My concept of universal healthcare:

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Discussion Overview

The discussion revolves around a proposed concept for universal healthcare in the United States, focusing on the structure, funding mechanisms, and implications of such a system. Participants explore various aspects of the proposal, including tax implications, coverage for different demographics, and the role of insurance companies.

Discussion Character

  • Debate/contested
  • Technical explanation
  • Conceptual clarification
  • Exploratory

Main Points Raised

  • One participant proposes a Health Care Oversight Agency with representatives from each state, tasked with overseeing universal healthcare implementation and compliance.
  • The proposed funding mechanism includes a 3% payroll tax on total income, with some participants questioning the sufficiency of this tax to cover the projected maximum healthcare costs of $75,000 per year.
  • Concerns are raised about whether the tax would be a flat rate or if there would be exemptions for certain groups, suggesting potential inequities in the system.
  • Questions arise regarding the role of insurance companies under this proposed system, with some suggesting that states may choose to insure their healthcare liabilities differently.
  • Participants inquire about healthcare provision for individuals outside their state of residence during illness or accidents, highlighting logistical challenges in reimbursement between states.
  • One participant expresses skepticism about the financial viability of the plan, particularly regarding the refund mechanism for unused health account funds.
  • Another participant notes that the proposed system is not entirely original and references similar systems implemented in specific cities.

Areas of Agreement / Disagreement

Participants express a mix of support and skepticism regarding the proposed universal healthcare system. While some agree on the general direction of the proposal, significant disagreements remain about the feasibility of the funding model and the implications for various stakeholders.

Contextual Notes

Participants acknowledge limitations in the proposal's financial assumptions and the need for further clarification on various operational aspects, such as interstate healthcare provision and the role of insurance companies.

GENIERE
The federal government will create a Health Care Oversight Agency with 1 representative from each state and employees with all necessary skills. The president will appoint the director after the first year following a presidential election if a 9-year tenure has transpired. The appointment will be for minimum 9 years but the director can resign at any time. In matters of health care, the oversight agency would have the authority to fine, or otherwise punish state elected officials, their appointees, agencies, and private corporations with congressional approval (a simple majority vote). Each state would be required to provide universal health care for its residents paid through a payroll tax. Having 50 different plans would filter out the good from the bad with the better plans being adopted, if desired, by all. Private and/or public supported plans would be allowed. In essence 50 plans meeting the requirements of the federal government, but the means to achieve it not regulated in any manner

Each state would be required to provide universal health care for its residents paid for via a payroll tax of 3% of total income (0 deductions). All individuals including federal employees, elected officials and appointees, will be covered via the health plan provided by the state they reside in. Certain individuals, because of the position they hold may be entitled to extraordinary care, but only during their tenure.

To limit misuse of benefits each individual of age would be taxed if employed and, on January 1, be able to draw from their state provided health account of $3000.00. All health expenses would be drawn from the account. Unused funds would be paid to the individual at years end. If the account is depleted, the individual continues to have full paid coverage. State maximum coverage would be limited to $75,000 per year averaged over 5 years. Anyone may increase coverage via a private plan, but the tax obligation is universal. A state may petition the oversight agency to have the federal government assume expenses for a specific individual incurring huge expenses, or for natural or man-made catastrophes. The oversight committee may meet in closed session to decide such matters, with appropriate congressional review.

Employers are relieved of most obligations re: health care. Employer provided health care plans would be considered taxable income. Those enjoying company paid for benefits such as spas, gyms and exercise rooms and the like would have the value of the benefit added to their taxable income. Employers would reimburse the state(s) for health expenses incurred from occupational hazards whether accidental or through exposure to hazardous conditions. Arbitration is via the oversight agency.

States must negotiate drug costs with the manufacturers. States may join together to maximize their purchasing power but only to the extent the combined population does not exceed that of the most populous state (promote diversified methods).

All those under 18 years of age would be provided free care thus isolating most of the burden from the parents. Parents would have their health accounts increased per child by $250.00 ($500.00 signal parent). Individuals caring for elderly family members will have their health accounts increased by $500.00. Those under 18 would not be taxed if working. Indigent, infirm and unemployed individuals would remain covered but would need to have their status investigated periodically. They would have less flexibility in health care decisions.

Military personal, after discharge will have their health care needs provided by the state they reside in. but will have 1/3 the tax obligation. Those put at risk via combat or other circumstances will have no tax obligation. The military will continue to provide the unique facilities and personal to attend the needs of health-impaired combatants. That part of the military budget relegated to the health care and the maintenance of unneeded facilities will be reduced proportionally to the degree the states assume the cost.

As a consequence of their vocation, police officers, firefighters, and other public service individuals may incur greater risk to their health. Their tax obligation will be reduced 0.1% per year of service. The individual state will not be allowed to determine the vocation that permits reducing the tax obligation. The determination will be made by the oversight agency in closed session and needs no congressional approval.
 
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Previously I have said:
Cover children and extreme cases. Give selection (ability to buy as much healthcare as one wishes), incentives to stay healthy, and doctor autonomy. Then you have the perfect system.

Sounds like you are quite on the right track. You mention a 3% income tax to pay for this system. Can you show me how your numbers will provide up to the 75,000/yr max for everyone?:)
 
Is this going to be a universal flat tax, or are campaign contributors going to be able to buy their way out of it?
 
What would be the role of insurance companies?

