A healthcare plan for you to comment on

[chefnerd]

With all the health care rhetoric the last few years, much of it vitriolic in nature, I thought it would be interesting to post this proposal I found. It is an actual proposal which was made and yes I can supply the link later on. It was also cut and paste so that I could remove references to dates and certain dollar amounts as well as get rid of the intro and summary parts
I thought I would put this out here for folks to comment/dogpile on and for entertainments sake see if anyone can state the source of it. So, have at it.


The plan is organized around seven principles:



First, it offers every American an opportunity to obtain a balanced, comprehensive range of health insurance benefits;



Second, it will cost no American more than he can afford to pay;


Third, it builds on the strength and diversity of our existing public and private systems of health financing and harmonizes them into an overall system;



Fourth, it uses public funds only where needed and requires no new Federal taxes;



Fifth, it would maintain freedom of choice by patients and ensure that doctors work for their patient, not for the Federal Government.



Sixth, it encourages more effective use of our health care resources; 



And finally, it is organized so that all parties would have a direct stake in making the system work--consumer, provider, insurer, State governments and the Federal Government. 



Upon adoption of appropriate Federal and State legislation, the Comprehensive Health Insurance Plan would offer to every American the same broad and balanced health protection through one of three major programs:



--Employee Health Insurance, covering most Americans and offered at their place of employment, with the cost to be shared by the employer and employee on a basis which would prevent excessive burdens on either;



--Assisted Health Insurance, covering low-income persons, and persons who would be ineligible for the other two programs, with Federal and State government paying those costs beyond the means of the individual who is insured; and,



--An improved Medicare Plan, covering those 65 and over and offered through a Medicare system that is modified to include additional, needed benefits.


One of these three plans would be available to every American, but for everyone, participation in the program would be voluntary.


The benefits offered by the three plans would be identical for all Americans, regardless of age or income. Benefits would be provided for:

--hospital care; 

--physicians' care in and out of the hospital; 

--prescription and life-saving drugs; 

--laboratory tests and X-rays;

--medical devices; 

--ambulance services; and,

--other ancillary health care. 



There would be no exclusions of coverage based on the nature of the illness. For example, a person with heart disease would qualify for benefits as would a person with kidney disease. 

In addition, CHIP would cover treatment for mental illness, alcoholism and drug addiction, whether that treatment were provided in hospitals and physicians' offices or in community based settings.


Certain nursing home services and other convalescent services would also be covered. For example, home health services would be covered so that long and costly stays in nursing homes could be averted where possible. 



The health needs of children would come in for special attention, since many conditions, if detected in childhood, can be prevented from causing lifelong disability and learning handicaps.
Included in these services for children would be:

--preventive care up to age six; 

--eye examinations; 

--hearing examinations; and, 

--regular dental care up to age 13.



Under the Comprehensive Health Insurance Plan, a doctor's decisions could be based on the health care needs of his patients, not on health insurance coverage. This difference is essential for quality care. 

Every American participating in the program would be insured for catastrophic illnesses that can eat away savings and plunge individuals and families into hopeless debt for years.
No family would ever have annual out-of-pocket expenses for covered health services in excess of $1,500, and low-income families would face substantially smaller expenses. 

As part of this program, every American who participates in the program would receive a Health-card when the plan goes into effect in his State. This card, similar to a credit card, would be honored by hospitals, nursing homes, emergency rooms, doctors, and clinics across the country. This card could also be used to identify information on blood type and .sensitivity to particular drugs-information which might be important in an emergency. 

Bills for the services paid for with the Health-card would be sent to the insurance carrier who would reimburse the provider of the care for covered services, then bill the patient for his share, if any.


Every employer would be required to offer all full-time employees the Comprehensive Health Insurance Plan. Additional benefits could then be added by mutual agreement. The insurance plan would be jointly financed, with employers paying 65 percent of the premium for the first three years of the plan, and 75 percent thereafter. Employees would pay the balance of the premiums. Temporary Federal subsidies would be used to ease the initial burden on employers who face significant cost increases. 

Individuals covered by the plan would pay the first $150 in annual medical expenses. A separate $50 deductible provision would apply for out-patient drugs. There would be a maximum of three medical deductibles per family. 

