Citizens Choice Health Plan

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Author: K Good

Started: October 4, 2009, 7:52:52 pm

Target: Congress

Category: Government & Politics

Supporters:

258

Goal:

1,000

Goal Progress:

Status

Active

1. Put everyone into the private healthcare system. This includes all
government employees federal, state and local and all Medicaid and Medicare recipients. The only way the the decision makers in government will properly handle the healthcare regulation is if they are in the same boat with the rest of us. Government decision makers cannot be exempt from the rules they apply to the rest of us. It must impact them equally.

2. Every person or family can open a health savings account pretax at a bank of their choice which is tax protected like an IRA. The money can only be used for healthcare including treatment, medications and health improvement programs like quit smoking programs, weight loss programs and drug and alcohol rehab programs. The money stays in the account until used for healthcare which can be paid for with a special debit card (it does not have to be used during that year making estimations easier). At death the funds stay in the account for the remainder of the family or can be transferred into a survivor's account tax free. (A bonus - this would help capitalize the banks)

3. Any entity subsidizing the healthcare of an individual including employer or government aid or medicare would deposit the funds into the HSA for the recipient to use to purchase coverage or use to cover health expenses at the citizen's discretion.

4. Everyone would be required to purchase catastrophic insurance from these funds. This would be similar to the way we insure our homes and cars. It would be seldom used and would only cover a true catastrophe like cancer, severe accident, hospitalization and the like. If desired, the person could buy a more comprehensive policy. This way we don't pay for uninsured people to use the ER as a doctor's office.

5. Insurance companies would be required to offer each plan (plan A, plan B etc.) at a single price for any adult and a single price for each child in the U.S. Risk would then be pooled amongst the largest group possible including all persons in the U.S. including government employees and recipients of government funds. Insurers could offer various policies but each policy would only have one price not various prices for various people. No pre-existing conditions, no caps on coverage dollars and insurance would be completely portable since the individual or family would buy it, not an employer. Insurance companies would spell out specifically what is and is not covered by each policy including which medications, treatments etc. Medical directors at insurance companies could not make treatment decisions about patients they have never seen. Insurance companies could require that the patient get a second opinion by a Board Certified physician in the applicable specialty at the expense of the insurance company but the patient would choose that doctor. If that doctor agreed with the initial treatment plan, it would continue. If not, the
patient could choose to have a third opinion with majority ruling on the
treatment decision. Insurance companies could offer discounts for patients
who do not smoke, have a healthy BMI and other such health issues that are under patient control and could be verified by a third party but could not charge more for health issues that are not under patient control.

6. All healthcare entities such as physicians, hospitals, labs, radiology
and drug companies would set their prices for all goods and services. The price would be the same for everyone. These would not be contracted with insurance companies, Medicare or Medicaid but would instead be listed for all individuals to see so that citizens could shop. These entities would also post their results such as statistics like the number of patients in the hospital who acquired an infection as an inpatient or who died during surgery etc. The individual would then make decisions based on the costs of the goods and services and would pay the difference between what their plan pays and the actual cost.
Physicians would be paid not per appointment but per time spent like attorneys are now. For example, let's say a child has an ear infection. The family's insurance company pays $15 per five minute appointment with a family physician. The child goes to a clinic that charges $20 per five minute appointment, so they pay the $5 difference. Or let's say that a person has a very complex medical problem and they have seen various doctors and have not found a resolution. They want to see a highly regarded specialist that charges a premium for services because of the extensive knowledge and experience. The charge is $50 per five minutes and their insurance plan covers $25 for that type of specialist. The specialist spends 30 minutes with the patient and diagnoses the problem. The charge is $300 and the patient pays $150 of that. In this way, the patient chooses the doctor, hospital or other service provider based on their needs and criteria rather than going to whomever is covered by their insurance.The same would apply for drugs - perhaps the insurer would cover the generic and the patient could pay the difference for the brand name. Better doctors, hospitals and other providers would be paid more than their counterparts as they should. Thus providers would be incentivised to provide better care and patients would be incentivised to keep costs down. Transparency of costs would help with this since a patient would now know how much an MRI or surgery would costs unlike the current situation. This should also cut down on unnecessary care since the patient would not want to pay their portion for a service that they feel is really unnecessary.

