| 1. Medicare coverage will be extended to all Americans under the age of 16 and also thoseunder 29 who are full time students.
2. Everyone between the ages of 16 and 65 will be allowed to purchase Medicare. The price at which they will be offered Medicare will be determined only by their Zip code and age.
3. Anyone who wishes to maintain equivalent coverage (of, at a minimum, catastrophic insurance with no lifetime maximum and annual out-of-pocket expenses capped at $10K) may do so. If proof of this coverage is not provided, and maintained, then the individual will be billed for Medicare. There will be minimum requirements for private insurance (examples above; additional requirements to be determined by the Department of Health and Human Services); they will also be required to report using a standardized template to facilitate comparisons between plans
4. Each individual will receive a voucher that will assist them in purchasing healthcare (either Medicare or private insurance). Any individual making less than the poverty limit will receive a voucher worth the full price of Medicare for them. Twice the poverty limit receives a voucer worth half price; three times the poverty limit receives a voucher worth one quarter the price.
5. Medicare will have full lattitude to negotiate all provider costs, including, but not limited to, doctor's fees, hospital fees, equipment costs, and pharmaceutical prices.
6. This will be paid for by: eliminating the cap on the payroll tax, eliminating Medicaid (it will no longer be needed under this plan), eliminating payments to hospitals for uninsured patients (it will also no longer be needed under this plan), and eliminating the tax exemption for healthcare benefits provided by employers.
7. All members of Congress, Cabinet members, and staff will be enrolled in the Medicare option.
Objections and answers:
O1: Healthcare reform creates a new beauracracy!
A1: No, it uses the existing Medicare bearacracy. Most Americans are pretty happy with it. How many people are eligible for Medicare who don't use it?
O2: I'll loose my existing coverage!
A2: Not unless it is substandard. Otherwise, you can keep your current health care just as it is.
O3: This is socialized medicine and that's bad, bad, bad!
A3: No, this is optional single payer medicine. Socialized medicine is the government employing the doctors and owning the hospitals. And, the governmental plan is optional.
O4: This will stifle innovation!
A4: Why? Pharmaceutical companies will still be able to negotiate rates. So will device companies.
O5: I shouldn't have my healthcare benefits taxed because I gave up wages for them!
A5: And the wages would have been taxed. Why shouldn't the healthcare?
O6: The Medicare option will stink!
A6: By forcing the people with control over it-- members of congress, their staff, Cabinet members, their staff-- to enroll in it, there will be an incentive to make sure it is structured correctly.
O7: This isn't single payer!
A7: No, it isn't. But if the Medicare option works well, it may evolve into single payer, assuming people vote with their feet. If they don't, then it shouldn't.
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