A Unique Plan for National Healthcare

The single payer system I propose is different from every other single payer system in the world because it would have three levels of public insurance, deductible, basic, and premium. Premium public insurance would be available to everyone at a higher tax rate than basic public insurance. All types of insurance would cover all preexisting conditions, prescription drugs, any and all medically necessary tests or procedures, and cover preventive care (Basic and Premium with no deductible). Premium insurance would have lower copays, not require referrals, and have a few other perks compared to basic insurance. Since the cost of premium insurance would be based on percentage of income, not charged at a flat rate, it will be an option for everyone. Deductible insurance is discussed below. In creating several levels of public insurance we solve the debate over lower taxes vs. more benefits by letting each individual chose for themselves which they prefer.

Insurance would be mandatory. Everyone pays a 3% tax for the public insurance program, and a higher tax rate depending on the plan a person uses. If a person has private insurance the 3% is all they pay, because it's not unlikely they would get dropped by private insurance and begin using a public program, and this would act as a progressive tax on the wealthy who would be more likely to have private insurance. Deregulate private insurance, let them drive themselves out of business, pick their insurance pools, drop people at will, etc. Anyone not covered under private insurance is immediately covered by basic public insurance (or their preselected type of public insurance) at a higher tax rate.

Each type of public insurance would set it own tax rate based on it's costs. Premium public insurance would be provided for free (subsidized by the general population) to certain groups, such as children, the elderly, the poor (people currently receiving Medicaid), and people with some serious chronic illnesses (including Cancer during treatment). The 3% base tax would be used to help pay for this.

The 3 Levels of public insurance. All levels cover any & all types of medical treatment required for any disease or condition, including mental health coverage.

1) Deductible insurance

• ✯ The government pays for medical expense over a 5% of a person's annual income
  
• ✯ A medical savings account containing the deductible would be required for this to prevent people from walking out on hospital bills
  
• ✯ After deductible is reached you continue paying the deductible rate & get basic healthcare, or pay less 2% more of your income (or the difference between premium and basic healthcare, whichever is less) to get premium care. 1 year after you reach you deductible you start paying the normal rate for either of those plans.
  

2) Basic Public insurance

• ✯ Pick your primary care physician, and get a referral to for specialists
  
• ✯ Copays around 20$ for appointment with you PCP (primary care physician), 35$ for a specialist
  
• ✯ 20% of any prescription under 125$, all prescriptions over 125$ cost 25$
  
• ✯ Higher fees for other tests & services, none above 50$
  

3) Premium Public insurance

• ✯ Pick your PCP specialists do not require referrals, but there would be limits on how often you could see a specialist in the same field without a referral (physicians could refer themselves if they wanted to see a patient often)
  
• ✯ 15$ copay for any dr. appointment
  
• ✯ 10% any script under 100$, $10 for anything 100-175$, $15 for anything 175$ +
  
• ✯ Fees for other tests & services stay below 20$
  

Emergency Rooms
Charge a 100$ fee for inappropriate emergency room use, 20$ for "non-critical care" (if someone was directed there by a doctor, or has a serious enough condition to warrant going to the ER), no charge for catastrophic accident use of the ER (if a persons would be unable to work for a period time after being admitted, or their were other significant economic consequences).


Profit
The fundamental problem with our current system is that profit is being made by denying people care. I have no problem with people making profit by providing quality healthcare services to patients, and I believe the profit motive can serve as an incentive to provide high quality care. Under a single-payer/multi-provider system, medical establishments make profit while working for the greater good. This involvement of profit is in everyone's best interest, as it increases patient chose and quality of care.

I have no objection to the government using tax money to massively subsidize biomedical research and the development of new treatments for illness. So I don't mind using tax money to pay high drug prices, if everyone who needs the drugs has access to them after they are developed.