Why Universal Health Care Vouchers is the next big idea.

[Lannes]

Who said progressives dont have any ideas?


http://www.washingtonmonthly.com/features/2005/0506.emanuel.html


An exerpt:

If progressives want to use this moment to achieve universal health care, they will need to put forward a proposal that makes the most of what's good about the current system and reflects America's basic values.

What would such a system look like? To begin with, any comprehensive health-care reform should meet seven elemental tests.

First, it should cover every American, no exceptions.
Second, it should pay for covering those who are currently uninsured by cutting waste, not by increasing the total amount our country spends on health care.
Third, it should hold down the rate of increase of future health-care costs.
Fourth, it should give Americans more choice of health plans, not less.
Fifth, it should make our economy more productive, not less.
Sixth, it should reduce, not expand, government bureaucracy.
Finally, to get anywhere, a comprehensive reform plan must be politically viable by offering advantages to more (and more powerful) interest groups than those it upsets, while cohering with American values so that it can draw a broad base of support.
This vision is not a wonky figment of the imagination. It is possible to recast our health-care system in a way that is fair, progressive, efficient, and realistic. We have designed such a system, which we call Universal Healthcare Vouchers (UHVs). As the name implies, our plan achieves goals long sought by both sides of the political divide: the progressive dream of universal coverage and the conservative values of free choice and efficiency. Most importantly, it puts the brakes on the ruinous increases in the cost of health care that threaten to engulf our economy.

[satya]

1. Kick. nt

[paparush]

2. Our Armed Forces have always used "Government Run HealthCare"

It may not be the best in the world, but our armed forces have benefitted from govt provided healthcare.

[Lannes]

4. This plan would rely on private health care but paid for by the government

An exerpt:

Ten Principles of Universal Healthcare Vouchers:

1. Universality: Every American under 65 years of age would receive a voucher that would guarantee and pay for basic health services from a qualified insurance company or health plan.
2. Free Choice of Health Plan: Individuals and families would choose which basic insurance program or health plan they wanted among several alternatives.
3. Freedom to Purchase Additional Services: Americans who wanted to purchase additional services or amenities, such as wider choices of hospitals and specialists, or more comprehensive mental health or dental services, could do so with their own money.
4. Funding by an Ear-Marked Value-Added Tax: Earmarking creates a direct connection between benefit levels and the tax level, serving as a political restraint on health care inflation. If the public wants more services to be covered in the basic plan, they must be willing to support a tax increase.
5. Reliance on Private Delivery System: This proposal does not call for government health care and would not legislate changes to the current private delivery system. Health insurance companies and health plans would continue to contract with physicians, hospitals, rehabilitation facilities, pharmacies and other providers for services to the individuals who enroll in their plans.
6. Ending Employment-based Insurance: Experience demonstrates that health insurance provided by employers lowers wages, raises prices or reduces employment. The end of employment-based health insurance would translate into higher wages, lower prices, and the recapture of lost tax revenue.
7. Eliminating Medicaid and Other Means Tested Programs: Since every individual and family would receive a voucher, there would be no need for Medicaid, the state Children's Health Insurance Program (S-CHIPs), or other means tested programs. Those covered by such programs would be incorporated into the mainstream health care system without means testing.
8. Replacing Medicare over time: While no existing beneficiary would be forced to change to the voucher system, Medicare would be phased out over time. Individuals turning 65 would continue to be enrolled in UHV; there would be no new enrollees in Medicare.
9. Administration: Modeled on the Federal Reserve Board, management and oversight would be the responsibility of a Federal Health Board with multiple regional boards to facilitate implementation of programs in different geographic regions. The board would be active contractor with health plans, defining and periodically modifying the basic benefits package, informing Americans about their health care options, reimbursing health plans, and undertaking data collection and research related to patient satisfaction, quality of care, and risk and geographic adjustments for payments. The board would regularly report to Congress on the health care system.
10. Technology and Outcomes Assessment: An independent Institute for Technology and Outcomes Assessment would be established. Its research and database would focus on assessing the effectiveness and value of different interventions and treatment strategies and disseminate information concerning outcomes of treatments delivered in regular practice.

