Medical Plan Option Change Form: Fill & Download for Free

It depends what your vantage point is on US healthcare.Warning: The Healthcare Crisis in the US demands that you take off your political hat. We must work together as a nation to address this problem. Our government AND private sector are BOTH at fault. If you insist on pointing fingers at only one sector, or the other, (public or private) then we ALL lose! Correcting this horrendous situation will require major changes in both the public and private sector. This is NOT a conservative answer. This is not a progressive answer. THIS IS NOT POLITICAL!We have 2 options:“Either way, it is important to understand a fundamental principal: 'Single-Payer' Healthcare Isn't Necessary -- But Single Pricing Is… and universal *coverage* is the delivery mechanism for single pricing. How we fund/finance that is (like other industrialized countries) variable by including a mix of ‘for profit’ and ‘not for profit.’” I am quoting Dan Munro Dan Munro, as he has said it best.Option 1: Maintain The Current System: This involves putting a bunch of Band-Aids on a heaving wound. We have already done that, as a first step, with the ACA. It is not working because it left the healthcare industry in charge, and making a profit by continuing to allow hidden multi-tiered pricing models. It also left the government in charge of setting pricing, along with the private sector, in a “cabal” like fashion. [1] If you believe strongly multi-pricing models in healthcare that are hidden from the public, is the right route; then I recommend an excellent answer that I just came across today, that suggests additional ideas for repairing what may be an irreparable system. We have 1 Trillion dollars annually in waste! 80BB alone in ER visits. See Joe Lonsdale's answer to The American health care system is insanely expensive. There are lots of entrepreneurs working on innovative ways to cut costs and deliver better care - what do they think we should be doing with the health care system overall? It is only fair that I add in the promises of some running for 2020 president, to address this “cabal" like pricing, so it can remained hidden, multi-tiered and less “cabal” like. I do understand why anyone even remotely affiliated with the healthcare industry would want to maintain a multi-tiered hidden pricing model; even if unaffordable and unsustainable. Obviously, any move to UHC is strongly objected to by a 4 trillion dollar healthcare industry that literally owns Congress. Their argument is that the healthcare industry is NOT truly free market or competitive. They believe, that if left without any government interference, that healthcare can be delivered to everyone affordably, accessibly and with high quality.Option 2: Transition To UHC (Universal Heathcare Coverage): If you believe that this is the route to go; then I have written an answer on why we need to remove multi-tiered hidden pricing models out of healthcare, and entirely transition to transparent, single pricing UHC. Pamela Pearl's answer to Will antisocialism be President Trump’s platform of choice for the 2020 Presidential election? Will it work? We can have quality and affordable healthcare; if we have the political will to do it. As part of this transition, we can move to a Medicare Buy-In, which is what Paul Krugman indicates may be more palatable for Americans now: Paul Krugman's answer to Is a single-payer healthcare system economically feasible for the U.S. right now? This does NOT mean that we will get rid of the pricing “cabal” mentioned in Option 1, but at least it offers some movement towards UHC. In additon, Paul Munro has written an excellent book, called Casino Healthcare, on why our current healthcare model is unsustainable. Dan Munro's answer to Why do Americans seem to be scared of a European/Canadian style of healthcare system? Here is a summary and video related to Dan’s book: The U.S. Healthcare System is like a Casino says Dan Munro | Datica BlogI would like to point out some important facts and fallacies that need to be told about profit and not for profit options.No Matter what, we MUST have transparency. [2] Without transparency, both within the existing model in this country, or if we transition to UHC, transparency and single pricing arr the keys.[3]US healthcare is NOT the most expensive in the world because it is the highest quality in the world. It is because we offer a hidden pricing, multi tiered, risk/actuarial based model of healthcare, where everyone is treated differently. Our model has not afforded American’s the highest quality healthcare in the world.Our drugs are NOT the most expensive in the world because of R & D expenditures by big pharma. They actually spend most money on marketing and lobbying, and relatively low amounts on R & D[4]The 1 trillion plus dollars of waste (referred to in Option 1 answer by Joe Lonsdale) is NOT government waste, it is for profit private healthcare business waste of our precious healthcare dollars. (Think open enrollment on the front end, and payment processing on the back end). Many estimate between 30–50% waste. Joe details the extraordinary amount of waste of our dollars in his answer.UHC does NOT have to mean government doctors and government run hospitals, as in Britain. UHC can be delivered by private doctors and non profit private hospitals, as in Canada. Both have pros and cons. The definition of UHC is often misinterpreted. The actual definition can be found on the WHO (World Health Organization Website): What is universal coverage?UHC can be single payer or multipayer, meaning to an employer, insurance company or government. BUT it can’t mean multi-tiered hidden pricing. It must be single pricing and transparent, to succeed.UHC is NOT socialism. It is NOT free. It is based on delivery of high quality affordable healthcare, (based