Monday, July 15, 2019

A Plan to Achieve Healthcare For All


July 2019

It's great to see that most people in this country recognize the necessity of having healthcare for all. This blog suggests that a Central Healthcare Agency and Marketplace (CHAM) is needed. Some of the goals and objectives of a CHAM include:
  1. Ensuring everyone has access to excellent and affordable healthcare, including Long Term Support Services.
  2. Setting standards and price ranges for healthcare products, services, and insurance plans that are subsidized.
  3. Ensuring that no one needs to pay more than a percentage(5%?) of their annual income for healthcare premiums and no more than an additional rate (5%?) for their total yearly healthcare costs.
  4. Enabling the private sector to provide healthcare products, services, and insurance plans that meet and surpasses standards set by CHAM. Anyone willing and able to pay healthcare costs that exceed CHAM's standards can do so.
  5. Ensuring that healthcare costs are sufficient to
    1. attract people to healthcare jobs and professions,
    2. continually improve products, services, and facilities, and
    3. promote innovation, research, and ever-increasing quality of care.
  6. Enabling employers and other third parties to offer healthcare plans either through their chosen vendor and/or by contributing to an individual's CHAM account.
  7. Confirming that most people all along the wealth spectrum see the system as equitable.
  8. Encouraging competition and healthcare investments.
  9. Ensuring that the system is economically self-sustainable.
The CHAM will set minimum standards for healthcare and long term support services. State and/or community CHAM boards will establish price ranges for all products, procedures, drugs, and other commodities associated with these services. Price ranges will also be set for healthcare plan expenses, including premiums, deductibles, copays, and out-of-pocket expense caps.

Private and public enterprises will sell their healthcare plans through CHAM. Each plan must offer all of the minimum set of healthcare products and services set forth by CHAM. Enterprises that currently don't provide the complete set should collaborate with other enterprises to ensure comprehensive healthcare and long term support services are available to everyone.

Individuals and households will sign up to be members of CHAM. Members will be charged monthly premiums that are a percentage (5%?) of their taxable income. Members total annual out-of-pocket healthcare expense will be capped at an additional rate (5%?) of their taxable income. Members choose any healthcare plan they want. CHAM pays all healthcare charges that meet CHAM standards and are within CHAM's price ranges. Members can select programs whose healthcare plans expenses exceed CHAM's ranges by waiving CHAM's responsibility to subside any of the member's healthcare charges for that enrollment period. Members will be charged for deductibles and copays up to their annual out-of-pocket expense cap. Members will also be charged for products and services that are not covered by CHAM standards or exceed CHAM's price ranges. See examples below.

This proposed plan needs to be vetted by healthcare professionals, the general public, economists, healthcare plan managers, healthcare insurance carriers, and legislators to ensure that the goals and objectives listed above are met.

I look forward to your feedback.
Examples
Re Healthcare Premium

CHAM's member's premium cap = 5% of taxable income
CHAM's price range for premiums = $0 - $400

  1. Example 1
    1. Characteristics
      1. Member taxable income = $10,000
      2. Healthcare premium = $200
      3. Member does not waive CHAM subsidy
    2. Member Pays $500 for premium (5% of $10,000)
    3. CHAM Pays $0 subsidy for premium

  1. Example 2
    1. Characteristics
      1. Member taxable income = $1,000
      2. Healthcare premium = $200
      3. Member does not waive CHAM subsidy
    2. Member Pays $50 for premium (5% of $1,000)
    3. CHAM Pays $150 subsidy for premium

  1. Example 3
    1. Characteristics
      1. Member taxable income = $10,000
      2. Healthcare premium = $550
      3. Member has to waive CHAM subsidy or choose a different plan
    2. Member Pays $550 for premium
    3. CHAM Pays $0 subsidy for premiums

  1. Example 4
    1. Characteristics
      1. Member taxable income = $10,000
      2. Member does not waive CHAM subsidy
      3. Healthcare premium = $550
    2. Member Pays $550 for premium
    3. CHAM Pays $0 subsidy for premiums
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