A single-payer health plan that could pass

Synopsis: Proposal for a Single Payer Partnership, funded equally by employer and employee, modeled after self-insured industries, administered by insurance companies selected through competitive bidding in the respective States.

A Plan Even Harry and Louise Could Love

The insurance industry has fought to continue the present system, because it is profitable. Employers famously complain that it would be too expensive to provide workers with health insurance. Too many working Americans must buy insurance they can’t really afford or risk losing everything because of major medical expenses. How about a plan that will protect each of these groups while providing basic health care for all Americans?

I propose a single-payer system — call it a Single Payer Partnership — funded by equal contributions from employer and employee (á la Social Security) plus taxes most people will agree to, such as on cigarettes, whiskey and killer bullets. Each State (no Big Government threat here!) would solicit proposals from individual insurance companies or consortiums to administer that State’s share of the fund; the best qualifying proposal in each State would be awarded the contract for that State — subject to review and renewal as are other government contracts — under which the winning bidder would be paid to administer the fund.

PRESTO! Health care for everyone, administered by those most experienced in doing so. Part of the cost savings is immediate, with insurance premiums eliminated, but with the insurance industry still a major partner and thereby continuing to make money; employers will not have to foot the whole bill because employees will (gladly) contribute a fair share; and the uninsured are now included.

Those already covered by Medicare and related plans — the elderly, the disabled, the indigent and certain low-income workers — are brought into this universal plan, along with their present health care funding (e.g., Medicare, Medicaid, VA, SSI). There should be additional savings realized when everyone is under one umbrella.

The insurance companies should like this plan, because it will keep them in the loop at a lesser risk to them (if in fact health insurance is as risky as they would have us believe). And there will still be a need for “gap” packages such as are now being sold to Medicare recipients as Part B — as well as a market for new policies of life insurance for those who now can afford it!

It is reasonable for employers, large and small, to contribute to their employees’ health care, since a healthy work force benefits the employer as it benefits and advances the greater society. But no doubt the employer will write off its share of the insurance fund, and perhaps raise the price of pizza by 50 cents. We can live with that.

The benefit to the economy, in addition to controlling out-of-bounds medical costs and freeing up more money for voluntary spending, will derive in part from increased job stability and work force quality. Many people now take jobs they don’t want, or leave jobs they like, just because of health insurance concerns; it will now be easier to attract and keep quality employees. More folks will be able to become self-employed because of the safety net, and this should lead to more jobs being available.

Existing Models

As anyone with Medicare experience knows, that plan actually works quite well. You choose your own doctor. You can choose to buy a “gap” policy, or not. You can choose your treatment. Freedom of choice is everywhere. Obviously, Medicare could be the model for a single-payer health care system.

Another model, that might be seen as a microcosm of the Single Payer Partnership proposal, is already common in U. S. industry, and it works. Specifically:

The employer is self-insured — that is, the company maintains its own fund for payment of medical expenses for all employees, and pays a major insurance group to administer it. How blessedly simple! The employer saves money by hiring a manager instead of paying premiums to an insurance company which then pays for management but also must provide a profit to its shareholders.

For a modest, say $15, co-pay the employee can go to whatever doctor he chooses, undergo whatever procedure he chooses, and if the procedure is not covered and/or he has chosen a doctor who has not agreed to the fee structure set by the insurance company, the procedure will still be available but will simply cost him more. The employee contributes to the monthly premium and has an also modest annual deductible for optional procedures — all quite manageable for the average working person.

With affordable health insurance available, the employee will almost always opt for wellness care, with the inevitable reduction in costs over time, and everyone wins.

There IS a Health Care Crisis

So long as frightened parents have to go on television to beg for money to save a child’s life; so long as people with diabetes, cancer or heart disease can be denied medical insurance or be obliged to pay thousands of dollars a year in increased premiums; so long as millions of Americans drudge along in jobs they hate and/or put up with poor working conditions just to get or keep insurance, there is a crisis.

In this rich country of ours, there is no excuse for anyone going without decent medical care, yet we lag behind the rest of the industrialized world in providing for our own.