Universal Health Care by Don Z

A Universal,Single Payer, Health Care Plan that works for everyone

Our health care in the United States is BROKEN and needs repair NOW.

Yes We Can!

This is a health care plan that needs your input. Yes it is different, but it provides everything we are talking about and more. It insures everyone, everyone pays their fair share, it saves money, simple, easy to administer, sustainable forever, inflation proof, reduces government involvement, allows the medical people do what they are trained to do, eliminates insurance companies and politicians and their lobbyists, provides a solution to control malpractice law suit, and saves millions of jobs. While doing all this, it creates the environment to create millions of new meaningful jobs.

This plan also allows the government to spend our tax money more efficiently, because the tax money is not paying for just government employee’s healthcare but everyone’s health care. Everyone pays their own when they spend their money. The wealthy spend more. Everyone gets the same health care, which will be the best in the world

This plan, Universal, Single Payer, Health Care, has a lot of merit. This Plan just needs to be talked about.

This is what people are saying about our present health care system but haven't really presented a solution that will solve all the problems without adding to the already "out of control" cost:

1. Our health care in the US is the most expensive in the world and our government can't pay their part.

2. Health care costs are not being shared fairly. Too many citizens aren't paying enough. The government is paying too much.

3. Dental, vision, and hearing are usually not covered by insurance, but yet if not treated, will result in higher costs later. These are the parts of the body that go bad with age and people don’t have the money it takes to pay for the necessary insurance .

4. There are 45 million people still without health care. Everybody should have health care in America.

5. Insurance companies and politicians are making critical health care decisions instead of doctors.

6. Prescription drug prices keep going up faster than inflation. People just can't afford them.

7. The employer is saddled with no control over rising health care costs. They can't afford to continue doing what they have in the past.

8. Our valuable volunteer network in America spends so much time and money providing health care to the poor, that other needs are being neglected, such as education, food and housing.

9. Many studies have been pointing out the waste in health care, such as hospitals administrating multiple insurance plans, each requiring special conditions.

10. Lobbyists are influencing our politicians for the benefit of better profits for their clients at the expense of our health care industry.

11. Insurance companies cherry pick the most profitable groups to insure(which is how they are able to compete with each other) leaving a lot of groups without insurance. The government, in order to help these people, created ways to give them the insurance they need (Medicaid and Medicare) but without a way to fund them. The results are; not everyone is insured and the cost to the tax payer is rising faster than inflation and we can't afford to keep going down this road of self destruction.

12. Malpractice insurance is out of control and the doctors and patients are the ones getting hurt.

13. Our veterans are not getting the care they deserve.

To correct all these problems, a complete overhaul of HEALTH CARE IN AMERICA will be required. It won’t be easy and it won’t come from one person or group. It will only happen when everyone playing a major part in the system comes together and does what is right. Our new system has to be a WIN-WIN situation, where no one is a loser. Our new President can solve this problem, but is still following the old ways. You can't mandate insurance and employers to do things without adding a lot more cost. What I have outlined provides new thinking for the solution to all these problems. The mechanics to make it happen are already there. I see this plan happening very quickly. A sales tax, as I will described, can be put in place within weeks. (Chicago did it last year to solve the Mass Transit problem). Computerized medical records are already being used by hospitals, they just need to be expanded to include realistic controls on medical costs. The people responsible for the costs need to know what the costs are. The technology is there. People losing jobs over this switch are people doing unnecessary work in the present health care system. It is these people that will fill the needs in more productive industries. This could even be in the new health care system. The U.S. Treasury will pay all the bills for health care for it's citizens but will also have the necessary information to make sure it doesn't pay for waste, (reasonable costs are OK but GREED FOR MONEY is not). The system will have to be more transparent. That is, everyone pays their fair share and no one takes more than they earn. This is a health care plan that needs your input. Yes it is different, but it provides everything we are talking about and more. This plan also allows the government to spend our tax money more efficiently, because the tax money is not paying for just government employee’s healthcare but everyone’s health care. Everyone pays their own when they spend their money. The wealthy spend more. Everyone gets the same health care, which will be the best in the world

The Health Care System will provide all the medical expenses at the time it is used. This includes dental, eye, drugs, doctor and hospital costs, and any other things the doctors decide is needed and economically possible.

