I haven’t run the numbers on how to pay for this yet (emulating all of my current political heroes). But, I have come up with a relatively simple “Universal Coverage” proposal that does not completely abandon our free-market system and the patient service and treatment innovation that system encourages. Here is a quick summary:
- Wellness Benefits – Age appropriate diagnostic screenings as well as regular physical exams for all paid at 100%.
- Calendar Year Deductible – Single and Family annual deductible resets each January 1st to 5% of previous year’s reported income. (i.e. – Individual who earned $26,000 in 2008 would have a $1,300 deductible in 2009, Family who earned $128,000 would have a family deductible of $6,400).
- Provider Charges – Publish Medicare fee schedule online for complete transparency of pricing. Patient is responsible for paying 10% above Medicare negotiated provider fees for care.
- Coinsurance – After the single or family deductible is satisfied, patient is responsible for 20% of approved charges.
- Calendar Year Out-of-Pocket Maximum – Single and Family annual out-of-pocket maximum (combination of all deductible and coinsurance expense) is 10% of previous year’s income.
- Health Savings Accounts – Allow covered individuals to fund and deduct from income up to their annual out-of-pocket maximum.
This plan, though it would obviously shift exposure for medical expenses to higher income earners, does so WHILE establishing a base level of care and an annual worst-case scenario tied to earnings (“catastrophic” coverage is somewhat subjective and relative to financial means). HSAs and insurance company supplements can be tools to manage costs. Everyone has an incentive to adopt a healthier lifestyle.