7. State and Local governments rather than the Federal government should decide when and how much insurance should be subsidized because the "poverty level" varies from place to place. The cost of living in rural Missouri is entirely different from the cost of living in urban New York. These places should decide how to fund the subsidy and should distribute the subsidy as they believe will best serve the people
in their districts. This should not be a Federal mandate nor should it be
funded through Federal taxes.

8. Implement tort reform for the medical industry. Doctors and other providers need to focus on providing good medical care to the patients and not on defensive medicine. Courts should throw out frivolous suits before they cost the system and malpractice insurers money. There should be caps on various types of malpractice suits. Transparency of results should help with this as well since the bad providers will be weeded out by customers choosing the better providers.

I think that this plan of improving transparency, competition and increased coverage for catastrophic care will keep costs down. Patients will be happier with more control and choice and get better quality of care since they are the decision makers. Medical providers will be happier because they will not have to negotiate with insurers and try to balance gains and losses on various contracts and will have less paperwork, fewer fights with insurers over treatment plans and will be better reimbursed for better care. Insurers may have somewhat lower premiums for expensive individuals because they have to base what they charge on the entire patient pool rather than individuals. However, they should be able to make this up by having fewer administrative costs in the form of determining premiums for each individual and since the patient will participate in the cost of the care, they will be motivated to keep costs down. This comprehensive plan should be able to achieve lower overall costs and cover more people with better care which is the ultimate goal of healthcare
reform.

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Added by: K Good on October 6, 2009, 11:18:48 pm
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Please sign this petition so that I can send it to Congress for their consideration.

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Added by: K Good on October 6, 2009, 11:21:08 pm
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Please enter the discussion if you have additional ideas you would like to add.
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Added by: K Good on October 8, 2009, 10:17:56 am
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If you like these ideas, go to this site and cut and paste whichever parts you like in place of the automated letter to encourage the Representatives to consider these ideas. I would like them to simply consider common sense ideas that do not add to the debt load for the taxpayers. If you have other ideas, please send them. I really think that the citizens come up with the best ideas because we are living this healthcare situation everyday while Congress is somewhat removed because they have their own special plan.

Thanks!

http://www.capwiz.com/freedomworks/issues/alert/?alertid=13777951
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Added by: K Good on October 12, 2009, 11:57:25 am
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If you have any additional ideas or comments, please go to the discussion area and post them there.
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Added by: K Good on October 13, 2009, 1:37:50 pm
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After listening to some of the discussion regarding the health care bill, I realized that we may need some kind of phase in period for pre-existing conditions. The concern is that people will wait until they are sick and then buy health insurance. This is a valid concern if people are not required to carry insurance continuously. One possible solution would be a 30/60/90 phase in. This would be a 30 day phase in during which the insured would pay 30% of the premium and get 30% of the coverage, the next 30 days pay 60% of the premium and get 60% of the coverage and then the next 30 days, pay 90% of the premium and get 90% of the coverage. After 90 days, the insured would be fully covered. This seems fair because the insured would only pay for the coverage that they receive and the insurance company would not have to instantly cover someone fully if they buy insurance only because they are sick.

An exception would occur if the employer changed the plan rather than the insured or if the insured was forced to change plans for some other reason but were previously insured.
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Added by: K Good on October 19, 2009, 12:14:24 pm
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I would like to clarify that prices for insurance policies would be set by the insurers based on the cost of that policy and coverage of the applicable patient pool for that policy not by the government.

The same would go for medical providers - they set the prices for their services. So, if they could command a better price for better service, they can charge a higher price. Based on discussions by doctors that I have seen on tv, this would actually free doctors to provide excellent services to those who can pay and also provide free or reduced price services to those that they believe really need their service but can't afford it. Right now, due to overuse of services, low reimbursement by medicare and medicaid, high cost of liability insurance and a mountain of paperwork, these doctors are not in control of their finances. Thus, they are not able to provide the caring services to those who can't afford it despite the fact that they want to help.