The government (300 million people) is the major player in the system and will represent us all as individuals; rich, poor, men, women, young, old, everyone equally. We elect politicians to run the government and we pay them to do this. Our politicians should not be in the business of 'Pay to play" and our government should definitely not make a profit at any time. If they need more money, they have the authority to tax us. If the legislators are transparent in making their decisions, the public will not object. When they spend more than they have, they must be accountable and correct the situation. One way is to INCREASE TAXES, BECAUSE THE FEDERAL GOVERNMENT MUST NOT GO IN DEBT, unless there is no other way for a short period of time. The Federal Government represents all of us equally. Without a strong Federal Government we are all weak together. When we are together with what we do, we are strong.

My proposal to fix all of these wrongs is huge and I find no one, so far, willing to take on this challenge. Doctors can’t get the politicians on board, insurance and drug companies use lobbyist to protect them from losing money, employers don’t want to pay more than they can afford, and our citizens are stuck with a system that doesn't take care of them when they really need the care. Our government is continually bailing out the system and going further into debt. What we have is a monster, with no solution. It is unsustainable.

MY PLAN

Eliminate the health care insurance companies and let them handle accidents and liability insurance for individuals and businesses. eliminate politicians making health care decisions because they are not knowledgeablenon what is needed. This automatically eliminates the lobbyists. This just leaves the medical people to make the decisians to run the health care industry. They are the most qualified and trustworthy! The question then is; How do we fund the system? Create a National Sales Tax, which is the fairest, easiest to administer and already in use in most all the states. However a simple sales tax won’t work because the poor pay more of their available income than the rich. I recommend a graduated rate based on a need to buy. This leaves a health care system, run by the medical field and congress controlling the cost.

Congress controls funding by; changing the sales tax when they have too much money or not enough. Everyone will pay for health care when they spend money. When some one needs health care, it is already paid for.

(The only unknown health care factor we now face is "when will I need a doctor and how much will it cost?"). Under this Plan, the U.S. Treasury pays the bill out of a health care fund, where all the National Sales Tax collected is deposited. Everyone is treated as equal.

The politicians can now spend their time on more serious problems. The Insurance Industry can rejoin the FREE MARKET SYSTEM and generate their profits without the help of government. My plan simulates the original Blue Cross Blue Shield plan in the 1930’s when the doctors and hospitals got paid through a system where the workers contributed a small amount to the system each week from their pay check. They never missed the money. The employer just deducted it and sent the check to the insurance company. Since they were non-profit, everyone benefited and no one made an excessive profit on someone being sick. I like this idea. Pay when you don't need it but get the care when you really need it. Pay when you spend your money. Everybody spends money. This is an insurance that spreads the risk evenly and pays for those less fortunate. Our health is not for sale.

A National Board of Medical Experts (NBME) will be assembled to administer the Universal Health Care System in America. It will evaluate the costing system now used by Medicare, Medicaid and insurance companies, and develop the payment system needed. (The code of charges.) This board will be comprised of representatives from each field of the health system and all be paid the same amount for their service. Three representatives from each field will share one vote with the board. (The reason for one vote shared is to eliminate the lobbying of a person. Three people makes it just more fair). Term limits are limited to 3 years and no one serves more than one term. This keeps all medical people actively committed to their field. Those on the board will be aware of most of the problems and can take action on solving them. The saving in administrative costs alone has been estimated by several studies to be quite large. The ultimate goal of the NBME will be; control what Medical Professionals will charge the system, make all changes necessary to make sure everyone is being treated fair. This should all be done in the open. The ultimate goal is to provide the best health care possible within a framework of what the people are willing to pay.

A National Record and Statistic Agency (NRSA) is formed to centralize ALL records and monitor the system. This Agency operates independent of the National Board of Medical Experts and Congress. Their responsibility is; develop and administer the record keeping system that will provide Congress and NBME with accurate information and statistical charts they need to administer and pay for the Universal Health Care System in America.

All invoices are sent through the NRSA to insure all requested information is there. They do not check for accuracy at this time, just that all information requested is there. When congress or the NBME see unusual trends, they investigate, WHY, and report back. When invoices are sent to the Treasury for payment, they will pay it within a 30 day period. Invoices that are incomplete or have questionable information will be returned to the sender and will result in delayed payment. The NRSA will also have field people to check for irregularities and will be constantly looking at why things are changing and report back to either congress or the NBME to verify why. Changes are then made by congress or NBME to improve the system.

