Health Plan – Ground Rules

I am not an expert at the ways of politics. Nor do I have access to actuarial material to know if this works. But in a few columns, I intend to lay out a health plan. This initial column tackles how we get people enrolled equitably.

First some assumptions.

  1. It needs to be single-payer. Anything other than that will leave too many exposed to cracks an crevices of not having insurance.
  2. Everyone needs to participate. If it does not have everyone, it will quickly devolve into an adverse selection program.
  3. There needs to be a mechanism by which low income individual and households are subsidized.

When you look at these basic assumptions, the only viable provider is the federal government. It pains me to say that, but it is true. Currently they are the only organization that has the ability to to reach everyone in both collecting premium and monitoring the subsidies.

Every working American is currently sending payment to the government throughout the year. The collection and processing infrastructure is already there. Its called the IRS and payroll deductions.

Yes there are people that are not currently employed, but if they are drawing unemployment, they should be filing a tax return. For those individuals that currently are not required to file a return? Start requiring one. A 1090EZ form takes less than 5 minutes.

Now we have everyone “enrolled” and those that have a means to pay are paying. That leaves only two things to work out

  1. What will be covered
  2. Subsidies for low income households

Admittedly when I say that, it is a clear over simplification. But the rest is administrative details. And while the devil is in the details, moving the conversation this direction as opposed to stops the posturing of politicians. When you strip away the ability to use “Health care is a right” or “Premiums keep rising” as talking points at your latest press conference and turn instead to the debate about pricing schedules for prescriptions or procedures, the rhetoric stops and the true work can begin.

We can also stop talking about the “individual mandate” and start calling it what it is, a tax. True, no one wants to pay more taxes, but we all think someone else should. Whether it is the liberals screaming the rich don’t pay their fair share, or the conservatives screaming the poor should pay something. Or the corporations should pay. Or we should do away with this deduction or that deduction. We all want “someone else” to pay.

Let’s agree though. Everyone should have access to basic health care and it is in our best interest to ensure that everyone, even those without financial means, do indeed have that access in a usable form. We have long ago accepted that providing a basic level of retirement security is something we will pay for. I believe the American people will do the same for health care. We just need to put politicians in office that would rather make that happen as opposed too many that view holding office as an opportunity to showcase to the world how bad the other side is.

As for the details, over the next few weeks, I will throw out some thoughts on those.

*I originally wrote this about a year ago, but never published it. That was long before anyone conceived that Donald Trump would be elected or that the Republican attempt at reform would flame out. 

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Do Not Let This Happen!

Before I get into my dissertation. Let me state my best wishes to the family of Justice Antonin Scalia.

With the passing of Justice Scalia the political world will no doubt be put into a tailspin. Should Obama nominate a new Justice? Will the Senate confirm them? Unfortunately, I think this will get ugly. Which is pathetic.

First of all, yes, President Obama should seek to nominate someone as soon as possible. Believe me, while I am not necessarily a critic, I certainly am not in the cheering section for President Obama. But whether I or anyone else is a fan of the politics, the simple fact is, it’s his job. Right there in the US Constitution. “shall nominate, and by and with the Advice and Consent of the Senate, shall appoint Ambassadors, other public Ministers and Consuls, Judges of the supreme Court” Read it yourself if you don’t believe me.  Article II Section 2 Ironically, as much of an origianlist as Scalia was and as clear as this clause is, I think he would be one of the strongest supporters of President Obama nominating a new Justice.

Now who President Obama chooses as the nominee will say a lot about his motives. Does he have the best interest of the country at heart? If so, he will look to find someone that can be confirmed with relative ease. Even if that means compromise. Is he looking for a fight to truly make this an election issue? If this is the case, we will see someone that is a clear ideological appointment.

Lastly, the Senate has these same questions. Will they choose to make a fight of someone that is a compromise type candidate? Or will they do what needs to be done and get a Justice confirmed?

My fear is that all the worst will happen. President Obama will dig in his heels, for the opportunity to “make” the court into his image of what it should be. And the Senate Republicans will do everything in their power to stop him from making any appointment.

It’s Time!!!

It all begins today.

The Iowa caucuses will take place tonight and will no doubt dominate the news on any station you happen to be viewing. I will be making my prediction on the outcome, but first I want to say a few things about the candidates.

Not singularly, but collectively. Seriously, is this the best we can do? I have no idea what happened to this country that we can not find a single candidate better than this slate. Just looking and listening, would you honestly choose any of them that you would be truly proud to stand up and say, “That’s leader of my country!” I don’t mean this too be entirely negative and I know each one has good strong aspects worth getting behind, but as an entirety, they also all lack something.

Whether it is Donald Trump, who lacks anything resembling the ability to an international statesman, or Hillary Clinton, who most of the country agrees is not trustworthy, they all carry a strong negative. Some more strong than others.

Now for the predictions. I claim to have no political insight and I do not have a connection to any candidate. I just like to make predictions. I may be way off, but I don’t care. It’s a fun little game. Before I get into the Iowa caucus predictions, I do want to put a few general long term items out there.

  1. Hillary Clinton will withdraw from the election – some scandal will come up and the Clinton Dynasty Image can not afford to have her lose another presidential election, so she will drop out citing personal reasons.
  2. Marco Rubio or Chris Christie will be on the ticket – maybe both, maybe the headliner, maybe VP. Not willing to say right now who gets the nomination, but each of these two guys give something sorely needed on the Republican side.
  3. There will not be a major third party bid – however, minor parties will receive a greater share of the popular vote than is usual.

So how do I see the results. First the Republicans:

  • Trump – 24%
  • Rubio – 20%
  • Cruz – 19%
  • Bush – 12%
  • Carson – 11%
  • Christie – 7%
  • Everyone else – < 5%, so we don’t care

On the Democratic side

  • Sanders – 49%
  • Clinton – 46%
  • O’Malley – sorry dude, you just don’t matter in this one

Hope you all enjoy the coverage and let’s get it started.