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 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.

3^rd 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.