PROPOSED ALTERNATIVE OF ACTIVE AID
EFFECTIVE PUBLIC-PRIVATE NATIONAL HEALTH PLAN
Preamble. The goals and objectives of this plan are to provide all US citizens and other legal residents with quality medical care; to provide reliable competitive private medical and hospital insurance business; reduce fraud, waste and misuse through personal insurance profit motives; and provide “socialized” care through Medicare for people of any age with chronic and serious debilitating physical or mental illness or injury. Medicaid and SCHIP should be discontinued.
Plan:
A. All citizens and other legal residents with chronic and severely debilitating physical or mental illness or injury will receive medical certification and are enrolled in Medicare, which will pay all reasonable and necessary expenses. It is assumed that Medicare payroll taxes will still be levied to fund the program.
B. All other citizens or legal residents, and not chronically and seriously disabled, should be covered by an individual, family or family insurance plan / contract (subject to the “grandfather” below). It is assumed that private insurance companies will actively compete on the basis of benefits, services and prices. “OTC” insurance value is a non-taxable expense. A federal premium subsidy program is established for lower-income individuals and families; with applications prepared and submitted in collaboration with the selected insurance provider; with the payment of subsidies directly to the insurer. Insurance policies must last at least 1 year, automatically renewed if they are not canceled by any of the parties at least 60 days before the policy expires. It is assumed that the insurer may refuse to extend the validity of insurance coverage for any insured person who becomes chronically and seriously disabled during the term of the contract. In this case, the insurer will help the policyholder treat disability certification and registration with Medicare.
C. It is assumed that all policies will cover catastrophic cases, emergency services, inpatient care, and the services provided and laboratory tests ordered by the primary care physician. Policies may vary by coverage and cost based on gender; for example, men do not need maternity insurance; and by age, as older people usually need more medical care. Political premiums may also be adjusted depending on the presence or absence of risk factors such as smoking, obesity, or drug / alcohol abuse; and any such allowances should not qualify as a government subsidy or tax deduction.
D. It is assumed that during the transition period, all existing forms of coverage or services will be supported in the new programs. After that, employers will no longer provide health insurance under their benefits program. (The policy on income from disability, life insurance, etc., may be provided at the choice of the employer or in the framework of a collective agreement).
E. It is assumed that for those who cannot receive private insurance for underwriting reasons, a pool of “assigned risk” will be required.
F. Anyone who needs medical / hospital care, but who does not have personal insurance or Medicare coverage, is personally liable (with parental responsibility for a minor) for all reasonable and necessary expenses incurred; and it is believed that he promised to pay and agreed to a court decision on any unpaid amount. In such a case, the service provider may submit unpaid invoices with a claim for reimbursement of expenses to the Treasury. Thus, the rights of the provider will be sub-controlled; and the Internal Revenue Service uses its collection procedures as necessary.
G. All citizens and other legal residents who have reached the age of 64 by the time this law is signed must be “grandfathered” into Medicare, with the option of waiving the unprivileged private insurance policy at any time.