[blondeatlast]

5. That's fine for those who are healthy. Those of us with chronic

conditions need affordable, quality care, and not incremental solutions.

Sorry, I've studied the issue in-depth, and this is as effective as school vouchers, In other words, for those who need it most--worthless.

[Lannes]

6. I was waiting for school vouchers to be brought up.

The difference being that right now every child can receive a public school education if they want it,the quality of that education is for another discussion.

School vouchers took dollars away from public schools.Ten of millions have no access to health care because they cant afford it.This plan brings more people into the system.How is that a bad thing?

You are right this plan doesnt cover everything it gives basic health care to everyone.Id love to see a plan that does and keeps this country solvent.I mean that.

[blondeatlast]

7. IMHO, single-payer, universal health care is the only chance.

Be aware, too, that even big business is starting to see it that way. They simply can no longer absorb the rapidly rising cost of health care.

If we want EVERY american to have a fair chance at good health, ther is no alternative.

This is an issue I am all too sasly familiar with, and I fight like a demon for single payer UHC--and against other proposals.

I respect you opinion, however. I simply cannot share it.

[Lannes]

8. and I respect your opinion as well.

Maybe you are right blondeatlast but I cant really tell without some details.Ive read about UHC but nohing in depth.If you have a link to a good site since you have some experience with this isssue Id really appreciate it.

[blondeatlast]

10. I'm glad you asked--do I ever! Thanks for taking an interest.

http://www.uhcan.org/

http://www.amsa.org/hp/uhcinitiative.cfm

http://www.physiciansproposal.org/

The first one (UCAHN) is the most activist organization, AMSA is the american Medical Students Association, and they are actively supporting the Physicain's Proposal (third link).

[Lannes]

11. Thanks!

Looking over some of the proposals I can see some great ideas in all of them.My concern is about the feasilbilty of these programs.Some quick observations..

The PNHP site proposes:

" Investor-owned facilities would be converted to not-for-profit status, and their former owners compensated for past investments."

That would be a very tough sell in Washington will all the influence the health care industry has.

The AMSA site listed as one of its disadvantages:

"A large number of private sector jobs would be lost as insurance companies would no longer be of consequence......"

Any bill that would put the insurance industry effectively out of business would be very difficult if not impossible to get through congress,again because of the health care lobby and all the senators and congressman they own and probably contine to own unless there is some serious legislation to limit their influence.

Getting rid of most insurance companies and putting HMOs out of business and replacing it with something better like UHC would be one of the BEST things that ever happened to this country.

Im just wondering if the forces marshalled against it are too powerful at this point.Before we can approach this issue we have to remove their influence in Washington through legislation.If we dont UHC is just a pipe dream.

Im not sure if the voucher ideas are the answer but they seem to address some of the roadblocks that the health care and insurance industry would throw in our way and still provide catastophic health insurance among other benefits.

Im going to have to read about all these plans in more detail.There are things in all of them Im sure that Ive missed.Thanks for filling me in.

[KingFlorez]

3. This is essential

The richest country on earth should have universal healthcare. Countries who aren't as rich as us have it. The neo-cons are so worried it will cost the corporate bosses too much taxes.

[LWolf]

9. I prefer this plan:

I always did. Now, in '05, I've had my mother undergo 2 major life-saving surgeries; we are now buried in medical bills not "covered" by her medicare. Then, 2 months later, major life-saving surgery for my grandson. And now I'm facing a cut in medical benefits, and a hike in what I pay for it, at work. I personally campaigned and voted for the candidate who would bring single-payer, universal health care to all Americans:

http://www.kucinich.us/issues/universalhealth.php