Should ObamaCare be continued even though it seems destined to fail ultimately or should we turn the money toward private sector insurance companies and reset the rules to assure that everyone can have coverage?
That could be accomplished if we make the decision before insurers and third-party administrators (TPAs) have scrapped everything they need to be in that business. And, it could be made if pre-existing conditions can be made to be covered within certain parameters thus eliminating the “need” cited by many.
With some tweaks made to assuage health care insurer/TPA concerns, the need for an “ObamaCare” can be eliminated and we can spare ourselves the agony of watching our Congress mess with something it obviously doesn’t understand after it gets fixed this time and something it really wants nothing to do with because it can only anger voters…the people who keep them in office.
We are concerned about the uninsured. Those people can be insured if they enroll promptly and there can be federal funding arrangements established to assure that insurers will be paid monthly amounts (premiums) to keep their coverage in force if they are deemed unable to afford their premiums. Employers could make arrangements as they do now to pay a share of the employee’s/dependent’s premiums and the insureds can pay the balance as they do now. If the government wants to be involved, then it can set the employer participation rules uniformly across the country.
Insurers are concerned about the currently uninsured and the bad health situations they might be inheriting if those people are brought under their coverage. If those people are under the age for Medicare, the employer’s plan can be required to provide coverage as most are today. If there is legally no “employer’s plan”, then a special program can be created with uniform coverage for those who need that form of “insurance”. Employers would be required to provide a minimum level of health insurance coverage for employees and their dependents just as most do today, and/or to pay a predetermined share of that person’s premium costs for the coverage.
Those who are unemployed would have a separate plan available that mimics the basic coverage of employer plan participants in the country but without “bells and whistles”. All plans would be required to cover all conditions stipulated by the law and to provide coverage for anyone with a pre-existing condition who is in compliance with the rules in place at the time. If a person has been deemed uninsured by his or her own volition, they will be penalized but will be provided ‘essential’ coverage at a premium that penalizes them for having gone uncovered when coverage was available.
Our elected state and national officials would be required to assure that the rules are being followed with penalties provided for those not abiding by the rules.
Unfortunately, we have managed to muck this whole situation up so that this kind of approach may well be the only viable solution. And the fact that this can still be remembered as ObamaCare is assigning responsibility to the person who ought to bear the majority of the blame for having made all this necessary. This is subsidized coverage and not really insurance since the only function of an insurance company is that of provider network management and claims payment. Providers would be required to accept patients and would also be required to meet the costs prescribed for each service or product provided under the plan.
This would remove government manipulation except for review of the national health care plan to assure that it is functioning as it was designed to function. Third party claims payers would pay all approved claims at the pre-approved rates for such services and products. Government meddling would be largely avoided except at macro levels. Micromanipulation would be prescribed by other approaches that used standard data not affected by political action or inaction.
Those who are now covered through other government plans such as those offered through the Veteran’s Administration would have plans issued to them with the benefit levels required to match the current plan or the new plan, whichever was better, and would be able to obtain their services and treatments from private sector providers thus eliminating the need for VA facilities that seem in disfavor today. Those confined to government institutions would be served by private providers if that was possible, and by government-paid providers, if that was preferred for certain situations.
Prior to ObamaCare, I would’ve hollered loudly if I saw this proposed. Today, I think this may well prove to be an improvement for these members of society who’ve paid a high price on our behalf.
Providers of services and products would work under a national reimbursement program that would be established on a state-by-state basis taking into account the marketplace functioning in each state to assure that everything required can be accessed.
All this is the result of President Barack Obama’s initial meddling with our healthcare delivery system and with the Democrats who passed this monstrosity known as ObamaCare in the dark of night without one Republican vote. That needs to be remembered for a long time.
Thanks to them, we are reduced to this.