After satisfying this deductible limit, an enrollee would then pay for 25 percent of additional bills. However, $1,500 per year would be the absolute dollar limit on any family's medical expenses for covered services in any one year. 


As an interim measure, the Medicaid program would be continued to meet certain needs, primarily long-term institutional care. I do not consider our current approach to long-term care desirable because it can lead to overemphasis on institutional as opposed to home care. The Secretary of Health, Education, and Welfare has undertaken a thorough study of the appropriate institutional services which should be included in health insurance and other programs and will report his findings to me. 



The Medicare program now provides medical protection for over 23 million older Americans. Medicare, however, does not cover outpatient drugs, nor does it limit total out-of-pocket costs. It is still possible for an elderly person to be financially devastated by a lengthy illness even with Medicare coverage. 
I therefore propose that Medicare's benefits be improved so that Medicare would provide the same benefits offered to other Americans under Employee Health Insurance and Assisted Health Insurance. 

Any person 65 or over, eligible to receive Medicare payments, would ordinarily, under my modified Medicare plan, pay the first $100 for care received during a year, and the first $50 toward outpatient drugs. He or she would also pay 20 percent of any bills above the deductible limit. But in no case would any Medicare beneficiary have to pay more than $750 in out-of-pocket costs. The premiums and cost sharing for those with low incomes would be reduced, with public funds making up the difference. 

The current program of Medicare for the disabled would be replaced. Those now in the Medicare for the disabled plan would be eligible for Assisted Health Insurance, which would provide better coverage for those with high medical costs and low incomes. 

Premiums for most people under the new Medicare program would be roughly equal to that which is now payable under Part B of Medicare--the Supplementary Medical Insurance program. 

The program of Assisted Health Insurance is designed to cover everyone not offered coverage under Employee Health Insurance or Medicare, including the unemployed, the disabled, the self-employed, and those with low incomes. In addition, persons with higher incomes could also obtain Assisted Health Insurance if they cannot otherwise get coverage at reasonable rates. Included in this latter group might be persons whose health status or type of work puts them in high-risk insurance categories. 

Assisted Health Insurance would thus fill many of the gaps in our present health insurance system and would ensure that for the first time in our Nation's history, all Americans would have financial access to health protection regardless of income or circumstances. 

A principal feature of Assisted Health Insurance is that it relates premiums and out-of-pocket expenses to the income of the person or family enrolled. Deductibles, co-insurance, and maximum liability would all be pegged to income levels. 

Assisted Health Insurance would replace State-run Medicaid for most services. Unlike Medicaid, where benefits vary in each State, this plan would establish uniform benefit and eligibility standards for all low-income persons. It would also eliminate artificial barriers to enrollment or access to health care.

These proposals include:



1. HEALTH MAINTENANCE ORGANIZATIONS (HMO'S) 



HMO's have proved an effective means for delivering health care and the CHIP plan requires that they be offered as an option for the individual and the family as soon as they become available. This would encourage more freedom of choice for both patients and providers, while fostering diversity in our medical care delivery system.



2. PROFESSIONAL STANDARDS REVIEW ORGANIZATIONS (PSRO'S) 



Place health services provided under CHIP under the review of Professional Standards Review Organizations. These PSRO's would be charged with maintaining high standards of care and reducing needless hospitalization. Operated 'by groups of private physicians, professional review organizations can do much to ensure quality care while helping to bring about significant savings in health costs. 



3. MORE BALANCED GROWTH IN HEALTH FACILITIES 



Another provision of this legislation would call on the States to review building plans for hospitals, nursing homes and other health facilities. Existing health insurance has overemphasized the placement of patients in hospitals and nursing homes. Under this artificial stimulus, institutions have felt impelled to keep adding bed space.



4. STATE ROLE 



The States would review the operation of health insurance carriers within their jurisdiction. The States would approve specific plans, oversee rates, ensure adequate disclosure, require an annual audit and take other appropriate measures. For health care providers, the States would assure fair reimbursement for physician services, drugs and institutional services, including a prospective reimbursement system for hospitals. 

A number of States have shown that an effective job can be done in containing costs. Under my proposal all States would have an incentive to do the same. Only with effective cost control measures can States ensure that the citizens receive the increased health care they need and at rates they can afford. Failure on the part of States to enact the necessary authorities would prevent them from receiving any Federal support of their State-administered health assistance plan. 



