What if Obama-care is rejected by the Supreme Court? Where do we start? My thoughts:
- Set a reasonably high deductible and make everyone responsible for say the first $10k of their annual medical care costs. Index for inflation, and allow people to drop this amount of money each year tax free into Health Savings Accounts to fund this deductible.
- Anything above this limit, have the federal government pick up 100% of the costs. This gives every citizen catastrophic coverage. We can have a debate on whether it is better for hospitals and such to be federalized or quasi-private enterprises I lean toward the latter, but this is not a show stopper for me. And yes, we may need a tax increase to fund this.
- Turn medicade over to the states with ZERO federal funding. Let each state decide if and how they will fund lower income, disabled, etc. folk who need assistance with the $10k deductable. And along the same vein, let private and public employers decide if they are going to provide insurance plans to offset some of the $10k deductible. If they do then consider this taxable income…a change from how insurance is treated today.
Making folks responsible for the first $10k puts market controls in place for things like routine checkups, doctor care for most typical ailments and injuries.
Putting the federal government in place as the backstop for catastrophic issues makes sure almost no one goes broke. I say almost because the federal government will have to make decisions as to what courses of treatment they will and will not fund. The “will not” will be a challenging and interesting debate.
Finally, leaving the states to help their disadvantaged ensures a measure of local control. And with no federal subsidy there are no federal strings.
And that’s it. Simple with clear lines of who is responsible for what.