The Scroll

Health Catastrophe Coverage: A Novel Mandate

Manav Midha ’19, Contributor

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Throughout modern politics, healthcare reform has been a major topic for candidates from both major political parties. Republicans and Democrats fiercely battle about moral, constitutional, and fiscal reasons for supporting one policy versus another. Yet what is often lost in the argument is the room for compromise between conservative and liberal healthcare policies. Therefore, assuming a clean slate to begin on, I propose my own solution. Some of these policies have been enacted, and some have not, but ideally all ideas presented would coalesce to improve patient outcomes.

I would begin by establishing a partial individual mandate for health insurance, with all residents not required to purchase full insurance, but rather only “health catastrophe coverage” that would fund major medical events. I would then create an independent federal health insurance corporation in partnership with private insurance organizations (similar to the Federal Reserve). This entity would offer public option insurance plans, both high- and low-deductible. The premiums for all government-sponsored catastrophe coverage would be limited to some amount linked to health care inflation and no American would be denied based on pre-existing conditions. The federal corporation would also offer several full insurance plans (that would now be cheaper because of the aforementioned catastrophe coverage). The full plans would be funded by both premium payments and float (premiums not yet paid-out) from the catastrophe coverage and would be required minimally to cover designated benefits.

For Americans wanting to purchase insurance from the private market, the corporation would offer tax-advantaged health savings accounts to all, not just people with high-deductible plans. Additionally, people would be able to withdraw funds prior to their retirement, with different levels of taxation dependent on many factors. A central database of electronic records would be created, with health information identification numbers as organizers. This database would be treated with the utmost caution and secrecy. No business would be required to provide health insurance to their employees, but companies would be provided significant tax benefits if they would provide insurance plans superior in benefits to public plans with similar pricing. To increase competition and drive costs down, private insurance companies would be allowed to compete interstate on a federal marketplace.

In order to combat rampant drug overpricing, drugs and generics manufactured in foreign nations with high safety and efficacy standards would be allowed to be imported into the United States. Furthermore, pharmaceutical companies would be required to publish their profit margins for all drugs individually (not just segments of their businesses in aggregate) and would be prohibited from directly advertising to patients unless explicitly allowed to by the government corporation. So as to not inhibit research and development, companies identified as responsible would be eligible to receive federal grant money.

So that medical professionals would remain pleased and effective, medical malpractice insurance premiums would be limited to some percent of a physician’s annual income. However, doctors would see less patients, as they would be evaluated based on patient satisfaction, rather than sheer volume. Thus, physicians’ money saved and lost would roughly balance out, with patients benefitting in the process. With a cursory glance, this element of the plan seems it would reduce appointment availability and hurt patients. However, the plan would account for this problem by allowing foreign physicians with rigorous training to work in the United States without several years of superfluous training. Also, doctors would be paid overtime pay for working extra shifts.

Every person born and visiting the United States would be required to be vaccinated according to general medical advice. This process would be at no cost to patients. This policy would be enacted not only to ensure herd immunity for those individuals who for whatever medical reason would not be able to be vaccinated, but also to ensure that less insurance payments would be spent on preventable diseases—overall costs would be lowered.

Of course, this plan requires rigorous long-term econometric analysis before it can or should be implemented. It also needs the support of the people, because they are who it would impact the most. If the financial landscape or other tangible factors make this plan unfeasible, so be it. But if politicians from either side try to exploit this plan and the public’s general lack of salient knowledge to selfishly garner votes, then I would be incensed. Both conservative and liberal ideas are involved in this plan; this is proof that they can co-exist harmoniously. Because in order to effect actual improvement in people’s lives, we must work together.

 

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