Saturday, April 29th, 2017

How to Provide Quality Health Care to Everyone in America


             Who among us can sit idly by and watch friends and neighbors destroyed by the high cost of health care?  And is it not proper that all people have access to quality medical care?  You would have to be pretty cold to reject the idea that all people should have quality medical care without regard to income or social status.  As Ted Kennedy said: it is really a moral imperative that we address this most important social issue of our time.  It’s incomprehensible that anyone goes without in America where we have such an abundance of riches.

            The current vision of Universal Health Care being proposed involves large sums collected from taxpayers and sent to Washington D.C. where it is doled out by government officials to pay bills that are generated by physicians, hospitals, pharmaceutical companies and other purveyors of health care services.  That’s an unnecessarily cumbersome and circuitous way to fund the vision.

            Why not cut out the middle-man?

            For those wealthy enough to pay taxes:

            If you spend a dollar on health care, you deduct it directly from your taxes.  Instead of sending money to the IRS and having a government agency pay it out to health care providers, you just don’t send it to the government in the first place, but pay directly to the provider.

            This plan means that choices are as varied as the imagination of the public because you simply choose your provider on your own, paying with money that otherwise would go to the IRS.  There is no government health Czar, simply a direct payment to the provider by taxpayers.

            It means we don’t have to change the basic employer-based system we have now, and any employer who wants to provide health insurance can do so (and really has no incentive to discontinue the benefit), but it means that those unable to obtain insurance through their employer will be able to divert money currently slated to go to the IRS to cover the cost – again, not fundamentally different in result than running the money through the IRS and back through a big government agency charged with distributing money to providers or subsidizing insurance for all.

             For those not wealthy enough to pay taxes:

            As to people too poor to pay any taxes (a vanishingly small segment of the population), several answers arise.

            First, we should allow your neighbor to pay your bill and take the tax credit.  Again, if the idea is “universal coverage” and if taxpayers generally are going to pay for all the care anyway, then there’s every reason to let providers just find a taxpayer willing to directly pay a health care bill without running the money through the IRS and through a government bureaucracy.

            Over time, of course, any provider with a modicum of common sense will develop a data base of supporters willing to pay the provider for free services to indigents in exchange for getting the tax credit associated with doing so, and – again – all we are doing is having taxpayers pay the costs of health care without the IRS getting in the middle.

            Second, we prohibit providers whose practice is qualified to receive tax credit payments from turning down any patient simply because the patient is unable to pay, essentially leaving in place the existing “emergency room” treatment model.  Providers who violate this law, would be removed from eligibility for tax credit payments – a penalty so huge that no one would likely try to violate the law.

            That should cause little concern because there is really no incentive to pose as “too poor to pay.” By posing as unable to pay, no one would get a single dollar more in their pocket.  The money withheld from a provider by posing as too poor to pay would instead go to the IRS.  So, with this plan, the number of those claiming to be unable to pay is likely to be much smaller than it is today.  Plus, as indicated, because any taxpayer can pay any other person’s health care bill with money otherwise slated to go to the IRS, most providers will have a data base of taxpayers willing to pay the bills of others.  And, finally, to the extent that fails, providers will soon learn on average what it costs to provide the free treatment to indigents, and that will get built into the price for the tax-credit payors, and so we will have taxpayers with money paying the entire treatment costs for everyone, but – again – without the IRS and a government health Czar in the middle.

            Because this does nothing more than send taxpayer money to health care providers for appropriate medical care, it won’t cost any more than the Universal Health Care envisioned by the most caring Americans.  Indeed, by cutting out the middle-man, it saves billions in annual administrative costs along with the waste and mismanagement inherent in every large organization. 

            This plan also avoids the essential fear many Americans have of any Universal Health Care system administered by the government, which is: control by an unaccountable bureaucracy over health care decisions.  This plan by-passes governmental control over health care entirely. 

            This will provide what is essentially “free” universal health care to all Americans.  This plan also meets President Obama’s pledge of reforming health care without raising taxes on the middle class.  The plan could increase the federal deficit, except that President Obama already indicated in his September 8, 2009 speech to the joint session of Congress that universal heath care could be funded mostly by eliminating waste and fraud in the existing Medicare/Medicaid programs; so, if we just address that, this could be deficit neutral, and this plan has the advantage of costing nothing to fund a large federal health care bureaucracy, something inherent in other forms of Universal Health Care.

            Funding Universal Health Care with a simple tax credit thus accomplishes the core goal of its most fervent proponents without any of the problems associated with existing proposals.  For that reason people of all political persuasions should embrace the idea.

By John S. Mills, Tacoma, Washington

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