Groups that are now involved in research or looking for ways to improve the system will remain intact and will not be funded thru the health care system. They are usually non-profit organizations and are funded through contributions.

The National Sales Tax is based on money spent. The tax money is deposited in a special fund with the US Treasury and used only to pay for our health care. Money is constantly coming in while health care bills are also constantly being paid. This means today's health care costs are spent with today’s dollars. Inflation is a non-issue. An example of the type information Congress would get on a monthly basis would be; a chart showing how much money is collected and a breakdown by state showing how much was paid. Also a chart showing the breakdown of how much money was paid out to each health program, general medical cost. preventative costs, surgeries, chiropractors. eye, ear, nose, psychiatric care, etc. Also show those same costs by states. These numbers won't mean much at first, but after a few years a pattern will be seen and they can be analysed to see why they are erratic, increasing or decreasing. Congress will become familiar with these charts and will ask why. The analysts will determine why, recommend changes. The effect of the change will be followed to determine if it is working. More changes, or a different approach, may be needed to fine tune the problem. These are all ways congress will be able to operate more efficiently. The technology has been around for years, and is already being applied in many industries today.

Everybody pays for their insurance according to how they spend their own personal money. It should be illegal to buy personal things with other peoples money. (Company expense and perks, if it is to be used for personal use, it must have a tax. If it is for company use, it becomes a company expense.) If we just use a sales tax of one fixed rate, it would be disproportionately greater on the income of the poor than the rich. In order to correct this, charge a higher rate for things the richer persons buy. This equalizes the tax based on how much you spend for unnecessary purchases. I suggest 4 levels at this time.

A. Tax things needed to live, at one low rate. Also used or reconditioned items could be included here to promote recycling items that are still usable. There are no exceptions, everything has a tax and will fit in one of these groups.

B. Tax a little more for things that make life better. Those that can afford it will have a better life and will be an encouragement for others to have more money through a better job or more education or better money management.

C. If we collect even more tax for extravagant things, those with the most money will help the poor people get their health care. This tax must not be too excessive since some people may reach that level of income and want to be able to afford those things too. All these taxes go to pay for health care. All the tax now collected, supporting health care, can be discontinued.

D. The last level would be for our medical people to determine those purchases that are causing health care costs to rise, such as unhealthy food, smoking and drinking. This tax could be a tax added on to one of the other three, because it can be removed if the product is made safer to the consumer. If the consumer wants this product bad enough than it’s their money and they can do what they want.
This tax revenue is paid the same as now except it all goes directly to the U.S. Treasury to be put in a special health care fund where only health care costs are paid. The records will show where the money comes from, without any middlemen involved. The candy store sends it’s check, directly to the Treasury. However, this check goes to the NRSA (National Records and Statistics Agency), prior to the Treasury to be deposited. The date, name, address, business ID# and amount will be entered into the Universal Health Care Data Bank as a permanent record. Now the Treasury knows where all the money came from. They know what city, state, Type business and the exact amount to assist any study needed to evaluate any situation. This data bank will also have other data, all interrelated for future studies. The NRSA will have simple guidelines on who has access to this information and what the procedure would be. They would have total control for privacy information. Walgreen’s headquarters for example may have the potential of seeing what the sales are in their different stores around the country, just to check their own records or use it for other business uses.

Anyone caught cheating will have to pay the penalty for Federal Tax Evasion. I would hope that penalty would be very steep. Criminals caught not collecting the sales tax or income tax has an automatic Tax Evasion penalty. (Example; Illegal drug dealers, selling drugs without collecting the sales tax.) This sales tax money is put into its own fund and the size of the fund can be regulated as needed, simply by increasing or decreasing the tax rate. This makes the system sustainable for future generations. The “A” tax and “C” tax can be the more stable taxes while the “B” taxes can be the regulator. Also, where a product fits into a rate can be easily adjusted when it appears to be out of line. There is a lot of simple adjustments available to bring everything into balance. I would think the ‘B’ tax could be the final regulator (raise this tax when more money is needed and lower it when less money is needed) as we gain experience. Only congress should have the power to change the percentage, based on facts presented to them by the statisticians as justification.

