My idea, let me show it to you.
I have been listening to the news a great deal lately, particularly as it pertains to the current financial crisis and health care reform. Earlier today, I heard a report that credit unions in U.S. are best withstanding the troubles caused by the so-called “credit crunch”, which was followed by a report on an increase in hospital emergency room usage as a result of people losing health insurance along with their jobs.
The combination of the two stories triggered my idea, explained in detail below, that may help resolve some health care issues, as well as free up some money being spent on health care (which I believe is currently in the vicinity of 16% of GDP, and only expected to rise) for other uses. To summarize briefly, my idea is to form a voluntary-membership health care union (HCU), along the lines of a credit union, that would help people who are otherwise uninsured obtain affordable health care, while avoiding a single-payer system. Details are provided below. At this point, I am compelled to disclose that I don’t have enough of a background in the health care, legal, or financial fields to fully understand or explain the regulatory, legal, and financial ramifications, so I will confine my remarks to a conceptual level.
Specifically, my idea is that anyone who is uninsured for any reason, is underinsured, or is dissatisfied with or ineligible for employer-provided health insurance, would be able to join a community-based health care union. The community in question could be at a municipal, county, state, regional, or federal level; in fact, there would be no reason that there couldn’t be more than one HCU available in any given area. An HCU could be administered privately, publicly, or in a public-private partnership. HCUs could also be set up as not-for-profit entities.
Under this model, multiple insurance companies could offer a variety of plans and à la carte products at any given HCU, just as credit unions offer a variety of checking and savings accounts. Customers would be able to customize their plans, and could opt for additional coverage that may not be available under our current model, such as an additional policy for complementary and alternative medicine, or a policy that covers prescription drug expenses that fall in the infamous Medicare “doughnut hole”.
Furthermore, there could be a variety of payers under the system. Employers could pay the HCU membership for employees, rather than working directly with insurers. This would be particularly effective for small businesses, which could not otherwise offer health insurance for employees. HCU fees could also be subsidized by municipal, state, or federal government entities. Finally, individuals could pay their own fees. HCUs, particularly if they are not-for-profit agencies, could even choose to offer fees on a sliding scale.
The benefits that I anticipate from the HCU model of health care are as follows.
Overall benefits:
• Avoids the problem of “rationing” and other issues related to a single-payer system
• Assumes that the insurance, pharmaceutical, and health-care industries continue to operate in a for-profit environment–because let’s face it, the odds of that changing any time soon are pretty low.
• Preventive care is covered, which saves everyone money, and saves us individuals a lot of preventable health problems
Benefits to health-care consumers:
• Accessible, affordable health insurance is readily available to everyone
• Consumers receive the benefits of reduced costs negotiated by HCUs
• It becomes practical to avoid using the emergency room for non-critical care
• Preventive care is covered
• If used in conjunction with a health-care savings account (the infrastructure for which already exists), HCU fees could be paid with pre-tax dollars
• Ability to customize coverage for themselves and their families; preserves individual choices
• Continuity of care and coverage across life stages and employment changes
Inducement to the insurance industry to go with the plan includes:
• Allows insurance companies to offer new products
• Retains a competitive environment for-profit model for the industry
• Gives insurance companies access to a new customer base that cannot currently afford or does not have access to products (the uninsured and underinsured)
• Reduced administrative costs associated with gaining and losing customers as employees change jobs
Benefits to the health care system include:
• Reduced use of hospital emergency rooms for non-critical care
• Provides an alternative model to Medicare and Medicaid reimbursement, especially as reimbursement does not keep pace with rising costs
• Improved sharing of medical records among providers for a single patient, especially as the industry moves towards standardizing electronic medical records
Benefits to employers:
• Reduce costs for providing health insurance to employees, freeing up funds that were previous allocated to cover ever-rising premiums (maybe businesses would even be able to avoid or reduce layoffs in the current economic environment)
• Increased ability to provide coverage options
• Potential to reduce administrative costs
• Aligns with the model of health care savings accounts
Benefits to government entities:
• As employers, government entities would be able to participate in the HCU model
• Avoids the costs and infrastructure bureaucracy associated with running a single-payer system
• Current benefit programs could be converted or folded into HCUs
And yes, I have already emailed this to every pertinent elected official at the state, federal, and local level (BTW, Governor Daniels, you need a link to your email address on your homepage, somwhere obvious. Srsly.) Feel free to send this link to your congresscritters, though.
[...] have actually had a semi-personal reply from one of the legislators to whom I sent my idea on health care reform…I shall not identify the individual in question, but I will say it’s the first time [...]