A practical solution for America’s healthcare crisis
A crisis created by a fragmented public-private insurance industry
A SOLUTION An outline for 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 President appoints a Board of Governors to be confirmed by the U.S. Senate. The Board appoints a CEO. 2. A new Congressional oversight committee oversees the Agency budget and operations. All Medicare assets and employees are transferred to the new Agency whereas all VA assets are sold or closed. 3. A sufficient flat rate payroll income tax, split between employee and employer, replacing the current Medicare tax is commenced. Self employed persons pay quarterly. All local, state, and Federal government agencies would participate and adjust budgets to account for the Agency’s takeover of healthcare. 4. Healthcare providers supply application forms for obtaining required picture ID cards. Healthcare providers bill client/customer/patient services to Agency regional centers via electronic terminals provided and serviced by the Agency. 5. Within thirty calendar days, all healthcare recipients receive a paper invoice itemizing service and a block-print statement offering a reward for fraud disclosure. Within ninety calendar days, all healthcare providers are paid via wire transfer to a bank. 6. 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. Total foreign country-by-country billing is also published on the internet as well as the national media. ___________ U.S. Constitution Amendment XIV, Section 1 (Ratified July 9, 1869) All persons born or naturalized in the United States and subject to 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 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) ____________________ Contact us: Healthcarenow@sbcglobal.net ____________________ Write to us: RWB P.O. BOX 2964 ORANGE CA 92869 ____________________ see www.americanhealthcarereform.org Last update April 8, 2009	____________________________ America, gifted with a wealth of expert healthcare givers, and arguably the world’s best medical equipment and facilities, is bogged down in a healthcare spending crisis. The fragmented public-private insurance industry spent more than $2.4 trillion, an unsustainable 16% of the gross national product, on 2008 healthcare. That is a deep hole in the economy. The old saw “when you find yourself in a deep hole, quit digging” applies here. To get out of the financial hole, we must understand America’s public private healthcare dilemma. ____________________________ · MEDICARE: Established in 1965, Medicare Parts A and B were designed to provide hospital and doctor care for all U.S. citizens over 65 years of age. In 1972 it was extended to cover the disabled of any age, and one year later, Part C, branded Advantage, was added to pay HMOs an overly generous monthly premium to take care of Medicare recipients. Effective in 2006, drug company invented and controlled, Part D was created to subsidize prescription drugs. To date, hearing and vision aren’t covered. An insufficient flat rate payroll tax and a modest monthly member premium theoretically funds the Medicare Trust, but most experts predict the Trust will be broke by 2016. Part of the high cost of Medicare is caused by only insuring the disabled and elderly. · MEDICAid: Managed by the states and funded with federal and compromised state general tax revenue, Medicaid is not part of Medicare. Created for those low income families that can’t afford private insurance, Medicaid (Medical in California) is means tested, that is, anyone looking for Medicaid help must submit an indigent statement. · veterans affairs: Administered by political appointees and subject to the whim of Congressional spending bills, Veterans Affairs owns and operates 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 co-pay is required. Complaints of poor care are common. · HEALTHCARE INDUSTRY: The profit motivated private retail healthcare insurance industry, dominated by just a few well-healed companies, spends 25% of all U.S. healthcare dollars on administrative overhead, executive salaries, and profit. They cherry pick the population for healthy people (Medicare in reverse), thus subverting the common “spread the risk” insurance objective. A single mother with treatable liver disease earning $60,000 annually can’t get healthcare insurance at any price, while a family of four with an annual income of $40,000 from a business that does not provide healthcare insurance, can’t afford $800-$900 per month for insurance. Neither example would qualify for Medicaid. Profit motivated individual retail healthcare insurance is not affordable. · UNEQUAL: Medicare, Medicaid, Veterans Affairs, and private retail healthcare insurance are incompatible with the U.S. Constitution’s 14^th amendment that provides in part: “No state shall . . . deny to any person within its jurisdiction the equal protection of the laws” (emphasis added). Each organization restricts benefits based on one or all of the following: age, health, income, military service, or residency. Hidden in plain sight, the federal government, through the IRS, unfairly subsidizes employer paid healthcare by exempting employer contributions from taxation as income. · a SOLUTION: Short of mandates or socialized medicine, there is a practical solution for insuring everyone at an affordable cost — replace Medicare, Medicaid, Veterans Affairs, and profit motivated private retail healthcare insurance with a Federal Healthcare Insurance Agency (FHIA), an independent agency of the executive branch of the United States. FHIA, paid for by a payroll tax split between employee and employer, and cost contained by a small deductible coupled with a life time limit on charges for care, 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 single-payer FHIA would pay for the healthcare of any person in the United States regardless of age, citizenship, ethnic origin, health, military service, race, or religion. Foreign nationals’ care could be billed to their home country. BACK TO TOP · REPLACING: Replacing America’s fragmented public-private healthcare establishment will require a large staff of accountants, administrators, consulting medical doctors, investigators, lawyers, and technicians. FHIA will be expensive; however, based on common sense cost assumptions, an FHIA administration would be a financially superior alternative to the exceedingly expensive, grossly inefficient, unequal healthcare we are paying for now. · WHO SHOULD CARE: All American healthcare consumers, for-profit hospitals and doctors, seniors, veterans, and especially employers have a vested interest in FHIA.