NOTE: I have a question whether a sales tax would apply to investments, which is spending money to make more money. I don't think a health care tax should apply here.

These are the immediate benefits to this plan:

Employers will keep the money they now earn, not having to fund health care. The company uses this extra money where they determine it will help the company most. Eliminate OT and hire more people; reduce the work load of workers and hire additional people; lower the cost of their products; update equipment; increase marketing and research budgets and spend more on new products, are all decisions they will make to affect how competitive they will be in the future. Workers, who kept their jobs only because the benefits were good, can now look for a job closer to home and do something that really turns them on. Health care is no longer an issue. Also, if people can work closer to home, less cars on the road resulting in less energy consumed and less maintenance on roads.

People now volunteering in health care can be replaced with trained workers, increasing better paying jobs. This allows those volunteers to work in other areas of need, such as education, food pantry, or housing, which also affects the poor.

Our education system, now recieveing money from taxes, wont have to pay the health care costs for employees and the retirees. Without changing the taxes, education will already have some of the money they need to improve education.

Non profit organizations, such as Churches, Red Cross, Salvation Army, etc can spend more money on their mission, helping others, rather than providing paid staff health insurance.

The Government will have more money for their missions. Park districts, public works, and a host of other government agencies will automatically have more money to do their work. Also the money paid for contract labor will be less, because those businesses won't have the health care burden.

Medicare and Medicaid can be eliminated, along with its debt.

Small businesses can hire more help.

Mothers or fathers won’t both have to work just to provide health care insurance. They can do what they want. One of them may volunteer in the schools, churches, helping the pooror the elderly.

People losing their jobs will still have their health care. They can get a lower paying job, temporarily, to buy food, wear clothes longer, drive the car less, move in with someone else, until a better job can be found. These are options they have control over. They still need to spend money to live and that alone is paying for their health care.

Employers can hire teenagers during the summer so they can gain work experience and earn money to spend, helping to pay for their own health insurance when they get sick. Unions should not require these teens to join a union, rather they should use this opportunity to work with the employee to insure these kids get good, high quality and safe experience during the summer so they will be better workers later.

Unions can concentrate on working conditions and maintaining fair wages whithout having to fight over who pays for the health insurance. They also need to be concerned that the employer can survive hard times. Unions must be a partner to the manufacturer and not an enemy. They need to represent the workers where they need help and make sure the employer treats the workers as part of the team.

Hospitals and medical centers will operate on the FREE MARKET SYSTEM. The government will know exactly what the hospital costs are and make sure the charges are fair. The data they will be working with will be the most accurate possible, allowing congress to make good sound decisions about what is happening. This is a big problem now, where the costs are buried in insurance and hospital private agreements. The tax payer is paying the bill, and this will change, saving many dollars. Medical charges will have their overhead costs included in the standard charges. Hospitals and Medical centers will receive part of those fees to cover their operating costs. The hospitals and medical centers will have to operate efficiently and maintain a % of full capacity in order to insure a reasonable profit. Doctors not producing efficiently or operating with bad practices will not be desirable. Some doctors that are specialists will work for several hospitals to insure a reasonable work load. Populated areas may also be just as competitive as less populated areas. Specialized medical facilities could be less apt to have general practice but be more technically equiped to handle their job and could be fed from facilities around the country. It must also be noted that some medical charges are inflated for various reason and this should be taken into consideration when the rates are restablished by the NBME. The NBME will be in the position to make these decisions most fairly and openly.

The poor will have another benefit for living in the US without being singled out as someone less than everyone else. They will have the same health care as everyone else. This may help them GROW into a better citizen, because they know they are now participating in a program the same as every other person in America.

Our Indian Affairs Agency can concentrate on other issues, other than health care. We need to be looking for ways for them to be more inclusive to our way of life, without depriving them of there heritage. We all enjoy the diverse backgrounds of our ancestors. Today we are all Americans together. Indians should not be singled out and given unfair advantages or disadvantages over other Americans. I think its time for a real treaty.

Our veterans will have the best health care possible when they come home. We will all be paying our fair share and if they need special help, we will all pay the bill. This is another cost of war we must all bear equally. The homeless on the streets have a lot of our veterans. This will give them the real help they need. We owe it to them. Help them be part of the American dream again.

