While I believe the best healthcare program for the United States would be some sort of single payer system, I also believe that (my idealized vision for healthcare) doesn’t matter even a little bit because it matters that we simultaneously take into account the concerns of people who see the issue differently. So, regardless of what I want, I think we have to look toward getting the best healthcare package we can get within the confines of gaining bipartisan support, rather than just trying to ramrod something down people’s throats. It’s for that same reason that I also reject the notion of “Medicare for all”– seen as a viable compromise by some so-called “progressives.”
I call my solution: “Medicare for more.”
Here’s what I envision we can actually get done with support of reasonable members of both major political parties: Firstly, I’d like to remove the current punitive measures of the individual mandate while maintaining the mandate itself. Instead of a fine for failure to maintain coverage, those not covered by a private company who find themselves in need of medical coverage and who are simultaneously unable to pay out of pocket for their medical needs (on the spot) would be immediately enrolled in medicare dating back to the time of their last coverage (to a maximum of 6 months) and they would owe (as legitimate public debt) the premiums (if any) to medicare retroactively. The goal of the individual mandate is not to harm people or even to fine people.
Rather, the goal is full coverage for people so that doctors, hospitals and clinics no longer have to raise prices to mitigate for the uninsured. Under this plan, hospitals, doctors and clinics could lower costs on the basis that they would know they are always going to be paid for services rendered. Nobody has an inherent right to risk that they will be a drain on the system because they chose to prioritize other things over health insurance.
Secondly, I would like to open up premium-based medicare coverage to anyone self-employed, or whose employer does not offer coverage or anyone who lives in an area where there are fewer than two providers on the exchange. Premiums would be based on the nationwide mean average premiums charged by providers in areas with two or more coverage options on the exchange. This gives areas with only one option a competitive advantage if they choose, by nature of the fact that the medicare premium rate will be pre-set by the totality of the free market rather than by figures that directly compete with local providers.
Thirdly, we can be relatively certain that the average person from 50-64 years old will be less healthy than the pool of people from 18-49 and relatively more healthy than the pool of people ages 65-dead. As such, I propose allowing people from 50-64 access to medicare no matter their locale, (at the aforementioned premium rate) so that the overall pool from 18-64 will be healthier and the overall pool from 65-dead will be healthier.
Fourthly, I would like to equalize the cost of pharmaceuticals for consumers by allowing people (as an opt-in program) to pool resources on pharmaceuticals. This sort of equalization seems to work well in the UK and I believe it would work here as well.
Fifthly, I would like to make visitors to our country purchase health coverage good for the length of their stay in the U.S. The whole point of my proposals is universal coverage so that doctors, hospitals and clinics can lower costs to a level commensurate with knowing they will always get paid and so that citizens have the care and coverage they need. My plan is far from perfect, as every health coverage plan on earth is, but given the amount of partisan rancor that exists, I believe these are ways we can move the discussion forward in both a hearth-first and a brain-friendly manner without decimating the free market and without leaving people to fend for themselves during the hours of their greatest need and without alienating a huge swath of people in this nation who love the country every bit as much as we do and who deserve to have their concerns addressed by those who seek to lead.