On July 4,
2019, declare your independence from the insurance companies. Get the healthcare you need and the coverage
you deserve with CadillacCare. This is a plan that inspires the American people and resonates
with the business community.
CadillacCare is the plausible alternative to Obamacare
CadillacCare is the plausible alternative to Obamacare
CadillacCare is the order of the day. Now is the time to replace Obamacare with
CadillacCare. CadillacCare is awesomely simple. It is clear, straightforward
and cut to the chaise. It crosses party lines Republicans, Democrats.
Here you’ll find no fluffs, no grand theories, no intellectual back flips.
Let’s have it now
without any delay. Desperate situation calls for desperate move.
This is a time to call for action. What we need right now is organized
chaos – work around the infrastructure that works. Do away with status quo
that stymie reduction of health care costs. Controlling costs should be
the dominant factor – low co-pay, no deductible, no COBRA, no coordination of
benefits, no dual coverage, no birthday rule, no gender rule, to mention a few.
CadillacCare is aspirational, credible and
real. This is what America needs and
what America wants. CadillacCare
consists of reality-based, solution driven recommendations to create order in
the American chaotic health care situation.
They are specific policy procedures to improve the health care delivery
system in the states. They are grounded
policies that are more than patches and can serve as pathways toward a high
performing health system throughout the country.
CadillacCare revolves around the
premise that access to health care should not be limited by limited or no
income. The paramount consideration is
to be able to provide a comprehensive and integrated approach to health care
for patients and a fairly decent compensation package to doctors, hospitals,
and other health care providers.
Healthcare is an inalienable right, not a privilege
CadillacCare is for
all at no extra cost. Over 328,506,943 people throughout the United States will
be covered by CadillacCare. It will
cover every men, women and children in every state from cradle to grave, from
womb to tomb without exceptions, without exclusions. CadillacCare makes
healthcare an inalienable right, not a privilege.
No pre-existing clause [condition]
The no pre-existing
clause [condition] is embedded in the CadillacCare health plan. For the first 30 days, a baby’s insurance is
attached to the mother’s. Subsequently,
the child will have his or her own insurance [See the breakdown of the payers’
monthly contribution to the HMO/medical facility].
Good bye fee-for-service
There
is no insurance pool at all but a fixed monthly fee based on the age bracket of
the patient/insured instead of the usual fee-for-service.
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
|
CadillacCare has three payers
There are three payers
in the CadillacCare health plan, namely, the State, the Employers and
Medicare. The State plan will cover all those who are unemployed or employed but
whose employers do not provide them with health insurance. 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. There are 54
million and more Medicare beneficiaries throughout the United States.
Guaranteed source of funding
Funding will
principally come from each state. This
is where the HMO/medical facility will have to pay $1.00 good will fee to the
state for each member enrolled in its organization. For example, if Kaiser has 10 million members
enrolled in northern and southern California, Kaiser will have to pay the state
of California 10 million a month [$120 million a year]. In New York, [Trump’s
home state], this translates to approximately $20 million a month, $240 million
a year.
State governors [Mayor of Washington, DC] on the limelight
Disbursement of the
good will fee to the state 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, Employers and Medicare]. If and when the $1.00 good
will fee may not be sufficient to pay for the beneficiaries in the state, the
state may have to dip into the state’s sales tax.
Next to nothing
All three plans
will have low co-payments and no deductible except for Medicare beneficiaries
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 for Part D
except for co-pay since prescription drugs will be covered under the three
plans.
Universal coverage from Alabama to Wyoming
Likewise,
CadillacCare has three identical, comprehensive, universal plans, namely:
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, [therapeutic]
massage, maternity and newborn care, mental health services, radiology,
prescription drugs, preventive health, specialty care and vision care.
The patients will
have the same coverage from county to county, from state to state.
In three months and in three stages
We have to move
fast, seize the momentum, not letting it go. The impact and ripple effect of
CadillacCare will be immediate and expedient as the implementation process will
take only three months and in three stages:
1st month – providers’ registration [all medical facilities/hospitals,
clinics in the state will have to register with the state’s managed care office
if they can provide or subcontract all the services provided in the plan.
2nd month – conciliatory meeting between providers and the 3 payers
[Medicare, State and Employers] regarding monthly contribution to the HMO as
well as the amount of co-pay.
3rd month – open enrollment of members by zip code, or up to
the 30-mile radius. For example, residents in the zip code 94538
[which is in the city of Fremont, California] can have a choice of doctors and
hospitals in the area, i.e., Kaiser, Palo Alto Medical Foundation, Sutter
Health Hospitals, Tri-City Health Center, and Washington Hospital, to mention a
few. Push comes to shove that some of
the residents are not satisfied with the services of the aforementioned medical
facilities/hospitals, they can opt to go to 30-mile radius and enroll at
Stanford University Hospital if Stanford University Hospital can accommodate
the fleeing patients from Fremont.
The state is sovereign
CadillacCare strikes down big government. The state becomes sovereign in its own right
and will not be needing federal funding to pay for its people’s health
care. CadillacCare relegates Medicaid to the sideline since the monthly
fees are paid by the three payers [state, employers and Medicare] direct to the
HMO/medical facility, thus cutting the middlemen and other private
insurers. Medicaid goes by different
names like Medi-Cal in California, Oregon Plan, MaineCare, Healthy Louisiana,
New Jersey Family Care to mention a few.
The doctor is the Boss
CadillacCare brings
back patient care to doctors. The medical facility/hospital comprised of
physicians and other health care providers will call the shot and run the
show. The program is absolutely innovative yet cost effective.
CadillacCare will level the playing field when it comes to health care.
Starfish concept
When any arm of the
starfish is cut off, nature reproduces the arm.
Likewise, CadillacCare proposals are like the starfish – they regenerate
themselves. While it generates income, CadillacCare also provides capital base
to every state for operating expenses. The funds come from the $1.00 good
will fee.
Fiscal impact
There will be more
hiring from medical facilities to provide services for increased
membership. CadillacCare will provide higher reimbursement from the three
payers [State, Employers and Medicare] since the insurance companies have been
cut off. Medicare fraud will be nipped on the bud. Providers will
no longer be burdened with too much paper work
The three bedrock requirements
Without a doubt, CadillacCare fulfills the
three bedrock requirements for real health care reform: reduce costs, guarantee
choice and ensure affordable care for all.
Vindication for the LGBTs
Last but not the
least, CadillacCare also addresses LGBT [lesbian, gay, bisexual and
transgender] issues. The LGBTs have always been there but not here. The
three plans will provide the same coverage/benefits regardless of sexual
orientation and gender identity.