A practical solution for America’s healthcare spending  crisis

Replace Medicaid, Medicare, and Veterans Affairs with a

Federal Healthcare Insurance Agency (FHIA)

 

Rapidly increasing healthcare costs have created a spending crisis. Most notably, the incredibly compli­cated public-private insur­ance mar­kets burned through $2.4 trillion in 2008. That is unacceptable. What can be done to manage healthcare costs and bring down spending?

 

    Replace Medicaid, Medicare, and Veterans Affairs with a Federal Healthcare Insurance Agency (FHIA):

·   An independ­ent agency of the executive branch of the United States paid for by a em­ployer/em­ployee payroll tax (for Agency details see Creating a Federal Healthcare Insurance Agency).

·   It would not own or oper­ate health­care facili­ties, employ health­care pro­fes­sionals, or make medical care deci­sions.

·   All health­care, pre­scrip­tion drugs, dental and vi­sion care would be delivered by existing pri­vate, non-govern­ment busi­nesses compet­ing “for profit.”

·  A not for profit single-payer FHIA would pay for the health­care of any person in the United States regardless of age, citi­zen­ship, employment, ethnic origin, health, mili­tary service, race, or religion. For­eign nationals’ care could be billed to their home coun­try.

·  Individual care costs contained by an annual deductible and life time cap.

·  This FHIA would not directly replace or prevent private healthcare insurance.

  Pri­vate health­care insur­ance, Medi­caid, Medi­care, and Veter­ans Af­fairs operate inde­pendent of each other — they do not operate as a system. A brief review of the four health­care markets illus­trates the need for a system organization:

1. The more than 1,000 pri­vate healthcare insurance cartel spend 25 percent of all U.S. health­care dollars on administra­tive over­head, execu­tive sala­ries, adver­tis­ing, and profit. Regulated state-by-state, they cherry pick the popu­la­tion for healthy peo­ple, thus subvert­ing the com­mon “spread the risk” insur­ance objec­tive. Some­one with a pre­exist­ing condi­tion earn­ing $60,000 annu­ally can’t get health­care insur­ance at any price, while a family of four with an an­nual in­come of $40,000 can’t af­ford $800-$900 per month for insur­ance. Nei­ther example would qual­ify for Medi­caid.

2. Medicaid is means tested; only the indigent get help. Man­aged by the states and funded with federal and compro­mised state gen­eral tax reve­nue.

3. Medi­care, managed by private insurance companies, in­sures citi­zens that are likely to need ex­pen­sive care — those over 65 or dis­abled. Part A cov­ers hos­pitaliza­tion, and for $96.40 per month, part B pays for 80 per­cent of most other health­care costs. Part C, branded Ad­van­tage, pays private insur­ance HMO/PPOs more than $800 per month to care for Medi­care re­cipi­ents. For an ad­ditional pre­mium set by insur­ance compa­nies, part D, re­cently created and controlled by the phar­maceutical industry, subsi­dizes prescription drugs. Without hearing or vision care, the Medicare trust, funded by an employer/employee 2.9 per­cent payroll tax, will be in defi­cit by 2017.

4. Veter­ans Af­fairs, socialized medicine administered by political ap­point­ees with fund­ing subject to the whim of Con­gres­sional spend­ing, owns and staffs more than 1200 clinics, hos­pitals, medi­cal cen­ters, and long-term health­care facili­ties. With an $87 bil­lion budget, all vet­erans should have ac­cess to the best healthcare with­out re­gard to their military ser­vice or ability to pay. But only veter­ans with ser­vice connected medical needs qual­ify for VA care, and, for all but the desti­tute, a co­pay is re­quired. Com­plaints of poor care and substandard facili­ties are com­mon. The VA is classic social­ized medicine.

    In view of the U.S. Con­stitu­tion’s 14th amendment “equal pro­tection” clause, is it reasonable for the pub­lic-private markets to re­strict care based on: age, health, in­come, mili­tary ser­vice, or resi­dency?

Universal not-for-profit insurance offers everyone in America healthcare access with sub­stan­tial cost sav­ings: (a) No state-by-state regu­lation ex­penses, (b) a con­trolled execu­tive sala­ry struc­ture, (c) no adver­tis­ing or profit, (d) reduced healthcare pro­vider opera­tional over­head, (e) elimi­nates em­ployer healthcare insurance costs, and (f) spreading the risk over Amer­ica’s age diverse population would radically reduce individual cost un­derwriting.

    All American healthcare consum­ers, hospitals, doc­tors, seniors, veter­ans, and espe­cially employers have a vested inter­est in pro­moting an FHIA, a practical solution for insuring everyone at an affordable cost without mandates or socialized medicine.

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Creating a

Federal Healthcare

Insurance Agency *

1.       Congress enacts and the President signs law creating a Federal Healthcare Insurance Agency, an independent establishment of the executive branch of the United States (the 1971 United States Postal Service model).

2.       The President appoints a Board of Governors to be confirmed by the U.S. Senate.

3.       The new board appoints a CEO.

4.       A new Congressional oversight committee oversees the Agency budget and operations.

5.       All Medicare assets and employees are transferred to the new Agency whereas all VA assets are sold or closed.

6.       A sufficient payroll income tax, split between employee and employer, replacing the current Medicare tax is commenced.

7.       Self employed persons pay quarterly.

8.       All local, state, and Federal government agencies would participate and adjust budgets to account for the Agency’s takeover of healthcare.

9.       Healthcare providers supply application forms for obtaining required picture ID cards, which could include an embedded memory of the applicant’s medical history.

10.     Healthcare providers bill client/customers/patient services to Agency regional centers via electronic terminals provided and serviced by the Agency.

11.     Within thirty calendar days, all healthcare recipients receive a paper invoice itemizing service and a block-print statement offering a reward for fraud disclosure.

12.     Within ninety calendar days, all healthcare providers are paid via wire transfer to a bank account.

13.     All foreign national healthcare services are billed to their home countries quarterly; USAID and trade agreements are attached and published on the internet, for those countries that don’t pay their bill.

14.     Total foreign country-by-country bill is also published on the internet as well as the national media.

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U.S. Constitution

(Amendment XIV, Section I)

All persons born or naturalized in the United States and subject the jurisdiction thereof are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of neither the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law, nor deny to any person within its jurisdiction the equal protection of the laws (emphasis added).

* For a comprehensive review of the world’s single-payer healthcare systems read The Healing of America by T. R. Reid.

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See www.americanhealthcarereform.org

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CONTACT US

Healthcarenow@sbcglobal.net

 

 

 

Last update November 21, 2009