I must say I am not too pleased with the ill conceived health care the Congress is trying to force upon America, so I thought I would see if I could create a better plan.

My objections to the current proposals are:

Too much potential power to the government to make life and death decisions

Health care may be arbitrarily rationed.

Competition is stifled

Taxpayers are expected to pay for illegal alien’s health care

Excessive bureaucracy is created.

As I have written before, insurance itself is one of the reasons health care is so expensive. See my previous post for an explanation. On the other hand, a single payer system would help lower the costs.

Here is what I would propose:

Every Citizen would be issued a health account, and initially funded or charged with a one-time credit based on age at inception. For the sake of argument, lets say that people over 60 would be funded with $200,000, and newborns with $300,000 credit to their health accounts.

This account would be used to pay all health related expenses for the patient, with no restrictions on exactly what treatments would be paid for. This would allow the patient to choose whatever treatments the patient thought best. If the patient believed a heart bypass operation served him best, it would be paid from his account. If he believed that the alternative chelation therapy best served his health, it also would be paid from his account. This would allow the ultimate in health freedom.

All drug costs could be paid from this account if the patient chose to do so. A small copay could be instituted to make the plan less expensive for the country.

The catch is of course; once the account was depleted, there would be no more taxpayer funded health care for that individual. If the patient wanted additional coverage, he would have to purchase it privately and would be encouraged to do so. This may sound bad, but the fact is, most private insurance policies carry a maximum lifetime benefits restriction; so this is no different than a private plan.

In addition, health care providers would be required to advise each patient up front of the cost of their services and of any recommended treatments, including any optional treatments available. This would allow the patient to make better choices, knowing that their own health care account was a limited resource. This alone would greatly reduce the cost of health care, as presently patients have no idea what a procedure or test is going to cost, and if they have insurance they generally do not care as long as the insurance company is paying.

The cost of child-birth would be born by the mother’s and father’s accounts, and the cost of post-natal child care by the child’s own account. In the case of a missing or unknown father, the cost would be born solely by the mother’s account.

In the case of an illegal (no health ID card), any emergency health care costs would be billed to the illegal’s government, and the illegal could be deported to his country of origin.

All cosmetic surgeries would not be covered except in the case of a disfiguring accident. Lets face it, people should not expect the taxpayer to pay for their nose job.

All pre-existing conditions would of course be covered.

The government’s basic duties in this system would be:

Perform the appropriate accounting

Pay the health providers for treatments rendered.

Audit providers to prevent fraud.

Provide patients with semi-annual statements of their account

Provide patients additional statements on demand for a small fee

Provide patients with information regarding alternative cost effective treatments

Under this system, there would be no need for Medicare/Medicaid, so that system would be disbanded. There would be no need for VA health care, so that system could be disbanded also. There would be no need for prescription drug plans. All state plans could likewise be disbanded if states chose to do so as they would be unnecessary. The elimination of all of these redundant systems would provide a large cost savings to the taxpayer.

How much would this cost? All health care is expensive, and over the course of a lifetime can reach astounding amounts. A bypass operation can cost $100,000, and chemotherapy can easily exceed that several times over. However, let us assume that on average, a person will only use 1/4 of their allotment. For newborns, this would mean $75,000 would have to be paid into their account over their lifetime. Assuming a working life of 45 years, that would require $1700 per year in taxes for each person. Since not everyone actually works and pays taxes, that means the amount of tax burden an actual worker would have to pay would be much higher, probably twice that amount.

I believe this would still be cheaper than our current system, and would provide incentives to not waste medical resources. It would bring down hospital costs because under the current system, the cost of non-payers using hospital services is born by those that do pay. Since the amount of free-loaders would be greatly reduced, hospital costs would come down. However, there is no such thing a free lunch. Somebody must pay, and that means the taxpayer through some sort of payroll tax perhaps similar to the Social Security scheme.

This system would be easily augmented by:

Allowing people to add credits to their own accounts at a discount, extending the plan to include health savings account features. IE: buy a dollars worth of health care for 80 cents.

Allowing employers to add to their employees health accounts as an employee benefit.

Reimbursing military or civil service personnel’s accounts for service related injuries. This would be fair to those facing above average dangers working in hazardous jobs.

Allowing a person to transfer a portion of his own benefits to his/her spouse.

This system would not:

Arbitrarily decide who gets what treatments.

Prohibit private insurance.

Discriminate against any class of citizen.

Require 1000 pages of legalese to describe.

Stifle medical research.

Reduce services available.

Prohibit private payment for medical service.

Restrict patients to any specific providers.

Make any medical decisions for the patients.

Stifle competition between technologies or providers

Would this work? I think so, and I would happily live under such a system.