patient signs a release. No information from the National Health Database may ever be sold or made public, except with the consent of the patient. No information from the National Health Database shall ever be turned over to law enforcement, except with the consent of the patient or under court subpoena. Violators of this policy are subject to a $500,000 fine, up to six years in federal prison, and the permanent revocation of all medical licenses.

I'm not sure if I'm comfortable with a national database with all my medical info on it. Personally, right now, I view it as a non-issue for myself because I have no diseases or issues that I'd like to keep private. But what if I did? There's no way such databases would remain private. Especially in the cases of celebs, public figures, etc. You can only punish the person who released such info if you can find them. Imagine trying to figure out who leaked that Angelina Jolie is HIV + when all doctors have access to such a system.

PAYING FOR IT ALL
12. In Fiscal Year 2011, 20% of employer-paid health insurance premiums shall be taxed on the employee’s income and payroll taxes as ordinary income. In FY2012, 40%. In FY2013, 60%. In FY2014, 80%. In FY2015 and every year thereafter, 100% of employer-paid health insurance premiums shall be taxed on the employee’s income and payroll taxes as ordinary income.
13. In FY2012 and every year thereafter, all income over $3.5 million shall be taxed at a rate of 42%.
14. In FY2011 and every year thereafter, all out-of-pocket health expenses (excluding cosmetic surgery) and all health insurance premiums which are paid by the consumer and/or the consumer’s dependent shall be tax deductible.

I think the employer/employee/health coverage link should be broken. I'm in favor of no employer being allowed to offer health care plans. I don't insure my car through work, nor my house, why should my health ins be tied to my
workplace? The practice of large insurance companies offering cheap plans to huge corporations with 1000's of employees while completely refusing to offer anything even slightly decent and affordable to small businesses needs to stop, the sooner the better.

talloulou · Mar 17, 2009

WI Crippler said:
Breaking the tie between employment and insurance isn't going to bring costs down for individual plans. The price for an individual plan is not tied to the price of group health insurance. The price of the individual plan is the market price. The employer tie to health insurance does keep cost down for the employed individual, usually because the employer is paying part of the premium. If you added together the employer contribution and the individual contribution and compared it against an individual plan, the difference between a group plan and individual plan is not all that great. Especially for smaller businesses.

This is not true. There are better more affordable plans with cheaper premiums and deductibles offered to larger companies vs smaller ones. Small businesses with 3-5 employees are royally screwed. It makes sense. In most cases if you are buying 2000 of something vs 10 of something it's almost always cheaper to buy in bulk, no matter what the product. I get that. However that shouldn't apply to health insurance. There should be no such thing as "group" insurance. All individuals should be able to buy their own plans at a fair price. Tim shouldn't be paying 3X the cost for his employees because he only has 4 employees compared to other companies that have 350 employees. Get rid of all that nonsense. Break the tie between employer/employee/health insurance and the plans offered will be more fairly competitive and accessible for everyone.

WI Crippler · Mar 17, 2009

talloulou said:
This is not true. There are better more affordable plans with cheaper premiums and deductibles offered to larger companies vs smaller ones. Small businesses with 3-5 employees are royally screwed. It makes sense. In most cases if you are buying 2000 of something vs 10 of something it's almost always cheaper to buy in bulk, no matter what the product. I get that. However that shouldn't apply to health insurance. There should be no such thing as "group" insurance. All individuals should be able to buy their own plans at a fair price. Tim shouldn't be paying 3X the cost for his employees because he only has 4 employees compared to other companies that have 350 employees. Get rid of all that nonsense. Break the tie between employer/employee/health insurance and the plans offered will be more fairly competitive and accessible for everyone.

I don't think you understand what I was saying. The reason that large group plans are cheaper for the individuals participating in them, is because the employer pays a significantly larger portion of the "other" part of the premium, meaning their contribution to the health insurance is usually greater than what a small business could afford to do. Is there a difference in overall pricing as a group gets larger? Sure, but its really not that significant.

talloulou · Mar 17, 2009

WI Crippler said:
I don't think you understand what I was saying. The reason that large group plans are cheaper for the individuals participating in them, is because the employer pays a significantly larger portion of the "other" part of the premium, meaning their contribution to the health insurance is usually greater than what a small business could afford to do. Is there a difference in overall pricing as a group gets larger? Sure, but its really not that significant.

You're wrong. I know. My husband owns a small company. Most insurance companies offer plans based on how many employees are going to be covered. The fewer the employees the more ridiculous the plan prices.

It is very significant.

WI Crippler · Mar 17, 2009

talloulou said:
You're wrong. I know. My husband owns a small company. Most insurance companies offer plans based on how many employees are going to be covered. The fewer the employees the more ridiculous the plan prices.

It is very significant.

I'm right, I worked in insurance.

The prices for large groups are ridiculous as well. They can afford it.

DeeJayH · Mar 17, 2009

No retards I AM RIGHT

Kandahar's Universal Health Care Plan

What do you think of this Universal Health Care plan?

I would vote for it, as is, if I was in Congress

I oppose almost everything in it

It needs some changes in certain areas (specify)

More options

Kandahar

Enemy Combatant

Goobieman

WI Crippler

DarkWizard12

Sir Poop A lot

Scarecrow Akhbar

DeeJayH

TOJ

Kandahar

Enemy Combatant

WI Crippler

WillRockwell

DeeJayH

WI Crippler

American

Trump Grump Whisperer

WI Crippler

CaptainCourtesy

I'm a Jedi Master, Yo

Jerry

Jerry

Goobieman

Tucker Case

Matthew 16:3

talloulou

talloulou

WI Crippler

talloulou

WI Crippler

DeeJayH