What if All Americans Had at Least Catastrophic Health Care Coverage

I really dislike the term healthcare reform.  I think our system needs to be changed not reformed.  I assume that I am not the only person who suspects that the recent health care reform act is not going to be the final solution for America’s health care problems.  The cost of healthcare is not really addressed at all, and even if it works better than expected some Americans will not have even catastrophic health care coverage.

This post is really just my first shot at  suggesting a way I think makes sense to address the problem of the large number of uninsured people in America, while at the same time leaving lots of choice and personal responsibility that seems to be needed and a part of the American culture.  I am certain that I have not thought through all of the gritty details, and really don’t profess to have the talent or knowledge to write legislation, but I think this basic tenant might be a starting point.  First my assumptions:

  1.  The biggest issue facing Americans who are uninsured is the possibility of personal financial ruin from a major medical condition.
  2. Americans want personal choice in choosing a medical plan and providers.
  3. American corporations are at a global disadvantage in having to pay for expensive health insurance plans that put their cost of producing goods and services higher than in countries with governmental health insurance.
  4. If American’s were more responsible for their health care costs, it is likely that they would take a greater responsibility for how their dollars are spent on healthcare than if they are spending other people’s money.

Next the basic elements of a solution:

  1. The federal government provides every American with a catastrophic coverage medical plan.  This would be a very high deductible plan to cover expenses over a chosen amount, say $5000./ family per year. (this number could be different, depending on actuarial and legislative input)  This would be paid for by a national tax of some sort, maybe a combination of a corporate payroll tax and health coverage value added tax, or other individual tax.
  2. Individuals and employers could choose to purchase supplemental coverage for themselves or their employers beyond this catastrophic coverage.  Most Americans would want to at least purchase access to a PPO type of network to access discounted fees negotiated between providers of services and insurance plans, much like PPO fees now.  They could also choose to contribute to a HSA account to save/pay towards the deductible or to a supplemental plan to cover some or most of the deductible expenses. There would be no mandated services to be covered in these supplemental plans.  Individuals could choose what services they want to have insured.  This would allow insurance companies to offer plans tailored to the desires and needs of individuals, not the current every willing provider, cover everything for everyone that the many current mandates dictate.  If we ar ready for really big change, this could be for all Americans, and our less affluent elderly and our poor could have some sort of assistance in purchasing supplemental insurance to replace Medicare and Medicaid. 

That’s pretty much it.  Everyone would have catastrophic national health coverage to prevent most Americans from facing the risk of financial ruin from an accident, injury, or illness.  We could all choose to purchase whatever other coverage meets our needs on a open market, without regulated mandatory coverage of any services we might choose not to purchase.

I’m hoping to have this topic be an ongoing forum for discussion.  Comments, better ideas, suggestions for major problems I’ve neglected to address, and the expected outrage that this idea is a step toward socialism, fascism, or some other ism is welcome.  Make comments and join the dialogue.

5 Responses to What if All Americans Had at Least Catastrophic Health Care Coverage

  1. I like it. I think it would work. It is one of the best ideas I have heard. Thank you.

  2. I always hear about how small businesses are where jobs come from. Lack of universal access to health care is a major deterrent to folks starting those new businesses. I know all kinds of people that stay in their corporate or government jobs just to keep their health care coverage.

    When folks quit those jobs two things happen – there is an immediate job opening to replace them, plus new jobs are created when they start businesses.

    I predict the objection to universal health care is not based upon its merits, rather the fear of wage inflation caused by people fleeing their unhappy corporate jobs for life-fulfilling pursuits.

  3. The devil is always in the details. Some way to assign a degree of personal responsibility for spending the health care dollar, and addressing the social needs of all in our society is a difficult balance, but at this time the balance is way off.

  4. Ed,

    That is a great start.
    The most difficult problem I see is that the poor would not be covered by the plan and would still seek care only on an emergency basis. How do we cover that?
    Also, because end of life care is often the most expensive, at some point we will have to make a choice on how to address that issue

  5. Thanks Ed! I agree that Americans want choices. One of the biggest problems is that thy want the choice to “self insure” and not have insurance thereby relying on the rest of us to take care of them in case something happens.

    I think that workable reform has to include fair reimbursement for providers.

    I like lyour idea of mandating a basic high deductable plan.

    Thanks for your ideas, Randy

Leave a reply