Our country is in massive debt. Medicare as it stands now is financially unsustainable even over the short term. The public option, however, is poised to deliver Medicare benefits, which are essentially limitless, to a much larger public(Keep in mind that The medical system already loses money on Medicare/Medicaid patients). So once utilization of health services through the public option increases(as it surely will, even with preventive services), the program will be a fiscal train wreck. When this happens, our government will choose to either go into more ruinous debt or drastically cut costs via hospital payments, provider payments, and most importantly benefits. When this happens, we will have a public system that rations care in very discomforting ways.

(Also remember, the enrollment in the public option is, if anything, underestimated. The public option has to, by definition, be the cheapest option available. Otherwise, this whole reform exercise is ridiculous. So if its the cheapest option, more people will drop their private insurance and switch, thereby hastening the bankruptcy of the plan).

So how do we begin to create an ethically satisfying system based in reality? We must first realize that there is no perfect solution to satisfy our ethical ethos. From there, we can start with the easy stuff. Insurance industry reform – abandon medical underwriting, abandon employer based insurance(give that cash to the employees), allow inter-state insurance commerce, and mandate coverage. The government can help here by picking up the tab on costly chronic conditions if and when insurance caps are reached. Second, create a safety net insurance program for persons of insufficient means. This program would have a fixed budget and thus would have to ration care. Remember, these persons have no insurance to begin with, so reasonable care is better than no care (Recall this is what Britain does). For seniors, their relationship with government will have to eventually change, given Medicare’s impending insolvency. Some ideas include enrolling seniors in the safety net plan with the option to purchase further supplemental insurance. Other ideas include allowing their children to include them on their plans. Fundamentally, however, any major changes to seniors would have to be phased in slowly (ie 20 yrs) so that persons have time to plan and adapt. Ultimately, the scale and scope of this government program could increase as resources increase. As the above article discusses, the author would pursue every avenue of treatment for his loved ones. Reckless reform would eventually take away that choice from most consumers. Most importantly, though, this sort of system gets everyone covered, allows choices for americans, and does it in a fiscally responsible way.

Imagine how different the debate would be if all the voices of those who’ve been directly affected by the current system could be heard. Unfortunately, those same voices of people who’ve suffered with the shortcomings and inherent injustice of the system are, by virtue of their weakened physical or financial conditions, the people least likely to be heard. And, ironically, those who champion the cause on behalf of those unfortunates, have become easy objects of attack by healthcare reform opponents.

Opponents have become so clever and devious that it’s almost impossible to prove they’re kicking the sick, weakened, and disenfranchised while they’re down. But, they’re sure kicking-the-hell out of the people who are trying to help those others get up.

The cost of a government health insurance plan could be based on the average health care cost for people in each age group plus a certain percentage. For example the government insurance for a person born in 1950 could be the average health care cost of everyone born in 1950 plus a percentage such as 2 to 10% minus likely deductibles and co-pays.

more info on possible health structure

Public Option that Doesn’t Directly Compete with Private Insurance

The cost of a government health insurance plan could be based on the average health care cost for people in each age group plus a certain percentage. For example the government insurance for a person born in 1950 could be the average health care cost of everyone born in 1950 plus a percentage such as 2 to 10% minus likely deductibles and co-pays.

Private insurance companies could pick their customers, they could not cancel their customers, their rates would have to be the same for all people in each age group, and they would have to cover preexisting conditions.

Private insurance companies and insurance cooperates would likely pick the healthiest people, leaving the less healthy people and people unable to pay to be covered by the government insurance. People without private insurance would automatically be in the government plan.

People would pay the government insurance though employer withholding and though sending the money to the government. The cost of the government insurance would be limited to a certain percentage of a person’s total income. The percentage of income that is limited could be higher for older people.

For example a 25 year old person’s government insurance cost could limited to 3 percent of that person’s income, while a 60 year old person’s cost could be limited to 12 percent. A person’s total income could include income from work, capital gains, dividends, interest, gifts, and inheritances.

This type of government plan would not directly compete with private insurance, but still it would keep private insurance companies from charging extreme amounts. The government plan may need extra funds since the plan would be covering the less healthy and people not paying the full amount.

Possible ways of getting extra funds would be to tax capital gains and dividends at the same rate as regular income for people with incomes over $250,000 and taxing high income people more.

This type of plan would increase payroll payment on some people, however they would be covered and they would have incentives to be healthy to find cheaper rates. Medicare could be funded though the general fund to somewhat lessen payroll payments.

Thank you
Doug Seger
812-678-3850
6915 N 925 E
French Lick, IN 47432