How would health care be provided for persons not in their state of residence at the time of illness/accident? (e.g. I 'live' in New York but 'work' in California and vacation in Hawaii and Guam).
 
So your tax would be instead of the current 1.45% Medicare taxes? I don't see how a net increase of 1.55% could support your plan.

Originally posted by GENIERE - To limit misuse of benefits each individual of age would be taxed if employed and, on January 1, be able to draw from their state provided health account of $3000.00. All health expenses would be drawn from the account. Unused funds would be paid to the individual at years end.

A person making $55,000 annually would only pay $1,650. According to your plan, if he only spent $500 that year for medical expenses, the state would refund him $2,500, that's $850 more than what he contributed.

Where can I sign up for your plan?
 
Sounds like you are quite on the right track. You mention a 3% income tax to pay for this system. Can you show me how your numbers will provide up to the 75,000/yr max for everyone?:)

I wrote the post in about 20 minutes. I have no real confidence in the numbers but determined the 3% tax would net about $5000.00 per US citizen, contrasted with about $4000.00 health cost per citizen at present.
Is this going to be a universal flat tax, or are campaign contributors going to be able to buy their way out of it?
It’s a progressive tax disguised as a flat tax. No one is exempt. I tried to appeal to both liberal and conservative views in several elements.
What would be the role of insurance companies?
Some states may wish to insure their entire health care liability, others none. Most I think would opt for some liability protection. Each individual also has a choice. I ‘d hope many different schemes would emerge.

How would health care be provided for persons not in their state of residence at the time of illness/accident? (e.g. I 'live' in New York but 'work' in California and vacation in Hawaii and Guam).

An individual’s state would foot the bill by reimbursing the state where the treatment was provided. Since costs would differ among states that would be 1 of 1000’s of issues needed to be addressed in the oversight agency.
So your tax would be instead of the current 1.45% Medicare taxes? I don't see how a net increase of 1.55% could support your plan.
As said I can’t support my numbers.
A person making $55,000 annually would only pay $1,650. According to your plan, if he only spent $500 that year for medical expenses, the state would refund him $2,500, that's $850 more than what he contributed.

This concept is not original to me. It has been done in at least 1 major US city for city employees. It did reduce total health costs for the city. It was not a tax-based system but the insurance companies were relieved of the first $4000.00 of liability. The drastic reduction in insurance rates made the reimbursement possible and profitable.

Where can I sign up for your plan?

No signature is necessary, simply send me $100.00 via paypal and I’ll guarantee your good health as best as I can. (offer open to all)
 
No signature is necessary, simply send me $100.00 via paypal and I’ll guarantee your good health as best as I can. (offer open to all)
Are you serious? (Don't want to appear too crass, but it's hard to tell [jk] sometimes )
 
By my numbers this plan would cost (on average) about 12% to be enacted (assuming about $4500 worth of care to every citizen)
 
And at that amount, the average person making 37000 a year would be paying 370/month into this program. I guess the extra money goes to subsidizing people under 18? and poor people?
370/month gets quite a damn good healthcare plan as it stands right now.

Not that I'm against this so much, simply, you'd have to find a good way to sell it (considering the average income of a voter is higher than that of the national average income)
 
  • #10
You’re never crass. Your posts are usually disagreeable to me but worth reading.

To support my health care guarantee, I’m planning to take a first-aid course (adult-ed).
 
  • #11
Phatmonkey-

The info I came up with, was that the total wages was about 5 trillion and total population was under 300 million. After moving the slide 4 times on my K&E log-log duplex decitrig; bingo! $5000,00. I hope I didn’t lose count of the zero’s.

If your numbers are correct, it’s a loser. Thanks for the interest.
 
  • #12
Originally posted by phatmonky
*SNIP
370/month gets quite a damn good healthcare plan as it stands right now.
*SNAP
First Evo, now phatmonky; should I tell my friend to get in touch with you guys? Under COBRA, he's looking at >$8,000 pa for himself and his wife; so far the *best* deal he's found (individual plan, NJ; no sign that anyone wants to employ him) is >$11,000 pa. Ouch. Surely it's not because he's over 54? I think he should definitely go live in Australia or Shanghai :wink:
 
  • #13
Nereid, it could be a lot of factors, age, personal health history, does he smoke or was he a smoker. New Jersey is a rather expensive state to live in.

It's scary to lose a job at that age. Potential employers consider the health risks of an older person as well as the fact that they are approaching retirement age and it makes an older person a less attractive candidate for a lot of jobs. I hope he's in a field where experience is valued and he finds employment soon.
 
  • #14
I don't understand why you need to force a health plan on people? Some may choose to go with their own insurance providers, in that case you are requiring people to pay twice for healthcare. Perhaps it would be better to draw upon the pool of those who choose to opt into this nationalized health care. You will most probably lose the taxes by those who make >$100,000 or so. Let us say 150,000,000 people sign up for this plan who's salary averages around $30,000. Let us also say you allow this plan to be funded by a 5% flat tax rate. That is over $225 billion alone. Seems to be sufficient to me, considering most won't use all of what they paid in - which would best be refunded or credit for the next year (so the government doesn't get happy with it's new source of cash and start pilfering it).
 
  • #15
As with any social plan, it is necessary for those not needing their allotment of services to finance those who do. To generate sufficient funds, a health plan must be universal. I’m against federal social programs, but the federal government is responsible for “promote(ing) the general welfare”. As long as the onus and financing is assumed by the states, it is OK by me.
 

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