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 14^th 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. __________________	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. ____________ 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. ____________________ See www.americanhealthcarereform.org ____________________ CONTACT US Healthcarenow@sbcglobal.net Last update November 21, 2009