Dr. Aaron is http://, now is not really the time to get in endless discussions on KOS, but to tell our elected representatives how we feel on health care reform.
Still, I am in the midst of searching through my own views on the subject and can't help using this forum to 'think' out loud.
After my diary reading through the single payer proposal H.R. 676, I got to thinking over the last few days. How could this law be amended or marketed to get over the 100 or so sponsors in the House it currently has?
Here are some random ideas:
Idea 1: Leave gaps in the National Insurance coverage to hold down cost to taxpayer and allow a place for private insurers
Although we'd all like the National Health Plan to cover 100% of everything, that would cause the problems of increased opposition from the well-entrenched health insurance industry and a higher rate of taxes necessary to fund the $2 trillion annual budget. We all know how politically difficult it is in America to raise taxes, so the less the Congress has to raise them to finance the plan, the more support can be garnered for a National Health Insurance bill.
So why not create a health plan with 'gaps' for those with high enough income and/or supplemental insurance to pay for those gaps?
That would create a market for the supplemental private insurance industry to fill in the coinsurance, deductibles and copays for wealthier Americans. Employers would take care of this supplemental insurance for most employees. Regulations would insure that self-employed individuals could purchase supplemental plans without pre-existing exclusions. All copays, deductibles and coinsurance under the national plan would be waived for those 300% of the poverty level, so they would not need supplemental insurance.
Of course, the health insurance industry would still be opposed to such a plan, but rather than completely eliminate them, it would still give their industry a place in our system. And the government payer would have control over all doctors and hospital fees. The paperwork and administration from the private supplemental insurance would be minimal, since the insurance companies would be prohibited from denying payment for any claim already approved by the government plan ('Medicare for all').
Idea 2: Financing
I have come to like the idea of several avenues of financing to keep the health system going. But I DON'T like the idea of a transaction tax on stocks and bonds, as is called for in H.R. 676. THAT needs to be reserved for the financial bailouts.
How about a windfall profits tax on pharmaceuticals and manufacturers of high tech medical equipment? If we can't control the costs of these products, why not plow some of the profits back in the system to help pay for them for the people who need them?
Additionally, to add to the income tax and payroll tax provisions on H.R. 676, how about a very small portion of state sales tax or income taxes, based on what each state currently collects for Medicaid?
These are just some random things to think about as we write our Congresspersons and the President-elect. I doubt H.R. 676 could pass as written (does any bill ever pass in its original form) but a few changes could increase its political viability.