This is not an article detailing any of the one thousand failings of the Private Healthcare system. This is an article detailing what we are going to do about it.
By Robert Simmons
The Third Option Universal Healthcare Operating System is designed to deliver affordable, accessible, preventive and patient-centered care. Government would no longer subsidize private healthcare, it would instead collect and evenly distribute the money necessary to run the entire system at the community level. Through the Department of Health and Human Services, government would retain a regulatory role, and utilize natural economies of scale to lower the cost of supplies and infrastructure. The new system would ensure complete coverage for every American resident, pay healthcare workers more (while having them work less), double the workforce in areas such as mental health and disease research, yet still be able to drop in price from its current $4.1 trillion a year (soon to be $6.2 trillion by 2028) down to a more manageable $1.2 trillion. The 1.45% Medicare tax (FICA) would be eliminated, as well as traditional forms of health insurance, in exchange for more direct forms of payment.
The new system’s ‘Online Care’ would cost $50 billion to build, and utilize the most current information and communication technology available; it would connect people to their local healthcare system and connect all local healthcare systems to each other, in order to share best practices in real time. ‘Premiums’ would range from $50 a month to $150 a month (based on age). ‘Copays’ ($20 for visits and $10 for prescriptions) would help apportion greater cost to those who utilize the system more often. Together, these two methods would cover nearly half of the annual $1 trillion price tag, and represent the kinds of care that is universal (generally needed by everyone) or unexpected (random events that could happen to anyone).
The other half of healthcare costs would be linked to the purchase or usage of products and services that have direct and predictable negative effects on patient health. These costs represent the things we willingly choose to do to ourselves –per our ‘Liberty’—and would be assessed utilizing either a one-time ‘sales tax’ or some form of longer term ‘Insurance’.
Finally, to better enable accessible patient-centered care, funding would be equally distributed among ‘communities’ of approximately 100,000 people (the United States has about 3,300 of these). Healthcare would now become a ‘community service’, and thus require the appropriate infrastructure to best promote this new agenda (for more go here).
Explanation of Benefits: Why Government Needs to Take Control of Healthcare
The most indispensable parts of healthcare are our healthcare professionals and staff, their supplies and equipment, and the infrastructure where they work. These costs alone account for nearly $1 Trillion a year, and while we can certainly negotiate a better price on supplies, equipment, and infrastructure, when it comes to people, we can no longer skimp on either side of the equation.
Healthcare professionals are the Rock Stars of Health. Give them some equipment and a venue to play, and they will belt out their greatest hits for us. All those other “suits” hovering around – various execs, producers, distributors, sales reps, brokers and other middlemen – they represent the ‘business’ of scoring some extra cash from the crowd that has gathered around healthcare. They are the ones hustling autographed t-shirts and $5 insulin for $350 a vial, peddling posters and $350 hip implants for $40,000 (installed), or unloading concert tickets and $300 defibrillators for $40,000 a pop. The rock stars themselves barely make 10 cents on the dollar. We the People score about 27 cents worth of healthcare for every dollar we spend. From now on, We the People are going to be all about the music.
If Government runs the show, $5 insulin would cost $5. All prescriptions and medical devices would be purchased and delivered ‘at cost’, because healthcare would no longer be a profit-seeking ‘business’.
Essential needs—from housing and food security to education and health care—can no longer be subject to the economic laws of supply and demand. Products and services that keep people alive will always be in high demand, thus the private sector will invariably overcharge to supply them, in order to maximize its profits; this will force government (tasked to protect the survival of its citizens) to pay the private sector ‘subsidies’, in order to bring the cost down so that everyone can afford these essential needs. To procure this ‘subsidy’ money, government must tax those citizens who have the money. It would be fitting, and self-regulatory, if those extra profits were taxed, then redistributed, except those at the top have conveniently dodged having to do this, which instead passes the cost onto the ‘middle class’ taxpayer. The rich invariably get richer, the middle class gets poorer, and the poorest remain powerless, just like the dominant race set it up originally.