MAINTAINING A PRIVATE ENTERPRISE APPROACH 



This proposal would rely extensively on private insurers. 

Any insurance company which could offer those benefits would be a potential supplier. Because private employers would have to provide certain basic benefits to their employees, they would have an incentive to seek out the best insurance company proposals and insurance companies would have an incentive to offer their plans at the lowest possible prices. If, on the other hand, the Government were to act as the insurer, there would be no competition and little incentive to hold down costs. 

There is a huge reservoir of talent and skill in administering and designing health plans within the private sector. That pool of talent should be put to work. 

It is also important to understand that the CHIP plan preserves basic freedoms for both the patient and doctor. The patient would continue to have a freedom of choice between doctors. The doctors would continue to work for their patients, not the Federal Government. By contrast, some of the national health plans that have been proposed in the Congress would place the entire health system under the heavy hand of the Federal Government, would add considerably to our tax burdens, and would threaten to destroy the entire system of medical care that has been so carefully built in America. 

We should capitalize on the skills and facilities already in place, not replace them and start from scratch with a huge Federal bureaucracy to add to the ones we already have.



COMPREHENSIVE HEALTH INSURANCE PLAN--A PARTNERSHIP EFFORT 



No program will work unless people want it to work. Everyone must have a stake in the process. 

This Comprehensive Health Insurance Plan has been designed so that everyone involved would have both a stake in making it work and a role to play in the process consumer, provider, health insurance carrier, the States and the Federal Government. It is a partnership program in every sense. 

By sharing costs, consumers would have a direct economic stake in choosing and using their community's health resources wisely and prudently. They would be assisted by requirements that physicians and other providers of care make available to patients full information on fees, hours of operation and other matters affecting the qualifications of providers. But they would not have to go it alone either: doctors, hospitals and other providers of care would also have a direct stake in making the Comprehensive Health Insurance Plan work. This program has been designed to relieve them of much of the red tape, confusion and delays in reimbursement that plague them under the bewildering assortment of public and private financing systems that now exist. Health-cards would relieve them of troublesome bookkeeping. Hospitals could be hospitals, not bill collecting agencies.


[Whirlaway]

I prefer this 4 step healthcare program:


Government help with tax credits and vouchers, however, primarily privatization with the following:

1. Eliminate all licensing requirements for medical schools, hospitals, pharmacies, and medical doctors and other health care personnel. Their supply would almost instantly increase, prices would fall, and a greater variety of health care services would appear on the market.

Competing voluntary accreditation agencies would take the place of compulsory government licensing--if health care providers believe that such accreditation would enhance their own reputation, and that their consumers care about reputation, and are willing to pay for it.

Because consumers would no longer be duped into believing that there is such a thing as a "national standard" of health care, they will increase their search costs and make more discriminating health care choices.

2. Eliminate all government restrictions on the production and sale of pharmaceutical products and medical devices. This means no more Food and Drug Administration, which presently hinders innovation and increases costs.

Costs and prices would fall, and a wider variety of better products would reach the market sooner. The market would force consumers to act in accordance with their own--rather than the government's--risk assessment. And competing drug and device manufacturers and sellers, to safeguard against product liability suits as much as to attract customers, would provide increasingly better product descriptions and guarantees.

3. Deregulate the health insurance industry. Private enterprise can offer insurance against events over whose outcome the insured possesses no control. One cannot insure oneself against suicide or bankruptcy, for example, because it is in one's own hands to bring these events about.

Because a person's health, or lack of it, lies increasingly within his own control, many, if not most health risks, are actually uninsurable. "Insurance" against risks whose likelihood an individual can systematically influence falls within that person's own responsibility.

All insurance, moreover, involves the pooling of individual risks. It implies that insurers pay more to some and less to others. But no one knows in advance, and with certainty, who the "winners" and "losers" will be. "Winners" and "losers" are distributed randomly, and the resulting income redistribution is unsystematic. If "winners" or "losers" could be systematically predicted, "losers" would not want to pool their risk with "winners," but with other "losers," because this would lower their insurance costs. I would not want to pool my personal accident risks with those of professional football players, for instance, but exclusively with those of people in circumstances similar to my own, at lower costs.

