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See webinar on how America could assure
unrationed health insurance
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INSURANCE FOR ALL.
Just as basic liability insurance is required of everyone who
registers an automobile, basic health insurance would be required
for everyone.
* CHOICE
OF PLANS THROUGH AN EXCHANGE.
Private insurance companies would compete by offering health
insurance plans through an insurance exchange; each company offering
health insurance would have to offer at least one basic plan.
Employers would have the option, in place of contracting with
specific insurance companies to insure their employees as is now
common, of instead allowing their employees to choose their
insurance through the exchange, with the employer payment for or
toward the premium paid through the exchange. (Employees who chose
plans costing more than the employer pays could have the extra
charge deducted from their paychecks on a pre-tax basis.)
*
INSURANCE FOR THOSE WHO CANNOT AFFORD IT.
Those with incomes too high to qualify for Medicaid but too low to
be able to afford to pay the full premiums for basic health
insurance would be certified by the government as entitled to
discounted premiums, on a sliding scale based on degree of need.
Need would take into account income, family size, and similar
relevant factors. They could choose among any basic insurance plans
offered through the insurance exchange, and would be charged based
on their particular certified sliding-scale discount.
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COVERING THE COST.
The prices health care providers charge those covered by private
insurance now have to help cover the cost to those providers of
treating those who are now uninsured – effectively resulting in
private-sector cost-shifting reflected in the premiums insurers
charge their customers.
Under the new proposal, those now uninsured would now be covered by
insurance, and cost-shifting at the level of the provider would no
longer be necessary. Accordingly, third party payers such as
insurers would be authorized to “set aside” a percentage from the
payments they make to providers who submit claims for reimbursement,
which would go to a fund to cover the costs of the sliding-scale
subsidies for insurance premiums. This percentage would be set in
advance of each year by a commission, calculated to be adequate to
cover the projected costs. Essentially, this would shift existing
private sector cost shifting from the level of the provider to the
level of the insurer; the net cost (ultimately reflected in
insurance premiums) would be about the same. |