Structured universal healthcare and eliminate the corrupt healthcare/pharmaceutical structure

[julian61194 (Julian)]

1. The Universal Healthcare Tax (UHT)

• Progressive Tax Structure: The UHT could be a sliding-scale tax based on income, where higher earners and large corporations contribute a larger percentage, while low-income individuals either pay a minimal amount or are exempt. This approach aligns with fairness principles, ensuring everyone has access to healthcare without overly burdening those with less income.

• Flat-Rate Option for Businesses: Businesses could be taxed at a flat rate on their gross revenue, incentivizing them to support the system but keeping contributions predictable, reducing their need for private insurance contributions and lowering administrative costs.

2. Transparency and Accountability in Spending

• Public-Led Healthcare Fund: Set up an independent public fund solely dedicated to managing the UHT revenue, similar to a trust. This fund would be overseen by a nonpartisan board accountable to both the public and an independent watchdog group. Regular public audits and open access to fund reports would help ensure money is spent wisely and responsibly.

• Cap on Administrative Spending: A cap could be placed on the percentage of UHT funds used for administrative costs, limiting bureaucratic expenses and freeing up more resources for direct patient care.

3. Anti-Corruption and Oversight Mechanisms

• Healthcare Oversight Authority (HOA): Create an independent federal authority, the HOA, with the power to investigate and prosecute fraud, waste, and abuse within the healthcare system. The HOA could be tasked with monitoring both medical providers and pharmaceutical companies, enforcing fair pricing, and ensuring no party manipulates costs for personal gain.

• Conflict of Interest and Transparency Laws: Implement stricter conflict-of-interest rules for anyone involved in healthcare decisions, especially in pharmaceutical pricing and hospital administration. Transparency laws could mandate that hospitals, insurers, and pharmaceutical companies disclose any payments or lobbying efforts aimed at influencing healthcare policies.

4. Simplified Payment and Billing System

• Direct Payment Model: Under a universal healthcare system funded by the UHT, healthcare providers would be paid directly by the government fund, removing complex billing practices and excessive middlemen. This would make billing more transparent and prevent overcharging, common in today’s multi-payer system.

• Unified Electronic Health Record System: A streamlined, single-payer system with unified electronic records would cut down on redundant testing, billing errors, and administrative costs, while making it harder for entities to hide fraudulent practices.

5. Encouraging Preventive Care to Reduce Long-Term Costs

• Preventive Care Incentives: Since preventive care significantly lowers long-term healthcare costs, the UHT could also be invested in wellness initiatives. This would reduce the likelihood of chronic conditions, helping control costs over time while improving population health.

6. Transparent Pricing and Pharmaceutical Regulation

• Price Negotiation for Medications: The HOA or another authority could negotiate drug prices directly with pharmaceutical companies, which would be funded by UHT. Transparent pricing standards would prevent inflated drug costs, benefiting everyone and preventing unnecessary spending.

• Generic Drugs and Public Production: Encourage the use of generic medications and consider public production of essential drugs, ensuring affordable access to necessary medicines.

Why This Tax Could Help Eliminate Corruption

A universal healthcare tax structured with transparency and accountability reduces opportunities for profit-driven exploitation:

• Eliminates Private Insurer Middlemen: By funding healthcare directly, there’s no need for private insurers to play a central role, minimizing the potential for billing fraud or inflated premiums.

• Reduces Political Influence: With transparent audits and oversight boards, it’s harder for healthcare companies to buy influence, especially if strict conflict-of-interest laws are enforced.

• Increases Public Accountability: With publicly accessible reports and audits, citizens can hold the government accountable, making it more challenging for funds to be misused or for corruption to flourish unnoticed.

[hwytoelle (Elle Lane)]

When Trump was campaigning to run for the Reform Party in 2000 one of his policies was universal healthcare. I support universal healthcare and would like to see him revisit this.

[laury]

Your Universal Healthcare Tax (UHT) policy framework is thorough, covering many essential aspects of funding, accountability, and anti-corruption measures. I’ll outline additional potential components and address potential cons, along with solutions to help mitigate them. Here’s an expanded version with added detail on possible challenges and safeguards:

Universal Healthcare Tax (UHT) Policy Expansion

Additional Policy Components

1. Equity in Healthcare Access Across Regions

• Regional Healthcare Investment: To prevent disparities, allocate UHT funds based on regional healthcare needs. Rural areas and underserved communities could receive higher funding to ensure quality care access.

• Incentives for Healthcare Professionals in Underserved Areas: Create programs funded by UHT to attract healthcare workers to high-need areas, like loan forgiveness, relocation bonuses, or subsidized housing.

2. Public Participation in Policy-Making

• Community Health Boards: Establish local health boards that include citizens, healthcare workers, and patient advocates to provide feedback and suggest improvements on healthcare delivery within their regions.

• Annual UHT Policy Review: Require an annual public review of UHT policies with an open feedback period where citizens can propose adjustments, fostering transparency and ensuring policies reflect evolving public health needs.

Potential Cons and Solutions

1. Con: Burden on Middle-Class and Small Businesses

• Progressive Scale Modulation: Regularly assess the impact of the UHT on middle-income earners and adjust tax brackets accordingly. Small businesses with lower revenues could qualify for a tiered tax system that prevents them from shouldering disproportionate costs.