Because of legal restrictions on the health insurers' right of refusal--to exclude any individual risk as uninsurable--the present health-insurance system is only partly concerned with insurance. The industry cannot discriminate freely among different groups' risks.

As a result, health insurers cover a multitude of uninnsurable risks, alongside, and pooled with, genuine insurance risks. They do not discriminate among various groups of people which pose significantly different insurance risks. The industry thus runs a system of income redistribution--benefiting irresponsible actors and high-risk groups at the expense of responsible individuals and low risk groups. Accordingly the industry's prices are high and ballooning.

To deregulate the industry means to restore it to unrestricted freedom of contract: to allow a health insurer to offer any contract whatsoever, to include or exclude any risk, and to discriminate among any groups of individuals. Uninsurable risks would lose coverage, the variety of insurance policies for the remaining coverage would increase, and price differentials would reflect genuine insurance risks. On average, prices would drastically fall. And the reform would restore individual responsibility in health care.

4. Eliminate all subsidies to the sick or unhealthy. Subsidies create more of whatever is being subsidized. Subsidies for the ill and diseased breed illness and disease, and promote carelessness, indigence, and dependency. If we eliminate them, we would strengthen the will to live healthy lives and to work for a living. In the first instance, that means abolishing Medicare and Medicaid.

Only these four steps, although drastic, will restore a fully free market in medical provision. Until they are adopted, the industry will have serious problems, and so will we, its consumers.

[CJ7]

free market healthcare has priced itself out of the market ...

people without health care now, will ultimately cost the government more $$ longterm than people that have healthcare and see Dr's to prevent/protect themselves from future illness ...


pay now or pay later ...

[Whirlaway]

News flash CJ; we don't have free market healthcare now....the feds have had their hand in the system for decades, and they have fucked the markets up.

[Sidewinder]

chefnerd, maybe I'm crazy, but that sounds a lot like Hillarycare, from the first year or so of the Clinton Administration.

[chefnerd]

Not surprising that it looks like it. Hillarycare, like Romneycare and Obamacare have a good deal of similarities with Nixoncare, which is what I posted here from his 1974 message to Congress.

http://www.kaiserhealthnews.org/stor...-proposal.aspx

[Laz]

Originally Posted by Whirlaway

News flash CJ; we don't have free market healthcare now....the feds have had their hand in the system for decades, and they have fucked the markets up.

This is the core of the current problem. Health care is NOT currently a free market system. The two categories of health care that I can think of where it is a free market system, corrective eye surgery and cosmetic enhancements, have both had quality improvements and cost reductions. To fix the system we must make health care a free market system using high deductible policies with health care savings accounts.

For the poor who can't even afford that the local communities can set up free clinics or other methods of providing health care to the indigent. There are a bunch of ways this can be done. However, I would not even offer the poor free care. For those capable I would require some type of work to pay for their care.

[CuteOldGuy]

Isn't it amazing how reasonable Nixon's radical plan appears when compared to Obamacare?

[CJ7]

Originally Posted by CuteOldGuy

Isn't it amazing how reasonable Nixon's radical plan appears when compared to Obamacare?

yup, and if we dont take full advantage of this healthcare law now, in 30 years a new law will be just as complicated when compared to this one ...

[CuteOldGuy]

There is nothing in the Obamacare bill that will improve either the quality of or access to health care. Quit fooling yourself. We need to get rid of it. Dammit, CBJ7, read something!

[CJ7]

Originally Posted by CuteOldGuy

There is nothing in the Obamacare bill that will improve either the quality of or access to health care. Quit fooling yourself. We need to get rid of it. Dammit, CBJ7, read something!

I have read something .. its a law.

and the law needs to be tweaked and fine tuned by nonpartisan actions as it evolves so it does improve the quality and access of healthcare.

anything less, and we're back to the nixon era.

[CuteOldGuy]

Ok. This is what's wrong with the current education system. We have to always teach to the lowest performing student. I'm not doing that anymore with you, CBJ7. You can either learn something, or stay ignorant. This has been discussed ad nauseam in other threads. Pay attention. Listen to the grown ups talk, and maybe you'll learn something.

[CJ7]

backhanded insults suit you well