on the WHO definition), without market forces driven only by profit, and without “cabal” like pricing. It is not government owned and controlled. It is government working with the private for profit and non profit healthcare sector to negotiate the best single rate, per procedure and drugs, pricing to deliver healthcare to a society.Your taxes go up, but that does NOT mean that your costs go up. You will no longer sustain the same premiums, co-pays and outrageous deductible amounts that you are paying now. If done correctly, your costs should go down; and you could end up overall having more disposable income.We can transition to Medicare buy in for age 55+, (which is a popular idea); but while very appealing, and less than most other insurance, it is still delivered as a multi-tiered hidden and fixed pricing model, that is still very expensive. See Paul Krugman’s answer on this.Realistically, it will be almost impossible to move to any form of UHC, without Campaign Finance Reform, because the 4 trillion dollar for profit healthcare sector literally owns Congress, and they do not want to switch from a multi-tiered, hidden pricing model to a single and transparent pricing model.Numerous credible sources have done research/studies in this area. These studies all correlate with each other. After reading enough in this area, it is easy to understand why the entire westernized world has moved to UHC. The US is an outlier by at least a decade from the previous outlier (China who moved 1.3BB people to UHC in 2009). Prior to that, the outlier was Russia, who moved to UHC in 1996.The #1 source for personal bankruptcy filings is for medical debt. [5] The public has been brainwashed to believe that people who file bankruptcy are spendthrifts, fraudsters and all alone irresponsible.I strongly recommend reading studies/research from The Kaiser Family Foundation, The Henry J. Kaiser Family Foundation WHO, Universal health coverage (UHC) The World Economic Forum: Our Mission, and The Commonwealth Fund: Home | Commonwealth FundOne might argue that UHC is socialism. That is incorrect. It is socialistic, like many other aspects of our capitalist society (e.g. Medicare, social security, public school, police, fire, military etc.); but it's not socialism.Finally, here is a nice summary of many of the different medical plan options that are being reviewed by the US House of Representatives.Mike Lieberman's share of "We read Democrats’ 8 plans for universal health care. Here’s how they work." in Ex ParteEither way the US decides to go, it is a monster problem that MUST be addressed, and will not get fixed anytime soon. Healthcare, as delivered in the US, is completely unsustainable and at crisis levels.Footnotes[1] The U.S. Healthcare System is like a Casino says Dan Munro | Datica Blog[2] http://www.americanhealthpolicy.org/Content/documents/resources/Transparency%20Study%201%20-%20The%20Need%20for%20Health%20Care%20Transparency.pdf[3] American Health Policy Institute[4] Big Pharma’s Go-To Defense of Soaring Drug Prices Doesn’t Add Up[5] This Is the No. 1 Reason Americans File for Bankruptcy -- The Motley Fool

Americans who are concerned about such issues sometimes point to Canada as a kind of liberal test bed. As I have said in some other Answers this can be very deceptive. Conditions are very different here. So is the Canadian Constitution. So are attitudes. So is the economy. So are the political lobbies.You can extract a few examples and possibilities but you have to be careful with them and not overextend them.You'd Need A Comprehensive US Liberal PlatformAt both the federal and provincial levels Canada has Liberal Parties. They put forward what their definition of what “liberal” means in the Canadian context. If they get elected they enact their liberal platform, to the extent that budgets allow.The United States does not have this. The Democratic Party does not pretend to be a liberal party. It's a grab bag of interests, big corporations, minority group activists, career social workers, people who believe in open borders, people who want the Second Amendment cancelled, some trade unions. etc. This does not add up to a liberal platform. The supporters of Bernie Sanders are saying just that. If it wasn't so difficult to form third parties in the USA, they would probably be one.The Liberal Party of Canada has, as part of its platform, things that are not necessarily part of a liberal repertoire. However, since they are the Liberal Party of Canada they have plenty of say so. The Liberal Party platform includes:-A commitment to multilateral free trade agreements.-A commitment to international peacekeeping.-A legalized commitment to a very limited, defined, constrained type of ethnocultural multiculturalism.-A legalized commitment to official bilingualism.-A commitment to high immigration levels, with a focus on economic immigration, and provincial participation in selection.-A commitment to recognition of the grievances of Canada's indigenous peoples, and negotiations on a “nation to nation” basis.-A commitment to managed agricultural supplies.-Economic stability as a strong, strong priority, with freedom of competition curtailed in some cases, if it has to be.-Using government-owned companies to accomplish certain economic and social objectives.