• Small Business Tax Credits: Offer tax credits or deductions to small businesses that face a substantial burden, particularly in the initial transition phase, reducing the immediate financial impact on operations.

2. Con: Potential for Mismanagement or Corruption within the Fund

• Independent Auditor General: Beyond the nonpartisan board, create an independent auditor general role, directly accountable to the public, to regularly review UHT fund expenditures.

• Real-Time Expense Tracking: Implement a public, real-time expense tracking system that allows citizens to monitor where UHT funds are being spent. This online platform could provide a breakdown of expenditures by category, promoting continuous oversight.

3. Con: Complexity and Potential Delays in Unified Billing and Records System

• Phased Implementation: Roll out the unified electronic health record (EHR) system in phases, allowing for adjustments based on initial feedback from healthcare providers.

• Provider Training Programs: Provide training and support for healthcare providers transitioning to the new system to avoid disruptions. Allocate a specific percentage of UHT funds for IT support and training during the first five years.

4. Con: Risk of Price Manipulation in Pharmaceutical Negotiations

• Third-Party Price Monitoring Group: Establish an independent group of economists and healthcare experts to oversee and evaluate drug pricing negotiations.

• Price Cap Legislation: Implement maximum price caps on essential medications based on international standards. This would prevent pharmaceutical companies from inflating prices during negotiations and ensure affordable access.

5. Con: Inertia from Private Healthcare Insurers and Lobbyists

• Transition Assistance Program for Displaced Workers: Offer job transition programs, including retraining and placement services, for workers from the private insurance sector who may be impacted by reduced industry roles.

• Lobbying Transparency Laws: Strengthen regulations requiring public disclosure of all healthcare-related lobbying activities and campaign contributions, preventing undue influence in policy adjustments.

6. Con: Insufficient Focus on Mental Health and Non-Emergency Services

• Mental Health and Preventive Care Fund: Dedicate a portion of the UHT specifically to mental health services and preventive care programs, ensuring they remain a priority. These programs can provide long-term cost savings by addressing health issues early.

• Expanded Preventive Services: Develop a standardized list of preventive services covered by UHT to reduce the long-term burden of chronic diseases, ensuring the system isn’t overburdened by preventable conditions.

Why the Universal Healthcare Tax (UHT) Model Could Effectively Reduce Corruption and Improve Healthcare Access

Enhanced Oversight and Transparency:

• Regular, public audits and the involvement of an independent auditor general will maintain high standards of financial integrity.

• Real-time public access to spending data and price monitoring for pharmaceuticals can further curb corruption and unnecessary spending.

Equitable and Fair Distribution of Burden:

• A progressive tax structure and small business support will distribute the financial burden more equitably, lessening opposition from smaller entities.

Prevention of Overlap and Redundancy:

• Unified billing and records systems, though challenging to implement, will reduce unnecessary administrative costs, redundancies, and errors in patient care.

• Standardized pricing and caps on administrative costs help ensure funds remain focused on improving patient outcomes rather than fueling bureaucratic expenses.

By addressing these cons with clear solutions, the UHT model can maximize transparency, public accountability, and access to healthcare. The policy’s success would depend on continuous feedback, adaptable structures, and a focus on preventive care, making universal healthcare more sustainable and equitable.

[Sotar (David Battles)]

Thank you Julian and Laury for your thoughtful ideas and proposals. Both of you highlight areas in need of reform and propose good ideas for moving things in the right direction.

It is also important to step back and try to figure out how we arrived at a place where our per capita healthcare expenditure is approximately double that of most developed nations and 50% higher than the 2nd and 3rd place spenders (Switzerland and Germany) yet our quality of health is around half that of other developed countries. If a corporate management team delivered results half as good as the competition at double the cost everyone would be fired.

At least part of the problem is that our healthcare system is not incentivized to create wellness.

Another problem is that we have allowed the medical profit lobby to have too prominent a voice. The AMA has to be curtailed so that the public gets all the facts not just the “party-line” that serves the interests of physicians.

The American public is shielded from information that seems to be readily available in other developed countries. Information about the usefulness of alternative medical remedies such as homeopathy, herbal remedies, etc. are discredited in the United States since there isn’t tremendous profits available from such therapies or remedies. We need to prevent government agencies (such as the NIH) from being in lockstep with the AMA and instead encourage full disclosure of facts so that the American public can make informed decisions about their health instead of essentially having to accept whatever the mainstream medical propaganda is.

Some (especially those in the medical field) might take offense to my comments, I would only point out the results (double the cost for half the results) and suggest that the mainstream approach clearly isn’t working and we need to adopt other strategies. For starters, we could simply see what approaches are working in other countries and follow their lead. If we just copied countries such as Japan or Switzerland we would dramatically improve our nation’s health status.

If we are going to keep a for-profit healthcare system, then we need to at least level the playing field by removing the single-voice monopoly that the AMA and it’s minions (CDC, FDA, etc.) has over the narrative and therefore public perception. A free-enterprise healthcare system can only work efficiently if the consumer is fully informed of all the facts and can make educated buying decisions.

If the public understood the importance of diet, nutrition and exercise and relied less on pharmaceuticals we would see a dramatic improvement in our nation’s health. Note that the average American consumes ten-times more pharmaceuticals than the average non-American. There’s definitely something wrong with that picture.