We Americans have prided ourselves on our ability to solve problems in a creative and intelligent manner. However, the national health care dilemma — our inability to provide affordable health care for all Americans — is a problem that we have been unable to address in a clear and effective way. Here is a national health care plan that allows a unique partnership between private enterprise and state and federal governments.
The first step would be to set up a Health Benefits Trust to be operated by each state government. In the first year, employers and employees would put their contributions into their state trust account. The federal government would double that contribution that first year as well as provide startup funding to maintain the health care policies in place. Those citizens presently not insured would be eligible beginning the second year. Federal government funds that are now being used for health insurance coverage of military and federal employees and retirees would be folded into the states’ trusts.
For the next two fiscal years, the federal government would match each state’s contributions. The federal government would continue for the next 10 years to contribute up to 40 percent of its original contributions to each state’s trust account or until the trust becomes self-sustaining through the private investments of the trust funds.
After the second year, employers would be able take the money that they would have paid out for health insurance and reinvest it in their companies, allowing them to pursue research and development and factory upgrades in order to help them stay competitive in the world marketplace.
Along with the Health Benefit Trust, each state would create an Office of Health Fund Management, which would negotiate with present health insurance companies for the best bid with the emphasis being on cost containment without sacrificing quality. Deductibles would be based on a sliding scale so that no individual’s health needs would be compromised.
Each state would also create a board of governors composed of a wide range of health care and business representatives. They would be responsible to ensure that the health care system is efficient, transparent, complete and accountable.
Here is how the coverage would work:
All individuals up to 26 years of age if not employed would be covered under this plan without deductibles. They would have a health care card that would cover all their health needs. All full-time students in community colleges, four-year programs and graduate students up to the age of 26 would be covered by the program as individuals, not as families.
All employees, documented immigrant workers, all persons retired from the private sector, the government sector, the military sector, and those on Social Security would be expected to contribute a percentage of their income based on a sliding scale to the health care system.
Citizens, while on welfare, would have health care cards. A small portion of their welfare payment would be deducted for their contribution to the system.
The following are the costs that would be covered by this plan:
Costs associated with hospital inpatient care. Examples: births, surgeries and diagnostic tests.
Costs associated with outpatient care. Examples: physical therapy, prescriptions, medications, prescription eye glasses, dental care, mental health care, chiropractic care and preventive health care, all with affordable deductibles.
Preventive heath care will be a new feature for citizen wellness. If the physician advises that a patient needs a physical fitness plan, the health plan would cover a membership, for example, in the YMCA with the stipulation that the criteria set forth by the physician must be met.
All military retirees and disabled veterans would be included in this program. All veteran hospitals would be closed down and health care would shift to the private sector. Funds would be allocated to the health care funds of each state through a formula based on the number of qualified veterans.
This plan has the following distinct advantages:
Every U.S. citizen would be eligible for affordable health care coverage with affordable deductibles for all income levels.
The combination of a private and public venture would stimulate the overall economy through private investment.
Veterans would receive care from local health care professionals and hospitals enabling them to receive timely and more convenient service.
Because corporations would no longer have to offer health insurance to their employees, they could invest the savings in their company’s growth, enhancing their competitiveness on the world stage.
By utilizing private health care companies, this plan taps into companies that already have expertise in health care management.
Because states would manage their own programs, a number of federal health care employees could be eliminated, freeing up the operation costs to be passed along to each state’s health care budget. Because the states are aware of their particular health needs, they would be in an excellent position to execute cost containment measures.
This model of universal health care has the potential to become the strongest and most practical health care program of any country in the world. The partnership of the best public and private expertise would guarantee the overall success of this health care program.
Bob Chaplin is a teacher at the Connors Emerson School in Bar Harbor and a teacher science intern at the Jackson Laboratory.