Healthcare 2017

All Inclusive Health Care 2017

Some may remember when the government decided that we must all have automobile insurance if we owned a car. People thought it was a horrible intrusion into the free market, the insurance companies loved it, now we all had to buy their product

If you look at the automobile insurance market today you will see many different rates, and many options for coverage, with a variety of payment plans. Competition in the market has kept premiums low, and we have many choices and just as many options. The insurance was portable and can be carried to any state that you lived, or moved to. Premiums are affected by your age, driving habits, accidents, the type of vehicle you drive, and whether it is new or used

If this model is used in health care, Insurance would still be mandatory, but competition would dramatically push your premiums down. With the ability to carry the insurance across state lines, the insurance companies would be forced to compete for your business, not the other way around. Premiums would be subject to adjustments and would be affected by relocations, age, incidents, and deductibles. Normal medical check-ups would not be a reason for rate increases. Annual limits on Increases will also keep premiums down, controlled by a percentage. Pre-existing conditions will put a person in a higher risk category, but insurance cannot be denied, and any attempt to do so by an insurance provider may result in a fine.

Students will be able to remain on the parent’s policies until they reach their 26th Birthday. If they are employed prior to 26, and all full and part-time employees will be able to get insurance on their own or from their employer, who will have reduced rates depending on the number of employees they have. Employers can use health care insurance as a recruitment tool, and can pay all or part of the premiums for each employee.

As mentioned previously, everyone will be required to carry health care insurance. Everyone will also be responsible for paying the premiums for their insurance, family plans will of course be the responsibility of the primary bread winner(s). Premiums will be capped at a certain percentage of the individual or family income, assistance will be available for all legal residents if the premiums go above this percentage. Annual increases will also be limited to no more than 7%.

An individual, or a family unable to make payments because of a disability or unemployment will be eligible for assistance paying the premiums. A disability will be subject to an annual review, an employment issue will be reviewed on a quarterly basis. Someone on unemployment benefits will receive assistance even if they work part-time, as long as they are below the threshold, unless they receive health care from the employer.

This document places the focus on health care, all other issues must be dealt with on an individual basis.

ALL INCLUSIVE HEALTH CARE

Committee: Ordinary Citizen

Bill No: 07042017HC 

Principal Author: Richard S

Delegation: Citizen

Title of Bill: All Inclusive Health Care

BE IT ENACTED BY THE PEOPLE OF THE UNITED STATES

Preamble: Health care costs have continued to spiral out of control even with the current AHCA law, and partly because of it. This suggested bill will effect changes in costs, responsibilities and provide basic benefits for all legal residents.

SECTION 1: Legal resident shall be defined as any person born within the legal boundaries, territory or military facility of the United States with parents that are citizens. Also included are all persons who have attained legal resident status.

SECTION 2: Health care shall include Doctors’ visits, prescriptions, Doctor recommended lab tests, diagnostic procedures and essential or emergency hospitalization. Emergency and essential reconstructive surgery will be included. Non-essential, elective surgery is not included in basic benefits.

  • SUB-SECTION A: Doctor visits will have a co-pay of $25.00 per visit
  • SUB-SECTION B: Specialist visits will have a co-pay of $45.00 per visit
  • SUB-SECTION C: Prescriptions will have a co-pay of $10.00 for generic and $25.00 for branded medications.
  • SUB-SECTION D: Lab tests will be included with Doctor visit and $25.00 if outsourced.
  • SUB-SECTION E: Diagnostic procedures and outpatient procedures will have a co-pay of $45.00
  • SUB-SECTION F: Hospitalization for essential services will have a co-pay of $250.00
  • SUB-SECTION G: MRI Scans and future technology will have a co-pay of $350.00

SECTION 3: Insurance;

SUB-SECTION A: General Insurance Fund

  1. All individuals gainfully employed, this includes self-employed and employees of small and large companies, will pay a 1% tax on income.
  2. Companies with 25 or more employees pay a 2% payroll tax.
  3. Employees earning greater than $250,000 per year will also pay a 2% tax on income. The government will match these funds on an annual basis.

SUB-SECTION B: The income from SUB-SECTION A will go into the General Insurance Fund. This fund will be locked for perpetuity from any access other than insurance payments.

