By Dr. Emelita D. Breyer

Contact: Breyer.foundation@gmail.com
http://www.emelita-breyer.com/11.html

T he need for healthcare for all the people in the United States has reached its time where a reasonable-and-affordable solution is just at an arm’s reach. As in the past the passion and dedication of the American people poured in town hall meetings, the media, the Internet, the streets and halls of the US Congress to design the structure of the healthcare system that currently accounts for one-sixth of the US economy and a major part of the country’s increasing budget deficit. However, almost all the proposed reforms do not address the needs of all the people here in America.

The Senate bill leaves 24-million uninsured while other proposed bills from the House and the Republican parties leave 18-million or less uninsured by 2019. Since Congressional Budget Office studies showed that 5% of the Medicare population is sufficient to cause more than 44% of US healthcare burden, the uninsured gap in the bills that cover 6% or more of the entire population could have a significant impact on the uncertainty in all the current reform projections and future forecasts.

As people talks about common sense solution to the problem, it is of prime importance to define the goals and objectively evaluate the outcome in satisfying these goals. There is no one solution that fits all, especially since we have such a heterogeneous uninsured population whose needs for access to an affordable and quality health care should be met with innovation and novel ideas. Providing grants alone for programs that are yet to be realized and instituting more bureaucratic agencies to form an even bigger barrier for access are not merely solutions to a solution but could result in a quagmire of problems that is yet to be realized, without proper overall direction of purpose and vision of where Americans really want to go.

US advancement in medical-and-pharmaceutical innovation ranks among the top in the world. In this time of economic uncertainties, countries all over the world are pooling their assets and cultivating their strength towards economic recovery and success. We should be able to balance our efforts in fixing the imperfection of our healthcare system while further enhancing our strength in the global market in this industry.

Improving our healthcare system is not only an end towards cost-and-deficit reduction but also a means by which US economy can recover and prosper.

The two major problems in our healthcare system are:

·        The increasing number for uninsured, currently at 50 million, some are due to lack of access through limitations on the pre-existing condition requirements in existing insurance plans;

·        The growing healthcare cost and budget deficit as a product of the current health care infrastructure and entitlement programs. This time is a unique opportunity for our country to build a well-designed and sustainable foundation coupled with strategically planned implementation to achieve these goals.

A simple solution for both problems is a categorical approach for the need of each group of uninsured, coupled with a structural healthcare framework that facilitates optimum efficiency and cost savings for all people in the country. The largest savings with quality care had been achieved for years in the Federal Health Benefit Group Plans with all private insurance offered to the leaders in the Congress and other federal employees. A similar approach that utilizes the strength of the federal entity called “national insurance exchange” to negotiate on behalf of all the 300-million American people for a fair discounted price in comparison to all current private-insurance premiums would tremendously reduce the cost for all without interfering with the individual’s constitutional freedom. Such decrease in the current insurance premiums can be achieved by inter-state and national insurance exchange where current insurance premiums could be reduced by as much as 20%-30%.

A simple solution that will immediately reduce cost for all Americans and enable insurance companies of all sizes to have free-market competition. Further savings will be achieved through a simple model of the national individual saving trust-fund support to the uninsured through a 20-cent tax-exempt donation for their medical care from every dollar saved by the individual through the system. Establishing a long-term and cumulative individual health-saving and retirement trust fund that are integrated to an effective but personalized preventive-care program, consumer support and system oversight would further promote a saving program linked to repairing the insolvency of the individual’s Medicare and Social Security systems. Failure to act now on this will result in increase taxes or reduction, if not elimination, of any future benefits in these systems.

Under the national insurance exchange, low-cost private insurance will be available to all. Further extending the health-insurance plans to beneficiaries’ children up to the age of 26 would provide access to 10-million to 15-million currently uninsured, while providing the tax credits or insurance bond options to the high income uninsured would provide health care cost security to another 10-million uninsured.

Homeless and other low-income uninsured could be covered by the same private-insurance standards through subsidies from the people’s contribution to the system, while foreigners and migrants will have the option to buy their own private insurance through the national exchange, without due burden to US tax payers. Reduction in the unnecessary emergency cost through more-efficient and effective preventive programs, especially for the underserved and high-risk individuals will further reduce healthcare cost. This is a simple approach and personalized long-term saving model that provides efficient-and-effective care for all 50-million uninsured,  while providing lower cost and  preserving the same high quality healthcare to all currently insured  people in US.

The Issue of Public Funding for Abortions

S uch structure could also resolve the current controversy regarding the status and beliefs of people on funding for abortion. As subsidies through the donations are directly provided from individual’s accounts, and thus they could choose, in the same manner as organ donors do, based on their faith and beliefs, whether to donate or not to this cause for the uninsured. Current laws on abortion would be applied with regard to federal funding.

Tort reform and new innovations could be easily integrated in this more-efficient system, through standardization of best medical practices and tests while providing ease and efficiency in the dissemination of new technologies and therapies. Individuals would have better information, and options to early access on new life saving therapies across the nation while a credible and effective oversight is in place in the system to ensure their safety. Through the system, the gaps between rural and urban care and expertise will be bridged through collaboration and integration of care across boundaries of geographic areas and expertise. 

America is one of the last developed nations without an affordable-and-accessible healthcare system for all the people. However, the last now has the opportunity to be the first, if the right reform is in place that will not only serve the initial goals but will also engage and bring incentives our people – from businesses to the consumers –towards good health and economic independence. We have a long time and vast examples from our neighboring countries to learn from their mistakes and successes. The best minds of the United States and their hearts could put together the best healthcare reform for all our people. # # #