The Federal Government can gain some needed respect from its people. Many people I have talked to, don’t like big government and they don’t want the government telling them how to live. They say Universal Health Care is leaning towards Socialism. My answer is that sometimes the federal government is the only answer to some problems. Our present National Defense is big government without controls. We, as a Nation, are not paying for the wars in Iraq and Afghanistan. We are now in big trouble. Why are we not paying this war in Iraq, instead of borrowing from someone else? Why are we cutting back on all our services for a better life because we can’t manage our budget? Why is our government going into debt paying for health care for those who can’t afford it or don’t want to buy insurance? Why is big government spending our SS money with no intent to pay it back? These are all principles we need to change. Our National defense should never be farmed out to someone else since we never know who our next enemy will be. The United Nations should be the place to work with other countries. We need to be the leaders in foreign affairs, not the bullies. When nations make treaties with each other, they defeat the idea of a United Nation. Is there a way to change this?

This plan has regulations and controls to make it work. This plan has everyone paying, will never go into debt, and is flexible to keep it current to the times. This plan will allow us to write-off our Medicare and Medicaid debt forever ,because we won't ever need that money ever again.

The problem with Social Security can also be solved following these same principles. Today we are collecting more than what we need. So our Federal Government, for the past 40 years, has been spending, without the taxpayers approval, all this excess money on programs no one knows anything about, didn't want and doesn’t serve all the people. Why not just reduce how much they collect and pay just the benefits. Keep track of where the money is going and let us know what each benefit is costing us. If we like what we are doing, there will be no problem for us to pay the bill. If not, our politicians will know and they can work on the problem. If more or less money is needed, adjust the %. Also all earnings should be taxed from dollar #1 to whatever is earned, no limit. The SS debt can be eliminated since we already spent the excess money and we won’t need that money ever again. If the government needs additional money to provide new programs, tax us and let us know what it will cost. We used to take care of our own parents and family, but times are different. Now we rely on the government to do this for us. As long as the government is not wasting the money, we should all be willing to take care of those in need. We can still do it with our democratic system. No big deal!.

Hybrid autos could benefit the lowest tax until it is acceptable for general use.

Green products could use the "A" tax. People could still choose to buy what they want, but will pay for their choice.

Summary of benefits:

1. Save big money, $100’s of billions a year.

2. Pays for the health care with todays dollars.

3. Uses a national sales tax system to fund the Universal Health Care costs, which pays for itself and will never go into debt.

4. Requiring the Federal Government to implement the plan; allows the medical experts to be responsible for its fairness; Charges the congress to regulate the tax based on factual data from a new records and statistics agency; and instructs the US Treasury to pay only the medical bills from its own health care fund, creating a complete clean system.

5. The health care fund used only for health care costs and adjusted such that no profits are made, makes for a sustainable system forever.

6. Insurance companies will go back to selling insurance to protect things of known value.

7 Politicians won’t have to be bothered with trying to fix an unfixable system.

8. Lobbyists won’t be needed in the health care business since the politicians are not making health care laws.

9. Eliminates the need for drug companies to advertise to the general public since doctors will prescribe drugs that the health care system will purchase. The best and most economical drugs will be used. When a better drug becomes available it will probably start using it as soon as the old drugs are used, eliminating waste.

10. Relieve the employer from the responsibility to provide health care for their employers. They immediately have more money at their disposal to perform their mission.

11. Eliminates the need for the federal government to insure those the insurance companies claim are bad risks.

12. Transfers our valuable volunteers from health care needs to areas such as education, housing etc.

13. Eliminates the effect of inflation to health care.

14. Workers are free to work where they want.

15. Unions can work with both the workers and employer to have the best and safest working conditions possible, without the fight over who pays for the health care. Survival of the company is most critical.

16. With prepaid health insurance, our people can again find their place in the work force and make a decent living.

I think the plan I am proposing make a lot of sense. Everyone pays for their own health care, up front, before they need it. There are rich people and poor people getting sick. Also some of the rich and poor go thru life without seeing a doctor. No one knows when they need health care, but knowing you’re covered is a good feeling. When you are young, you don’t need a doctor as much, but when you get older, doctors are important. It’s a good feeling to know that everyone is paying for the health care they are getting. Its also a good feeling to know that everyone has the same quality of care.

CAN WE MAKE THIS BETTER?

YES WE CAN