|
Well, somebody already has. Actually, two somebodies.
In the June issue of the excellent magazine "Washington Monthly," two health experts -- Dr. Ezekiel Emanuel, an author and cancer physician, and Victor R. Fuchs, a Stanford University professor emeritus of economics -- describe their proposed Universal Healthcare Vouchers, or UHVs. As they maintain in their article, their idea might just "achieve goals long sought by both sides of the political divide: the progressive dream of universal coverage and the conservative values of free choice and efficiency."
The plan?
Every American household would receive a government voucher "entitling its members to enroll in a private health plan of their choice." The current private health insurance carriers and any new ones would by law have to guarantee coverage for doctor visits, hospitalization, pharmaceutical medicines, emergencies and catastrophic coverage.
Those with pre-existing conditions and higher expected costs would be covered by adjusting reimbursement values of the vouchers to the differing risk levels the insurance companies absorb. Thus, for covering older and sicker patients, the insurance company would receive a higher payment -- eliminating the current incentive to exclude high-risk patients.
Medicare would be replaced, or more accurately, phased out. Senior citizens currently enrolled in Medicare would see no change, but there would be no new enrollees. Americans who turn 65 will simply keep their voucher-paid coverage. Medicare, its hideous payroll tax that financed it, and, as the authors call it, its "calamitous fiscal future," would over time be completely replaced by the voucher system.
Because every American would be covered regardless of income, Medicaid and its terrible burden upon states and localities would also be eliminated.
Private doctors would, like today, choose to accept or reject different insurance plans. But they would avoid the massive paperwork and fighting with bureaucracies that causes many to retire early.
Doctors and hospitals would no longer have to absorb, and pass on to insured folks, the cost of "charity care" for uninsured patients who lack payment means.
"Frills" coverage, such as for Viagra and cosmetic surgery -- the source of unending debate in localities and legislatures -- would not be provided under the UHV plan; you'd have to pay for these non-essentials on your own.
The workplace would be reformed. You could switch jobs, be your own boss, go to part-time work or any combination of the above without fear of losing your health coverage.
Employers would be free to hire workers without figuring in the health insurance costs, thus improving the economy.
A new Federal Health Board would administer the system. It would be modeled after the Federal Reserve Board, with regional sub-boards.
The voucher system would be paid for by a Value Added Tax, which would probably increase the cost of your new car by eight percent, but would spread the tax burden broadly and encourage savings. VATs are much harder for the affluent to evade than income taxes. Most Americans would be paying about the same for health care coverage.
But all Americans would have it, and your paycheck would be bigger. The authors say the cost of extending coverage to all 250 million Americans under 65 would be about $713 billion. The current cost to employers and the government on health insurance is about $800 billion, and the system leaves 45 million Americans without any coverage at all. As the fella says, a billion here and a billion there, and it adds up to real money.
|
|
