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Repeal and Replace

Simply repealing ObamaCare will not be enough. Sadly, Liberals have convinced Americans that it is the responsibility of Government to solve all our problems.  As a Conservative, I profoundly reject that premise but whether we like it or not, the public will expect and demand that Speaker Boehner and the Republicans offer an alternative to the 2600-page monstrosity that is about as popular as a root canal, that few have read, and even less understand.

In that spirit, I will offer here a vision of a healthcare system that corrects the pre-ObamaCare shortcomings – and does so without the strong arm of Government imposing unconstitutional mandates or excessive control over one-sixth of our economy and the health of this nation’s citizens. And more importantly, it is based on free-market principles that are sacred to Conservatives. We believe that the marketplace should be regulated not by laws passed by Congress, but rather by the natural laws of supply and demand – and that competition is a more just and effective regulator of consumer prices and product quality than artificial price controls and overreaching regulations imposed by Government.

The FDIC has been a successful program. It doesn’t mandate regulations upon banking institutions, but rather requires banks to voluntarily accept certain restrictions if they choose to participate. My vision is modeled after the FDIC program in the sense that participation by healthcare insurers and consumers is a choice – not a mandate.

My vision begins with the establishment of a non-political, independent commission consisting of representatives from business, health insurance companies, medical professionals, and consumer advocates. I will hereafter call this the Universal Healthcare Commission (UHC).  Although Government funded, the power and authority of the UHC will be extremely limited as will become evident later. I envision 12-15 members on the panel plus a few staffers. Elected politicians are banned from membership.

The primary duty of the Commission will be to write a small handful (5-6) of health insurance policies to accommodate customers of varying ages and health. These policies will be written in simple, easy-to-understand, language that leaves no ambiguity whatsoever as to what is covered,  what is not, co-pay amounts, and the limits of out-of-pocket expenses to be borne by the insured. I will call these plans UHC Plan A through UHC Plan E for the purpose of discussion here.

UHC Plan A, for example, could be written for young healthy people who want to be covered only for catastrophic illnesses. Accordingly, this plan would have a very high deductible and be somewhat limited in covering minor medical issues. Plan B would have a lower deductible and cover more medical conditions than Plan A. The progression of each plan from the previous plan up to Plan E would reduce the maximum out-of-pocket expenses while expanding the limits of coverage.  Plan E would be for those approaching Medicare age and more prone to health issues. Perhaps a UHC Plan S could be written as a Medicare Supplemental for seniors.

Once the UHC insurance policies are written, all health insurance companies may be permitted (but not required) to offer these plans to the public without any modifications to official UHC language or substance of each plan. Since this is the very foundation of my vision, let me repeat: Insurers are not required to sell UHC health insurance plans – doing so is strictly voluntary.

Here comes the rub:

If health insurers choose to sell officially-sanctioned UHC insurance policies or if consumers elect to purchase them, then both must accept a rigid set of rules and restrictions as follows:

  • Insurers may set their own price of premiums for each UHC plan, but that price must be the same for all customers.
  • Insurers may not deny anybody a UHC policy for any reason including pre-existing health issues or prior health history.
  • Insurers may not drop coverage on any UHC customer for any reason (including lifetime limits) so long as premium payments are current.
  • Health insurers will be permitted to sell their UHC policies across state lines unrestricted (but not non-UHC policies).
  • Consumers who elect to purchase UHC-sanctioned insurance policies will be required to limit medical malpractice compensation to actual costs plus $250,000.
  • Advertised UHC premium prices for all insurers will remain in effect from January 1st to December 31st of each calendar year. Premium increases (or decreases) must be submitted to the UHC for posting on their public website – and must be submitted no later than September 30 to both the UHC and current policy holders in writing for changes that take effect January 1.

 

 

 

You can bet that health insurance companies won’t like the restrictive rules attached to UHC policies. Tough. Bankers probably don’t like FDIC rules either, but they know customers will not come to their bank unless there is a “Member FDIC” logo on their front door. Similarly, why would consumers give up the guaranteed consumer protections, certainty, and peace of mind the UHC plans offer in favor of remaining in a system that is morally corrupt?

 

 

My vision returns true competition to the marketplace. UHC Plan C offered by United Healthcare is absolutely, unequivocally identical in every aspect to the Plan C sold by Blue Shield – the only difference being price.  Comparative price shopping today for health insurance is a virtual impossibility. The average consumer doesn’t have a Harvard law degree or access to a team of lawyers to wade through the seemingly-infinite number of plans available out there with much of the important details buried in the fine print written in legalese dialect.  One has to wonder how many times an insurance salesmen gave this pitch to a prospective customer: “our plan may cost a little more, but it covers more than the Blue Cross policy.”  Yeah, right.

Tort reform is achieved without Congress and ugly partisan politics. Limiting malpractice awards will legitimately lower the cost of health care. Consumers will gladly give up their prospects to become obscenely wealthy (along with their attorney) in exchange for the peace of mind in knowing their health insurer cannot screw them over. Insurers will have more of an incentive to work with health care providers to contain spiraling costs of medical treatment because they are locked into a fixed price for their premiums from Sept 30th to December 31st of the following year. Doctors and hospitals could elect to offer discounts to patients covered by UHC policies because it eliminates the threat of multi-million-dollar malpractice lawsuits.

The ongoing role of the Commission (UHC) will be to monitor insurance companies, investigate consumer complaints, and enforce compliance. They have no power to write regulations beyond establishing the official insurance policies applicable under the UHC program.  The Commission will also maintain a public website that thoroughly and clearly explains each of the five-six insurance policy plans sanctioned by the UHC. And it will publish the premium costs of each insurer’s policy plans along with the previous 3-year history of their prices to show consumers the insurer’s pattern of rate changes. The website will devote a section to consumer rights and provide an easy means for consumers to file complaints directly with the UHC.

The only role of Congress would be to approve the creation of the UHC, lift restrictions governing sales of UHC insurance plans across state lines, and then stay the hell out of the way. Congress will have no authority to write or modify the policy plans written and approved by the UHC.

I perfectly realize that by putting my vision out in the public domain, I am painting a bull’s eye on my forehead. That’s ok. I’m a big boy and can take the heat. And if anybody actually reads this, I’m sure they can find flaws within it. That’s ok too. Innovation begins with a simple idea. I offer this more as a concept than a detailed proposal.

The way I see it, it’s not enough for those of us who oppose ObamaCare to simply complain and whine about how terrible it is. To do so makes us look like partisan political hacks out to sling mud at the opposition party.  Speaker Boehner promised Repeal and Replace.  It is therefore incumbent upon Conservatives and the Republican Party to put forth an alternative.

And that’s what I have attempted to do here.

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