In three SIMPLE (not easy) steps
1) Straight repeal of Obamacare. Probably the most difficult to pass as the Dems will likely filibuster. So be it. Let them deal with the voters.
2) Create a national exchange where the People can voluntarily purchase healthcare insurance and where Insurance companies can either participate in all categories of insurance or not participate at all.
Set the exchange up to have several different categories or options of insurance from high to low options / premiums / co pays etc. One option should address pre-existing by a) not include pre-existing, b) allow pre-existing with an annual cap on payments and c) an option for unlimited pre-existing conditions.
3) Change the tax code:
- for businesses so that they receive a tax deduction for any contribution to an empolyee’s health insurance (HSA account) plus small percentage (1 or 2 percent) if provided to all (full or part time) employees. Treat it like an IRA or 401k
- for individuals to create health savings accounts with pre-tax dollars
- allow for HSA’s to pay for premiums, co-pays, prescriptions, equipment, etc. And allow savings to accumulate and roll over year to year. (save for retirement years)
This will encourage
- businesses to provide a flat amount or percentage an employee receives.
- businesses to provide that payment to all employees
- individuals to participate and save
IMO, these are all proposals that could be useful for controlling the cost of “routine” medical care, but they don’t effectively address the problem of “catastrophic medical cost”.
That doesn’t mean the ideas are unworkable or unsound, just that they are actually only one half of a practical health insurance system.
Of actual existing systems, New Zealand’s probably comes closest to a practical system based on the underlying philosophy you suggest,.
While this type of arrangement it would not be my first choice of solutions, but it would be a lot better than what we have now.