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Edited on Fri Mar-12-10 10:22 PM by Cleobulus
First off, price controls at the following rates.
Premiums should be set at no more than 5% of monthly earnings for everyone, regardless of income level, with subsidies to help pay for premiums up to 400% above poverty level.
Deductibles should be set at no more than 500 dollars per year per person, with a Government subsidy based on a sliding scale starting at poverty level subsidy of 100% and reducing it 10% for every 100% above poverty level.
Copays are to be set on a sliding scale based on income level but will not exceed 50 dollars for doctor's visits or prescription drugs.
Plans that cover dependents under the age of 18 years old will be exempt from deducts and copay amounts listed above.
Employer based insurance shall be discouraged.
Oversight controls of insurance companies:
Independent federal body to deal with claims appeals process, there is already in the HRC bill a plan like this, but not independent of the insurance companies. Insurance companies would be bound by the decisions of this independent federal body.
Insurance companies who have their denial of claims successfully appealed by members shall be penalized at no less than 50% and no more than 90% of the cost the claim itself, this is in addition to having to pay the claim that they denied.
Any Insurance company that has had denials repeatedly overturned by the federal body mentioned above(percentage based, say 20% of denials overturned) shall be abolished, its members allowed to move to more responsible insurance companies and all assets of said insurance company shall be seized by the Federal Government in compensation.
Insurance companies will be audited by the Federal Government annually and they must spend at least 90 cents on every dollar paid in premiums on health care.
The federal government will be responsible for negotiating pricing on health care on behalf of Insurance companies, in instances of prescription drugs and treatment payments, health care and pharmaceutical companies will be bound by these negotiations that are to be revisited every 5 years.
Simply put, this will outright forbid Insurance Companies from at least 90% of the shenanigans they are and have been guilty of in the past and in addition will make not only health insurance affordable, but being able to actually use it affordable to the vast majority of Americans, hell, you can even mandate this and it wouldn't be that big a problem for me.
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