Walter’s Healthcare Reform Plan

I can’t really say this is mine because it comes from a number of ideas floating around out there. But this is what I am advocating for as a replacement for that horrid and horrible government power grab called the Patient Protection and Affordable Care Act (PPACA). In essence, the problem that needs to be solved is that everyone needs affordable access to healthcare. Intentionally blowing up the existing system to help 10-12 million people out of a total of 300 million is unwarranted and only demonstrates that the goal is not to help those who are uninsured but to control healthcare for all. Healthcare is not a right. It is a privilege. Yet I believe every American agrees insurance companies should not be able to drop people who already have coverage when they get sick (i.e., rescission), and that people with pre-existing conditions should have access to coverage even if it is more expensive. But no one should get healthcare for free unless elderly or truly poor. These groups are served respectively by Medicare and Medicaid. So with these principles in mind, I propose my healthcare reform plan that will promote competition, provide favorable tax treatment for individuals that is now only available to companies, and will also bring down health insurance costs.

This healthcare reform plan has NO federal mandate for coverage, but it does call on the federal government to invoke the Commerce Clause in order to stop states from preventing health insurance to be sold across state lines. I had considered a federal mandate because I thought that if the federal government simply required everyone to have health insurance without having ANY stake in what they bought or who they bought it from, then this would work in concert with federal non-rescission or pre-existing condition regulations.  However, these two regulations are of a different class from a healthcare mandate, as a healthcare mandate is unconstitutional at the federal level and can only be implemented through a constitutional amendment or by the individual states themselves.

Without a healthcare mandate, it does make it problematic to avoid adverse selection (having so many sick people that the insurance pool cannot stay solvent). This is because without a mandate, those who are young and rarely sick may not participate in the insurance pool to balance out those with pre-existing conditions who will certainly join the insurance pool.  So the health mandate, as stated above, would best be implemented at the state level or through a constitutional amendment (which requires 3/4, or 38 states, consenting) to ensure there are no problems with adverse selection. If done at the state level, the insurance pools will be far more than sufficient when everyone participates considering the fact that the typical small group employer plan is between two and forty-nine employees, and a large group employer plan is only fifty or more employees.

So here are the six basic principles of healthcare reform that I am proposing:

1. medical tort reform to bring down health provider costs,
2. sale of insurance across state lines to promote competition,
3. expand Health Savings Accounts (HSAs) whose contributions are deductible from income to not only apply to high-deductible plans but to all plans,
4. provide the same tax treatment for individuals as for corporations, where insurance premiums are tax deductible,
5. allow doctors to deduct pro bono services from their taxable income so there will be greater access for the truly poor,
6. make all health plans portable, so once you have your plan you have it for life so there won’t be the possibility of pre-existing conditions in the future.

Additionally, there should be a set of bare minimum benefits set at the state level that plans must cover, but these minimums must be things that are common to all people and are not sex- or age-specific.  For example, preventive care, prescription drugs, and hospitalization should be covered, but maternity care and pediatric care would not be a part of minimum coverage. In the same manner that auto and home insurance will have minimum sets of coverage with the ability to add on other desired coverage, healthcare plans should be able to do the same thing. People should only purchase what they want or need above the minimal set of coverage. In looking at the Affordable Care Act “10 Essential Benefits” as a guide, I would modify as follows:

• Emergency services
• Hospitalizations
• Laboratory services
• Maternity care
• Mental health and substance abuse treatment
• Outpatient, or ambulatory care
• Pediatric care
• Prescription drugs
• Preventive care
• Rehabilitative and rehabilitative (helping maintain daily functioning) services
• Vision and dental care for children

If someone wants maternity care and pediatric care on their plan, then they can pay extra for it.  Insurance companies can aggressively compete on these additional health plan coverage options.