‘Big Government’ happens because essential ‘public’ needs are delegated out to ‘private’ contractors. These contractors are the ones who gouge us—government is only guilty of writing them the check. Government writes these checks because politicians –who are paid for by the private sector—vote for government to do so. It’s all just business. A private ‘interest’ foots the bill for a politician to go to Washington, in exchange for their ‘loyalty to the company’ who got them the job.
Just as government intervention (the Civil Rights act of 1964) thwarted separate and unequal healthcare practices in the past (by establishing Medicare and Medicaid), government needs to intervene again, to establish Universal Healthcare, in order that it might do its job more effectively and efficiently, per the tenets of Economics, and more fairly and responsibly, per the tenets of Democracy. This would begin America’s attempt to form a merger between two currently competing entities—economics and democracy—and create a giant socio-political megacorporation that we will tentatively call Economic Democracy.
With all the misinformation swirling around, it is perfectly understandable to not really know who to trust, so it is perfectly fine at this point to not trust anyone –the private sector or government—and on this basis, fashion a system that operates outside the influence of both. In the current arrangement, we train ourselves in healthcare in order to work for the private sector, who charges as much as it can get, and is empowered to do so by government, who reinforces their demands by paying them off, and helping them to maintain a monopoly on the American people. The Third Option plan is to take our own money, through premiums and copay, taxes and insurance, and only use government to allocate the funds among communities, for them to build equivalent healthcare for their members. Through a National Public Bank, which would also equally allocate loans to communities, in order for them to build all necessary infrastructure, the cost of healthcare would again drop significantly, as our health care premiums would easily cover the mortgage payments on any health care loans. The money paid back to the National Bank, at four percent interest, would be the people’s money, and would come back to us through ‘retirement dividends’. This would replace payroll taxes, which is why we would no longer need to pay the 1.45% Medicare tax (FICA). Through this arrangement, we could unleash the power of ‘Small Government’.
The hardest part of changing to a system like this is changing our inherited mindset, from the traditional paradigm of top-down Control, to one of Empowerment. When we see government as an entity designed to empower us rather than control us, we can more efficiently and effectively utilize it to provide our most essential needs. One of these is healthcare.
Economies of scale could once again work to lower supply costs (as they should), rather than raise them (as it currently does). The power of government could shop wherever it wanted for the best-priced pharmaceuticals, devices and equipment, and buy it in bulk. No middlemen, no advertising, no large CEO salaries. If necessary, government could even make its own supplies, and do its own research and development, elevating our scientists to rock star status as well; one should be allowed to dream.
Everybody who deserves to get paid will get paid well. We the People (collectively through government) are far richer than any single individual. It is time for government to grow a pair and stop letting individual profit-seekers siphon money from us over our basic right to survive. Life, according to government mandate, has already been freely given to us; we should not have to pay some private entity for the right to keep it.
More About The Third Option Plan
I. Entering the New Universal System: “Online Care”
If our goals truly are affordability, efficiency, accessibility and convenience, utilizing every facet of up-to-date information and communication technology would be essential. Utilizing a new Communication Grid would also give us a chance to be active participants in our own healthcare.
Through a personal account, individuals could access their [entire] medical records, consult a symptom database, or order lab tests (some tests could even be administered at home, either individually or with the assistance of a visiting medical professional). You could ask questions online, get a video consult with a doctor or counselor, and if a visit is necessary, navigate to a specific doctor’s schedule and book appointments yourself.
Preventative Services or Screenings could also be booked online, as well as outpatient (or inpatient) consultations. Copays would be handled within each personal account. Updated urgent care waiting lists could be posted online, in order to put one’s name into a queue prior to arrival. Even Emergency Care transportation could be handled online, much in the style of Uber or Lyft. Whether your care needs are minimal, manageable, urgent, or critical, efficient communication is the first step, and should make whatever proceeds it run more efficiently as well (see more here).
II. Healthcare Insurance and Tax Assessments
People get in car accidents while driving in a car (a $23.4 Billion cost). People receive gunshot wounds from a gun (an $8.6 Billion cost). Ski accidents happen while on skis. Not everyone decides to have a baby, or skydive, or ride a motorcycle. Accident insurance costs can be added to car, motorcycle and gun registration (yeah, gun registration), ski lift tickets, football, hockey and basketball league fees, or gym (and other club) memberships. Accidents are a $40 billion cost annually and need to be accounted for in a fair manner. With costs spread out among all car drivers, snowboarders or boat owners, individual expense would be minimized.
