Mundercare - My solution to healthcare in America

Part One – The Federal Government’s Involvement 

The United States Treasury shall be the default reinsurance carrier for all American Citizens. The Federal Government shall fund a stop loss plan on every person equal to $50,000. This means the maximum any individual is responsible for paying for medical care is set at a $50,000 limit annually.  Individuals may purchase an insurance policy to transfer this risk to an insurance carrier. 

For lower income earners the $50,000 limit shall be reduced based on income. Individuals even at the poverty level will have some level of shared costs in order to allow for individual responsibility. The Government shall not pay for anyone’s insurance but rate cap the annual spend on needed care based on income and considering assets. Able bodied workers can be required to find gainful employment to have access to these benefits. 

This fall back option shall only cover basic care as defined by the Hippocratic Oath. Drug manufactures and medical facilities will help fund cost for lower income individuals in order to have access to participation to the $50,000 reinsurance program. 

Part Two – The States Governments Involvement

The individual state shall be tasked with the responsibility to provide Children’s (including maternity) benefits within the Federal Structure as they see fit. States will also be encouraged to provided Tier one care (basic everyday services) as they see fit to reduce impact on vulnerable individuals (homeless, immigrant, and others). States will also be given authority to establish any sort of plans and programs as they see fit. For example if California wants a single payer option they can choose to establish one.

Part Three – The Involvement of Insurance

Two types of insurance programs will be established. The first is to provide more comprehensive services and access in above to the basic benefits as assigned in the over $50,000 reinsurance program. For example access to a nationwide network of specialized hospitals or to elective services like gender reassignment or abortion. 

The second type of insurance program is will focus on the under $50,000 risk that is borne on individuals to pay annually. This $50,000 risk can be reduced to any amount, for example $5,000 by paying a premium to an insurance carrier. 

Part Four – Elimination of Provider Discounts

All providers of care, including medications, will be required to charge the same amount for a service or drug to all individuals. Copayments, networks and any other sort of mechanism that allows for cost shifting shall be abolished. All fees and costs must be provided upfront to the patient or their representative except in the case of emergency or urgently needed care. 

Part Five – General Welfare Provisions

General welfare pertains to the over health of the population in terms of limiting the spread of infectious disease (vaccinations) and deficiencies based on environment (pollution and natural disaster). This section also falls under the Federal Government’s responsibility as these risks are irrespective of state boundaries.  I have very strong opinions regarding vaccinations but they are out of scope for this article.

Part Six – The Employers Involvement 

Employers will benefit dramatically from reduced costs based on the $50,000 reinsurance program funded by the government. Employers will be tasked with collecting payments for the program via a payroll tax.  Individuals based on income will also be required to contribute to the program. Nothing is free.

Part Seven – The Individuals Part

Much of medical costs can be eliminated by good personal lifestyle choices. Individuals with poor health have a special responsibility to work for good health outcomes for the betterment of the health of the community. In the spirit of brotherhood/sisterhood any individual tapping into the $50,000 reinsurance program and low income individuals receiving special assistance will be required to work toward health outcomes as assigned by a community if their peers (individuals with the same health issue).

Part Eight – The Role of the Association

Like minded individuals shall be given the right to bind together via free association to bear the burdens of one another based and shared values, for example a church, social organization, or union.

Part Nine – The Medical, Governmental, and Elite Classes

No governmental, medical, or global organization shall be allowed to establish any structure to provide special services, programs or entitlements without first forfeiting lifetime access to the $50,000 reinsurance program

Part Ten – Prescription Drug Reform

Comprehensive drug reform is essential and will be included in reform efforts. This topic will be covered in depth in a latter release.

Part Eleven – Tort Reform

Tort reform is essential and will be included in reform efforts. This topic will be covered in depth in a latter release.

Part Twelve – Monopolies 

Market reforms are essential and will be included in reform efforts. This topic will be covered in depth in a latter release.

Part Thirteen – Vision, Dental, & Hearing

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Part Fourteen – Alternative and Holistic Medicine

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Part Fifteen – It’ Getting Complicated is it not, I am sure I missed something…