There will be three universal health plans, which can be replicated nationwide. These are the State Plan, Employers’ Plan, and Medicare Plan. All three plans will cover acupuncture, ambulance, chiropractic services, dental care, doctor visits, family planning services, hearing, hospital and emergency care, laboratory, maternity and newborn care, mental health services, radiology, prescription drugs, preventive health care, specialty care and vision care. The State Plan will cover all those who are unemployed or employed [and their dependents] whose employers do not provide health insurance. Funding will principally come from each state. In addition, it is proposed that 1% from the sales tax from the state would be earmarked for this plan. All those who are employed and whose employers provide health insurance for their employees and their dependents will be covered by the Employers’ Plan. All those eligible for Medicare benefits will be under the Medicare Plan. Medicare is a federal health insurance coverage for people 65 and older, certain disabled people, and those with end-stage renal disease [ESRD]. With fewer employers subsidizing health coverage for their current retirees and their spouses, the Medicare Plan can provide health insurance coverage for those older workers – the age group that has the hardest time buying individual policies. There are 54 million Medicare beneficiaries throughout the United States.
Next to Nothing: All three plans will have low co-payments and no deductible except for Medicare patients where CMS [Center for Medicaid and Medicare Services] will determine and retain control over individual premiums and deductible for Part A and B. There will be no out-of-pocket cost for Part D except for co-pay since prescription drugs will be covered under the three plans.
Breakdown of the Payers’ Monthly Contribution to the HMO/medical facility:
01–11 months-$20.00/ 01–04 years-$30.00/ 05–11 years-$40.00/ 12– 17 years-$50.00
18–39 years-$60.00/ 40–64 years-$70.00/ 65 + years-$80.00
Fiscal Impact: The plan will bring about a change in consumer spending. It is proposed that 1% from the total sales tax generated from the state should be earmarked for one of the plans, the State Plan. The sales tax will definitely make a direct impact on every American.
⦁ Every time one makes a purchase, the thought that a fraction of the transactions will help support the health insurance coverage for a segment of the society is enough incentive to boost the sale and purchase of any product or services. If the buying spree stimulates the sagging economy, so much the better. As membership in the HMO/medical facility increases, more jobs will be created. This might even help bring unemployment down.
⦁ The program will generate monthly income to every state. The HMO/medical facility will have to pay $1.00 good will fee to the state for each member enrolled in its organization. In Texas alone, this translates to approximately $26 million a month, $312 million a year.
⦁ Disbursement of the collected funds from the good will fee will rest solely on the discretion of the Governor of the state as he/she deems it fit and proper. The HMO/medical facility will have to exercise due diligence in keeping track of its members and at the same time providing an accurate monthly roster to the three payers [state, the employers and Medicare].