Pollution is a $270 billion health issue, and we are all accomplices in it. With an overall Carbon Tax rate of $37 per Metric Ton of Carbon produced, this would add 33 cents to a gallon of gasoline, or 35 cents for every gallon of jet fuel burned during your airline flight. Until a new Green Energy Grid is completed, expect a 1.7 cent addition to every kWh of electricity used. Agricultural Pollution is a thing, and a $34 per acre tax on Agricultural Land use will unfortunately add 20 cents a pound to beef prices, as livestock feeding and grazing takes up an amazing amount of farmland.
Obesity has direct health costs. Most agree that eating whole foods is better than food enhanced with chemicals or “additives”, and if we cut the crap for a moment (literally and figuratively), we would all conclude that chemicals to make food look and taste better are there so people will purchase and eat more of it. There are also significant health costs from food allergies and food poisoning. The fair thing to do is put pennies on calorie consumption, plus target specific additives like trans fats, sugars, artificial preservatives, flavors and colors, etc., and calibrate it so that a 2000 calorie a day diet would yield a tax of perhaps $100 a year per citizen (or 27 cents per day). At that point we would likely sit back and observe in horror how much tax we actually collect toward our diabetes and heart disease costs (currently needed: $327 billion and $351.2 Billion, respectively).
Alcohol plus tobacco equals high healthcare costs. The current taxes imposed on these items should be redirected toward paying healthcare for our subsequent heart disease, otherwise we would need to impose a separate tax of 33 cents per “standard drink” and 50 cents per cigarette to cover the healthcare cost needed to treat this group of consumers.
Finally, antibiotic resistant bacteria is formed when the antibiotics we take do not actually kill all the bacteria within our bodies. Apparently, whatever doesn’t kill you does make you stronger, if you are bacteria (in humans, whatever doesn’t kill you gives you PTSD and a tendency toward poor health outcomes). $10 would be added to any copay used to fill an antibiotic prescription; this money would go toward creating new more effective antibiotics.
Allegedly, with rights come responsibilities. When healthcare is considered a right, how each person exercises that right would now come with a certain financial measure of accountability attached. Unhealthy or risky behavior is certainly a choice, but not one that the rest of us should subsidize. Accountability, that comes with freedom of choice, would necessitate paying the true health cost of one’s lifestyle choices.
III. A Community-based Delivery System
Half of all yearly healthcare visits funnel through crowded emergency rooms, hampered by poor communication with lab and imaging services, plus restricted access to inpatient beds, according to data from the National Institutes of Health. Overcrowding is inevitable when “EDs help ensure that basic health care is available to anyone, regardless of ability to pay.” When the entire system is made available to everyone for the cost of a copay, and coordination of care runs through a network of small communities, more efficient, effective and convenient healthcare would be the result. In larger urban settings, patients could even be rerouted to nearby communities, when availability issues arise.
Aesthetically, current healthcare infrastructure runs the gamut from depressing to gaudy. Downsizing healthcare to a more intimate community level would free up architecture to construct sustainable, aesthetically pleasing, functional, or simply less imposing designs. It could also offer a chance to artistically capture a community’s special flare or character.
It is time to better clarify our goals. It represents a “conflict of interest” when the private sector sells us products and services designed to extend our life at the same time they sell us products and services designed to shorten it. The business of private healthcare is booming (28.3% of government spending, and 20% of Gross Domestic Product), but the actual health of American citizens is not so promising. The goal of health care should be to produce healthy people. When healthcare is placed into a business model, the goal becomes less clear.
Basic survival needs will always be in high demand. A profit-based model cannot help but ‘capitalize’ on this, which ends up pricing the lower wage earner right out of the market, leading to necessary government subsidies (because life is an inalienable right). This further (artificially) increases demand, enticing profit seekers to further bleed taxpayers. Taxpayers can only surmise that government is either weak or corrupt. Government needs to stand up for itself, regain some self-respect, and get back to doing its job: representing, protecting, and providing for its people. Universal Healthcare would be a strong first step.