PROPOSED ALTERNATIVE TO THE AFFORDABLE CARE ACT A COST EFFECTIVE PUBLIC-PRIVATE NATIONAL HEALTHCARE PLAN Preamble: The purposes and aims of this plan are to provide all U.
S.
citizens and other legal residents with quality healthcare; to allow for a robust competitive private medical and hospitalization insurance business; to reduce fraud, waste, and abuse via the private insurance profit motive; and to provide "socialized" care through the Medicare system for those, of any age, with chronic and seriously debilitating physical or mental illness or injury.
Medicaid and SCHIP programs shall be phased out.
The Plan: A.
All citizens and other legal residents with chronic and seriously debilitating physical or mental illness or injury will be so medically certified and enrolled in the Medicare system which will pay for all reasonable and necessary costs.
It is anticipated that Medicare payroll taxes will continue to be levied in order to fund the program.
B.
All other citizens or legal residents, not chronically and seriously disabled, are required to be covered by either an individual, couples, or family private insurance plan/contract.
(Subject to "grandfathering", below.
) It is anticipated that the private insurance companies will vigorously compete on the bases of benefits, service, and price.
The "out-of-pocket" premium cost shall be a tax-deductible expense.
A federal program of premium subsidy shall be established for lower income individuals and families; with applications prepared and submitted with the cooperation of the selected insurance provider; with subsidy payments going directly to the insurer.
Insurance policies shall be for at least 1 year duration, renewed automatically unless canceled by either party at least 60 days before the policy expiration date.
It is anticipated that an insurer may refuse to renew the coverage for any insured individual who becomes chronically and seriously disabled during the contract term.
In such event, the insurer will assist the insured relative to certification of disability and enrollment in the Medicare system.
C.
It is anticipated that all policies will provide coverage for catastrophic occurrences, emergency room services, hospital care, and services provided and lab tests ordered by one's primary care physician.
Policies may vary as to coverage and cost on the basis of sex; eg.
, males don't need maternity coverage; and on the basis of age since the elderly generally require more medical care.
Policy premiums may also be adjusted based on the presence or absence of risk factors such as smoking, obesity, or drug/alcohol abuse; and any such surcharges shall not qualify government subsidy or tax deductibility.
D.
It is anticipated that during the transition period into the new programs, all existing forms of coverage or services will be maintained.
Thereafter, employers will no longer provide medical insurance as part of their benefits program.
(Policies relating to disability income, life insurance, etc.
, may be provided at the option of the employer or as part of a collective bargaining agreement.
) E.
It is anticipated that an "assigned risk" pool will be required for those unable to obtain private insurance for underwriting reasons.
F.
Any individual requiring medical/hospital services, but who is without private insurance or Medicare system coverage, shall be personally liable ( with parental liability for a minor) for all reasonable and necessary costs incurred; and shall be deemed to have promised to pay and to have agreed to a court judgment for any unpaid amount.
In such event, the service provider may submit the unpaid bills, with an application for reimbursement to the Treasury.
The provider's rights will thereby be subrogated; and the Internal Revenue Service shall employ its collection procedures as necessary.
G.
All citizens and other legal residents who have attained age 64 by the date of the signing of this legislation into law shall be "grandfathered" into the Medicare system, with the ability to opt-out for a non-subsidized private insurance policy at any time.