SUB-SECTION C: Everyone must have insurance, whether an individual or family. Elected representatives will be included in this plan, there are no exceptions.

Individual

  1. Basic Insurance – with a $1,000 deductible
  2. Basic Insurance with catastrophic – with a $1,000 deductible
  3. Regular Insurance – with a $500 deductible
  4. Regular Insurance with catastrophic – with a $500 deductible
  5. Premium Insurance – with a $250 deductible
  6. Premium Insurance with catastrophic – with a $250 deductible

Families

  1. Basic Insurance – with a $1,000 deductible
  2. Basic Insurance with catastrophic – with a $1,000 deductible
  3. Regular Insurance – with a $500 deductible
  4. Regular Insurance with catastrophic – with a $500 deductible
  5. Premium Insurance – with a $250 deductible
  6. Premium Insurance with catastrophic – with a $250 deductible

SUB-SECTION C: continued

Pre-Existing conditions

  1. Basic Insurance – with a $1,000 deductible
  2. Basic Insurance with catastrophic – with a $1,000 deductible
  3. Regular Insurance – with a $500 deductible
  4. Regular Insurance with catastrophic – with a $500 deductible
  5. Premium Insurance – with a $250 deductible
  6. Premium Insurance with catastrophic – with a $250 deductible

SUB-SECTION D: Premiums

  1. Premiums can be subject to individual payments, or if provided by an employer subject to discounting and reviewable on an annual basis
  2. Premiums are transferrable with changes in job or re-location including crossing state lines.
  3. Groups and associations can take advantage of discounted rates
  4. Premiums can be reviewed on an annual basis and annual increases are capped by percentage, exceptions can be reviewed
  5. Premiums will be open for competition between all the insurance companies
  6. Employees will be given a choice of insurance companies pre-determined by the employer. The discount will not be affected

SUB-SECTION E: Limits

  1. Rates must not exceed a pre-defined percentage limit of basic salary
  2. Once that percentage has been reached it will be eligible for assistance
  3. Rate increases are limited to a specified percentage.
  4. If the rate increase places the premiums above the limit, it will be eligible for assistance

SUB-SECTION F: Assistance

  1. Assistance will come from the General Insurance Fund
  2. Those that are unable to pay for the insurance, including those un-employed will have the premiums paid for.
  3. They will have access to the basic insurance with catastrophic coverage
  4. Eligibility will be reviewed on per pre-defined schedule
  5. Assistance will be provided with a change in situation until the safety net is no longer needed

SECTION 4: Optional coverage

  1. Additional coverage can be offered at additional cost for any plan. The responsibility can be negotiated with an employer on an individual basis. This also applies to the group and association plans.
  2. Abortions
  3. Non-essential surgeries

SECTION 5: Doctors will be responsible for the health and well-being of their patients. A Doctor will diagnose, prescribe medicine, tests, and procedures as needed to ensure the health of their patient. Unnecessary tests and procedures will not be covered.

  • SUB-SECTION A: Doctors are held to a high standard because lives depend on decisions they make. As long as a Doctor uses sound judgment in their diagnosis they will not be held liable for the unforeseen
  • SUB-SECTION B: Carelessness will not be accepted and a Doctor that develops a pattern of such behavior will be subject to a license review
  • SUB-SECTION C: In the case of a patient who was injured due to an error by a Doctor, fair compensation will be offered and insurance for the additional injury is already covered in an earlier section
  • SUB-SECTION D: Doctors will be protected from lawsuits, medicine is an imperfect science and all patients share in the healing process and therefore share responsibility
  • SUB-SECTION D: Pharmaceutical Companies will not advertise their products to consumers on Television, Print, Radio, Internet or any future media
  • SUB-SECTION E: Doctors are trained to understand the efficacy of a particular drug, only they will know the appropriate treatment for each individual patient. This should result in lower costs for prescriptions.

This is meant to be an outline as an example of one solution to repeal and replace the AHCA.

For a limited time this plan will be available for a free download with the following link.

I ask for your opinions and/or criticism, and if you like it, to pass it on.  We need as many people as possible to get involved, The Senate and Congress seem to be unable to agree on a workable solution.  Even if this is only a starter.

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