Single payer - nuts and bolts...
Many of us would prefer a Single-Payer health care system. What is single payer and how would it work?
Well, let's first look at the current system. The multiple payers include:
-Insurance companies paying out money that they collect from individuals/companies (as premiums via health insurance, car insurance, malpractice insurance, workman's comp insurance, homeowner's insurance, etc.)
-Individuals out of pocket directly to the provider
-Defendants as a result of successful lawsuits
-Taxpayers through medicare/medicaid or because hospitals/doctors write-off non-payments on their taxes
The market based mullti-payer system is flawed. With the current multi-payer system, the payers screen each claim and try to pass it off on another payer. For example, to get bills paid for an injury, claimants often have to complete extra paperwork that reveals if the claim can be made against workman's comp, car insurance, homeowner's insurance, etc. before they will actually pay out on the claim. Meanwhile, the doctor who performed the service is waiting for payment. Also, insurance companies CURRENTLY second guess doctors on what tests, procedures and medications are appropriate - these are the very real "death panels" that are part of the insurance-based market system. With the current system, doctors and hospitals charge everyone more to cover the bills that go unpaid.
For multi-payer insurance, the premiums are based on the size of the pool and specific information about members of the pool. As we all know, with the current system, many either cannot afford medical attention and go without or they go bankrupt trying to keep up with all the bills.
What is Single-Payer and how would it actually work?
Instead of multiple collections of money into multiple pools to pay on claims, we would still collect from multiple sources but the money goes into one pool and make payments are made without trying to pass it off on another payer.
First, there would still be a deduction from all paychecks based on the amount people make. (We should probably include all income so that the folks that live on investments/interest are paying into the pool too.) This, however is not the only point for collection. People who make less than a living wage would pay nothing or very little out of their paychecks but they will likely pay in other ways...
Divert the EXISTING charges that CURRENTLY goes to insurance coverage on the following items in which there is a liability to ourselves and others and a certain level of added responsibility/risk. For these entities, there could be a deduction for no claims to encourage safe policies. . .
-car/motorcycle owners & renters
-homeowners (A landlords' portion comes from renters so the renters are essentially paying this. (Just like they are paying property tax even though the poverty-level renters don't get credit and are still called "moochers"
)
-storefront owners (the someone-slipped-because-we-had-slippery-floors tax)
-doctors (takes the place of malpractice)
-airplane owners
-boat owners
-any business with employees (just like workman's comp so that safety is a priority)
SMALL "danger tax" on items such as these:
-cigarettes
-junk food
-ALCOHOL
-addictive prescription drugs - (to go for rehab facilities)
-sky divers & scuba equipment/services
-biking/skateboard (the equipment plus use of skatepark)
-trampolines & pools (homeowner insurance currently goes up for these things)
-pets (homeowner insurance currently goes up for dog owners)
-highly processed foods (end subsidies for high fructose corn syrup and start TAXING it)
-carcinogens - such as benzene used in fracking
-GMOs (would be nice to include)
Btw, this insurance really should include vision, dental and non-elective orthodontia!
Do I care about all the insurance-related business that would be pushed out? To be honest, they had their chance to do right by their customers and blew it so I'm not feeling a lot of empathy there. That said, there's plenty to do with a single payer system and many skills of the insurance industry would still apply. Claims still need to be screened - we need to look for fraud rather than passing the bill to others. (Incidentally, when Bush was in power, gov agencies went through an "A-76" process where jobs were turned over to contractors. The gov workers were told that they'd be able to apply for the new contractor jobs. Reverse situation here.)
We need policies in place so that costs come down overtime and better health outcomes are the goal.
Instead of profits being the goal, we want to move up on the list of countries with healthy citizens. We want to reduce infant mortality. We want healthier children ready to learn. We want healthier, more productive workers. We want to ELIMINATE bankruptcy due to medical bills.
If Republicans hate "Obamacare" so much, how about they join with INDEPENDENT Bernie Sanders and push for single-payer?
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