Quote:
Originally Posted by Arles
While a registered democrat, I consider myself more conservative when it comes to health care and economic policy. instead of a single payer, here's what I would try to do:
1. Fully or partially subsidize health care plans for people making under a certain amount (say $100K) who don't have employer provided health care. Maybe under 50K it is 100%, 75% under 75K and 50% under 100K. The government would just give them a tax credit that could be used for their premium costs per year (basically act like the employer).
2. Setup better exchanges for small business owners with some % subsidies for premiums there as well.
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1-Government needs to stop living in 1952 and legalize marijuana, two immediate needs for the tax revenue, healthcare and education. It also opens up research, allows MD's to prescribe and impacts the opioid crisis. The biggest obstacle here are obviously big pharm and middle aged conservatives who still think Harry J. Anslinger is a saint.
2-This is the big thing. Meritus the Arizona exchange was an absolute disaster and was a convoluted mess run by people better suited to selling used cars. They created plans to try and appeal to everyone, including things that officers of the company wanted covered for themselves, which made them almost impossible to administer effectively.
Training was sub-par, cost containment was nearly non-existent, and since they were playing with house money they had no immediate sense of urgency to stop hemorrhaging funds. The federal government gave them far too much leeway and should have mandated a very select group of plan tiers. Meritus put bids out to TPA's with the understanding they would offer a dozen plan options. That number increased to over 90 when time came for implementation and it was a shit show in terms of configuration. To go down this route again there needs to be a standard template, which ideally should follow CMS guidelines like Medicare and offer PPO, HMO and Select options with no more than 3-4 plans in each tier.