-A commitment to nation wide standards of medical, educational and social services, expressed in part by transfer payments from the wealthier provinces to the poorer ones.Most or all provincial governments accept some of these principles, as well as the commitment to a comprehensive social safety net, expressed by government enacted social programmes.You Need Political Parties, Not A Bunch of People ShoutingWhat political party would be prepared to advocate this in the USA, to the extent it is applicable? And, you need a political party, not a bunch of individuals and groups grandstanding, blogging, expressing passionate views, decrying enemies, etc.At the United States federal level, that political party would have to commit itself to a “core” standard liberal programme, basically a capitalist social democracy with social justice created via social programmes. Then they would have a menu of alternatives like the above and would have to choose some. It wouldn't be much different at the state level.The Supreme Court Would Have A Field DayThe default position of the United States Constitution is that powers not specified as federal belong to the states. The Canadian Constitution is the reverse. Canadian law and cultures don't have the same concept of society being subservient to the untrammelled rights of the individual. A federal or state political party that tried to approximate Canadian liberalism would face a barrage of lawsuits and court challenges. The decisions would establish how far American liberalism could go, without constitutional amendments. This would play out over time as standards are established by legal precedent.So, Liberal America Takes ChargeSay, for example, revulsion against the excesses and failures of the Trump Administration opens a window of liberal opportunity. The Sanders faction and its allies take over the Democratic Party at the federal and most state levels. This liberalized Democratic Party continues much of the Sanders platform, with some add ons. The Democratic Party wins the Presidency and one or both houses of Congress. Similar things happen at the state level.Various permutations and constitutions could arise. Here is just one scenario:We're BrokeThe new Democratic administrations look at the books and choke a little bit. They are taking over after a Trump administration that wasn't fiscally conservative. Rather, the Trump Administration made deep tax cuts without creating countervailing sources of government revenues. (Except tariffs, which are a tax paid by American consumers and consumers to the United States Government. In Canada, the federal government at one point was virtually addicted to these tariffs.) They have to do the same exercise that new administrations in Canada customarily do. That is, announce a fiscal crisis, blame it entirely on the previous administration, and use it to justify cancelling their campaign promises.Then the new administration looks for spending freezes and cuts that won't cause a public uproar. The go-to is freezing civil service salaries and reducing the civil service by attrition . (Civil services have unions and contracts with the governments. You can't just fire people.) Then, the new administration looks to creep taxes up. Start with higher “sin taxes”, liquor, tobacco, and in Canada as of October 17, weed. Then, raise the gas tax a few cents. Raise income taxes on higher income people. Reduce tax rebates. Look for ways to tax Internet-base transactions.Some of the Social Programmes Are Already ThereThe USA is far from being without some social programming. That's what social security and medicare are about. The new Liberal governments will have to squeeze out enough money to augment them and make them more universal. Social security benefits get raised but people may have to pay more payroll taxes until they retire. Obamacare gets expanded. However, the new Democratic federal administration hits a medical wall. The American medical system is among the most costly in the developed world, without producing population wide superlative results. In Canada, doctors bill the provincial health insurance plans. Hospitals are controlled by the provincial governments. Canadian citizens and permanent residents don't get hospital bills. The hospitals get provincial government support and also bill the provincial medical plans fee for service, for services covered by those plans. (Many Canadians buy supplementary coverage from private health insurance plans, or their employers provide it.) This system is cheaper, although you don't get many celebrity millionaire doctors. Those new Liberal governments either need to procrastinate or bite a very hard bullet.Then, The Really Hard Part BeginsI believe these new American Liberal administrations would stumble over the a la carte parts of liberalism. Canada got through the stumbling stage a long time ago. The Liberal Party of Canada decided on the menu options a long time ago, and stuck with them.In the United States, developing that stock Liberal platform will cause pain. A lot of Americans who present themselves as progressives will be very disappointed. However, the liberalized Democratic Parties of the USA will have to reach out to swing voters or else get another Trump-type, rewave.No Open BorderYou can't maintain bearable labour market conditions for your less-skilled workers unless you keep your borders under control. Maybe you even construct parts of the Trumpian wall. You enhance investigations and prosecutions against those who illegally hire undocumented workers. You shift the focus of legal immigration quotas away from family members and specified nations, to skilled worker and business immigration. Maybe states get invited to use their local labour market expertise and participate more aggressively in selection. Some legitimate labour needs get supplied by legal temporary Work Permit programmes. Canada has one for seasonal agricultural workers.Eat Multilateral TradeThe Trump Administration is doing the American people a great service by showing them that economic nationalism doesn't work. Trade wars aren't good and easy to win at all. The trade struggles become protracted, America's trade rivals take reprisals against working class Americans and farmers, unite against the USA and look to do business with each other. Average Americans get hurt, badly.The new federal Democratic Administration