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Healthcare reform needs to accomplish 4 goals:

1. Give universal hospitalization coverage to everyone in the U.S.
2. Reduce the cost of healthcare to businesses and government agency's
3. No freeloaders on the system, everyone has to pay into the system
4. Keep freedom of choice for everyone.

The U.S. spent approximately $713,000,000,000 in hospitalization cost in 2010, that cost equals $2200 for every person living in the U.S.,  I believe that everyone should pay into the hospitalization system.  It should be  a progressive tax system ( the poor pay less than the rich ) but since everyone benefits from our hospitals, everyone should contribute. 

Let's face it, we already have a national hospitalization benefit, no one gets turned away from our hospitals.  My suggestion is that we come up with a more fair way to pay for it.  Right now there is too much burden on our health insurance system from hospitalization.  We need to supplement the cost of the hospitalization benefit in our health insurance system and have a national hospital benefit that is fairly paid for by everyone in the US.

My solution is simple:

  The supplemented hospitalization benefit will be paid for by a combination of sales taxes, income taxes, and property taxes.  The tax breakdown will have to be decided on by the politicians.  I see it as a combination of a 3% to 5% sales tax on all goods and services and a higher tax rate on vice items (alcohol, tobacco products, etc..) and luxury items, in addition a national progressive property tax on properties over $1,000,000 and a progressive income tax on wages over $1,000,000.  These new taxes will be used to reduce the cost of all current health insurance sold in the US by giving everyone in the US a hospitalization voucher.  The voucher will have a monthly value of approximately $165 per month.  These vouches can be used to purchase a basic hospital benefit from a private insurance comany or it can be used toward the cost of a full health insurance plan through your employer or privately.  This voucher will be given to everyone in the U.S.  This system will have many advantages.

1.  Everyone will be covered immediately for hospitalization.  No more freeloaders, the national sales tax portion of the new tax collection system will encompass everyone( citizen or alien ).  The rest of the cost will be paid for through, progressive property taxes and progressive income taxes.  This will spread the cost of health insurance more fairly.
2.  Everyone will be paying toward the cost through a fair progressive tax system.   It will spread the cost fairly over the whole population.

3.  Major medical health insurance( doctor visits, tests, etc.. )  will remain private with the insurance companies.  Your current doctors will continue to be your doctors.
4.  Prescription benefit will remain private with the insurance companies.  You continue to get prescriptions at your pharmacy.
5.  Everyone who has private coverage will be able to keep the same insurance through your employer or privately.
6.  The cost of all health insurance premiums will decrease immediately by 30% or more.  The vouchers are used to reduce the cost of all current health insurance premiums.
7.  Goods and services can decrease in price, since businesses will be getting a major reduction in their health insurance costs.  US businesses will become more competitive internationally.
8. Businesses will be able to hire more workers since their health insurance cost will be much less expensive.
9.  All systems are currently in place for an immediate change to this system.
10. Government agency's struggling to stay solvent will have a large decrease in their health insurance costs.
11. Medicare beneficiaries will have an increase in their social security checks, since the part A medicare costs will now be paid for through a more fair tax system.
12.  When someone leaves a job their COBRA costs would be much lower.

I see many advantages to this plan.  There are probably even more that I'm not seeing yet. 

This would just be a starting point, we could lower the cost of health insurance further by implementing reforms:

1. The government needs to place price controls on the pharmaceutical companies. Under our current system the drug companies use our health insurance system as a crutch to sell their drugs at obsene profits.  No other country in the world allows this.  Our health insurance system is subsidizing the cost of drugs for the rest of the world.
2. Tort reform on malpractice to limit awards.
3. End of life treatment.  This is the toughest of all.  End of life treatment needs to be addressed, there needs to be dignity and caring.  Public insurance dollars should be used for positive treatment, not merely for life extension, with no quality of life.  The last 2 months of life account for 20% of our entire hospitalization bill.
4. Chronic disease management  accounts for 75% of our nations healthcare spending.  Here is where costs needs to be better managed.  I believe education maybe the best solution.  We need to teach everyone, from a very young age, how to lead a healthy lifestyle.  Ultimately, this is where our biggest savings can come from.  Our society needs a major adjustment in lifestyle,  I don't think it's right to use our healthcare system as a crutch to lead an unhealthy lifestyle,  it's not fair to the people who are trying to lead a healthy lifestyle. 

But these issues seem to be much more complicated and politically difficult to implement.

So this is my solution, let me know what you think.

Cliff Grekin

Posted 3:28 PM

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Bill Wenner said...
It may not be perfect but your thoughts sure make sense. Good thinking on your part. Lets hope it starts some thinking in WA.

Roger walker said...
The issue not addressed is cost of medical care. We need to bring hospital costs down. The Canada system covers hospitals and has gov clinics. Rich people have private insurance in Canada. Your plan will lead to a class system for medical care like Canada. People do not discuss how rich are covered in Canada. Medicare is not sustainable as set up so using that system is a non starter. It is about medical costs being high.
SUNDAY, NOVEMBER 20 2011 1:19 PM
Cliff Grekin said...
@ Roger, The cost of the hospitalization will be limited to re-imbursement rates of the medicare system, this will lower hospital costs. The hospitalization will be paid for in full with the new sales tax system, the government will set up the sales taxes to cover the cost of all hospitalization making it sustainable indefinitely. The rest of the healthcare system will be much less expensive since the weight of hospitalization will be removed from it.
SUNDAY, NOVEMBER 20 2011 2:14 PM
John Spek said...
Two other factors

There are 10s of millions of state union, federal union, and private union workers who have better and more widely accepted insurance than Medicare.

In addition, there are another 20 - 30 million who are retiring or have retired with those promised benefits.
How will you get them to give up prime coverage and have them accept the downgrade to medicare

How will you get all of them to accept a cut in the benefits they are entitled to under contract and under existing law?

Medicare does not cover all of the medical costs
Even adding a supplement plan and part D, the insurance is incomplete

If you research Medicare and what it does and does not cover, you will see the large gap

How do you cover all of the nursing, and home costs that medicare does not touch?
MONDAY, NOVEMBER 21 2011 9:44 AM
Cliff Grekin said...
I am not replacing our healthcare system, I am only nationalizing the medicare hospitalization benefit. Everyone keeps their current health insurance benefits. The difference by reducing most of the weight of hospitalization, the cost of health insurance for major medical and prescriptions is reduced greatly.
MONDAY, NOVEMBER 21 2011 9:59 AM
Chris Chiarenza said...
I like your plan. I only hope the powers-that-be adopt it (or a variation of it), so we can solve some of the problems that plague this country. And small companies can afford to offer quality health insurance to their employees - and brokers can sustain their income. Thanks.
FRIDAY, MARCH 02 2012 7:43 AM

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