Doctor-patient relations will be direct and result in better quality of care as well as financial cost control and accountability. The dual purpose National Health Credit Card, managed by private banks similar to Master Card or Visa, will provide easy administration of the universal healthcare plan without reams of paperwork or a new huge bureaucracy. Instead, the existing reporting mechanisms to the IRS and the audit capabilities of the IRS can be used to monitor the simplified reporting of medical entitled benefits and costs. Medical cost types and further details will be able to be tracked historically on a national basis. Medical histories of patients will ultimately be embedded in the same National Health Credit Card which is used to charge medical costs.
Costs will also be controlled by requiring the patient to pay an annual deductible, including a variable medical transaction deductible, to ensure the patient has à ‚¬Ëœskin in the game' with each medical transactions he or she decides to do. To meet federal budget constraints, the plan uses a system of tax credits with the deductibles to create funding flexibility, which can be adjusted very simply, according to the state of the economy, experience over time, type of medical costs incurred and income levels of those benefiting from the plan.
Most importantly the patient will have freedom of choice to go to any doctor he or she wishes, unlike the present system where one must change doctors when the employer chooses a new insurance company. No longer will medical benefits be tied to the employer's opinion as to what plan is least costly to its business, which results in disastrous consequences to employees monetarily and in terms of healthcare continuity.
By using the insurance companies at a global pool level to insure or reinsure portions of the US government paid health cost portfolio against the risk of abnormal increases in benefits that must be paid out on a monthly basis, the cost and predictability of cost to the US government may be optimized. In addition, Wall Street may be able to securitize tranches of the US government debt that will be issued to cover non-patient contributed health costs incurred on the National Health Credit Card, which could optimize capital costs and the amount of debt required to fund the universal healthcare system proposed.
The plan does not address cost reductions that could result from technology and other innovations like low cost clinics and voluntary cooperatives that may compete with present medical providers in the future. These would be in addition to the savings in healthcare that would result from changing the business model as suggested.
Finally, the ideas presented in this paper are structural building blocks. Much work needs to be done to refine these ideas. The author invites feedback and discussion on these concepts.
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