folds down the trade disputes, returns trade discussions to professional negotiators and diplomatic interchanges, and accepts that multilateral trade agreements will stay a fact of American political life and sometimes, the USA will lose.A Little Bit of Multiculturalism And That's ItRace isn't the same as ethnicity. The USA has been somewhat successful at integrating various races into American culture, at least enough.However Spanish has emerged a de facto second language in the Southwest and a few major cities in other regions. The federal Democratic Party discusses the situation with the state governments. The probable result? English gets declared the sole official, national language of the USA. Areas with sufficiently large Spanish speaking populations get legislative guarantees of a limited range of Spanish-language services, maybe including school bilingualism, the publication of Spanish-language versions of some municipal, state and federal laws, bilingual signage at some federal buildings, and that's it and that's all.Spreading False News and IncitementCanada has worked at enforcing against this for a long time. Yes, Canadians have freedom of speech but not freedom of threatening behaviour. So, if you want to express your views that us Jews are out to replace you, you can. However, creating false facts like the Jewish replacement plan and saying, we are acting in self-defence so let's go get “em”, is hate speech that incites to violence and, at least, discrimination. The federal and state Democratic Parties enact laws that criminalize that behaviour. Then they fight it out in the Supreme Court.The Right to Bear ArmsThis right is in the United States Constitution. Nowhere enough states will agree to a constitutional change that eliminates the Second Amendment. The liberalized Democratic Parties of the USA don't even waste effort at trying. The better effort is to increase school security and increase pre-sale checks on gun buyers. You can't win them all.I could go on and on with this list.Learn To Love Your Bureaucracy, Tough LoveIn Canada the Liberal Parties have to work really hard to keep their bureaucrats on the level. There is a saying here, “The pigs are always at the trough.” English-speaking Canadians are generally adverse to public displays of emotion. However a hot news story about public servants behaving badly, will justify throwing a total fit at your local sports bar. Liberal governments have to reply heavily on social programmes and strict law enforcement. Never assume that your civil servants will be competent, place the public interest over their careers or do the right thing.So, that's your Liberal, quasi-Canadian, America. Disbursements, taxes, functioning bureaucracies, realism, national humility, you can't win 'em all and nobody even gets a full win, eat the hit and move on, there's no free lunch. If you need passion and victory, look for it in a sports competition or in your romantic life.How many Americans could live with this? How can you tell?Martin Levine

There are many steps Biden can take to improve Obamacare after taking office, at least providing that he has a Democratic majority in both chambers of Congress.Add a public option. Biden has committed to this for individuals. This would be Medicare. It should be based on projected costs of providing medical care after all government spending is otherwise accounted for, and it would have sliding-scale premiums based on income assuming there actually is a premium.Let small businesses participate in the public option, and increase how large the business can be each year for a decade. This will allow small businesses to get the public option for their employees and will allow supposedly-better private insurers a chance to compete with government based on the quality of coverage and on cost.Consolidate public health plans. It’s time to change Medicaid into fully-covered, no-copay Medicare, which translates to sliding-scale Medicare after people earn enough money — and change income evaluations to yearly instead of monthly, so people can stop fretting about that extra $50 this month. Many providers will be relieved because Medicare gives a better reimbursement rate than Medicaid. While increased reimbursements increase the cost of the program, the paperwork changes and streamlining should partially offset that increase.TriCare should be a special Medicare Plus plan, meaning access to regular hospitals as well as the VA.Regulate the paperwork. Simply put, make it so every insurer must use the same forms as Medicare when dealing with hospitals. We’d need a roundtable with both Medicare and private insurers to make sure the form is properly designed, but it’s doable and would significantly reduce paperwork costs — my conservative wild-ass guess is a savings of about 25% of paperwork costs, or about $200 billion dollars.Allow Medicare to negotiate rates with pharmaceutical and medical device concerns. This would be a notable cost-saver for government and for private insurers, who currently base their initial negotiations with insurers based on Medicare rates. We could potentially see savings of over $100 billion a year.Consolidate Medicare and Medicaid taxes, then double them and apply them to unearned income as well as earned income. We can put in a homestead exemption, but just doing that will raise hundreds of billions of dollars in revenue, possibly as much as $500 billion a year even if we end the double tax for sole proprietors.Open the online exchanges to year-round enrollment. Let people actually change plans when they need to, and stop crashing the server every fall.Look, Medicare for All would be much simpler. It’s where I want to be. That said, many of the items above would be involved in any move toward a good Medicare for All plan.We need to be agile as a hummingbird to thread this needle.