Government to mandate a single price at Medicare rate for all medical services. This rate applies to cash payment at time of service as well as insurance payment. Other services e.g. private room, premium food, entertainment would not be covered.
Providers could opt out by not accepting insurance and set their own prices.
Providers could also charge for premium service e.g. expedited appointment times.
Orphan drugs and select drugs under patent would be provided free by the government. The government could negotiate these prices with the drug company.
Government to pay the base premium for all. The individual is free to choose the insurance company. Laws would be changed to allow insurance companies to charge additional premium depending on lifestyle* and compliance with medical treatment **.
There would be no additional premiums for a preexisting condition. Underwriting would be based on each individual; there would be no group policy per se. Companies would not be obligated to pay for health insurance.
Insurance premiums would go directly to insurance companies by payroll deduction
A health savings account (HSA) would be mandatory and would cover drug costs, copays and deductibles. Government would fund the HSA for the unemployed and poor retirees. Medicare initially to remain unchanged but new Medicare patients would join a Medicare advantage plan. The government would pay a base premium with additional premiums to be charged the patient by the insurance company based on lifestyle choices and compliance with medical treatment*
Medicaid initially to remain unchanged but no additional patients would qualify.
Patients that will not or cannot pay additional premiums and do not have insurance can either pay cash or be cared for at charity clinics and hospitals.
Insurance would be free for those compliant with medical treatment and live a healthy lifestyle. The government would Collect additional taxes on cigarettes and alcohol to pay for free addiction treatment. (If we legalize street drugs, additional taxes can be levied on these drugs as well.)
Each insurance company would maintain its own medical record and provide access to treating physicians. Patients would have access to their own records.
Each hospital would provide access to all treating physicians and the patient.
*Lifestyle and compliance with medical treatment
It is generally accepted that living a healthy lifestyle is statistically associated with lower healthcare costs. By maintaining a modicum of physical fitness, avoiding smoking, street drugs and excessive alcohol use, maintaining a normal weight and getting proper sleep one has a good chance of avoiding illness. However, this does not protect completely from COVID 19, genetic disease, injuries, cancer, multiple sclerosis or a myriad of other disease. Nevertheless if you are a member of a group leading a healthy lifestyle, health care premiums should be lower. It is also generally accepted that treatment for epidemic diseases such as diabetes and hypertension reduces complications and decreases the need for expensive medical care.
Annual physical exam
The advantages of an annual exam include the discovery of asymptomatic disease e.g. hypertension, documentation of medical compliance and documentation of a healthy lifestyle.
Change laws to regulate what medical emergencies must be treated before transfer of uninsured patients to charity hospital. A state board should enforce these regulations through fines. No lawsuits allowed.
Adopt medical malpractice laws as in Texas so that a state board handles the bulk of complaints.
Allow insurance companies to sell across state lines to increase competition. Allow insurance companies the ability to innovate new technologies to lower healthcare costs, thus increasing profits and improving health outcomes.
Allow importation of drugs from regulated drug stores in Canada to increase competition.
Improvement of the public health by using financial incentives for patients to abandon an unhealthy lifestyle. Decrease the demand for illegal drugs.
Decreases the cost of healthcare by mandating Medicare pricing
Removes company responsibility to provide health insurance; removes the need for patients to work in order to obtain health insurance.
No surprise billing; price transparency
Eliminates the pre existing condition. Compliant patients get free care.
Improvement of public health by finding undiagnosed disease through annual physical exam
Improvement of public health by financial incentives to comply with medical treatment
Decreases the overuse of medical services
Possible shortages of services if Medicare prices are set too low.
Possible decrease in quality of services
Possible large increase in the use of charity hospitals and clinics resulting in decreased quality of care
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