Attempt to start a real conversation on a bi-partisan health plan

by Chana Cox

Disclaimer:  Although I am a member of a political party and of other organizations, I am not speaking for any party or any organization in this post. This is simply one individual’s attempt at stimulating a conversation on a cobbled together, potentially bi-partisan plan for our own very blue state. As with my posting on Glass-Steagall, I anticipate that this will be controversial.  (As a potentially bi-partisan plan it violates some of my own ideological principles.)

So, Oregon Catalyst reader, what would you need to know, to add, or to change before you would even consider such a plan?

In Oregon, the left wants universal coverage, the right wants individual choice, everyone wants to control costs, and virtually everyone is agreed that Obamacare does none of these things.  The left wants to soak the rich, the right wants to get business off the hook for basic health care, and almost everyone wants to greatly reduce the administrative burdens of the current system.  So here’s the plan…

The State of Oregon applies for exemptions from all Federal Health care mandates in return for a block grant and a commitment to use those funds as partial funding for The Plan described below.

1. Every Oregonian contributes a fixed (by law) percentage of his/her/questioning income to fund The Plan because there is no free lunches much less free health care.
2. Every individual, adult or child, irrespective of employment status or pre-existing medical conditions will receive (a) a voucher of precisely equally monetary value, and (b) $2,500 to be deposited into a Health Savings Account (HSA).   The voucher must be used for the purchase of a health insurance package.  The balance of the voucher amount, if there is a balance, must be deposited in the HSA. Vouchers and HSA funds for children will be managed by their parents or legal guardians.
3. Private insurance companies (in state and out of state) may bid on providing packages that would be paid for by the voucher.  All such insurance plans would be open to all individuals.  The minimum required plan “Model T Plan” must cover prenatal doctor visits, inoculations for children, and the minimum catastrophic care for every individual.
4. The Model I Plan would cover any life threatening condition after a deductible of $5,000.  The definition of “life threatening and the level of the coverage will be determined by the state.  One of the strengths of the original Kitzhaber health plan was that it transparently, exhaustively, spelled out what would and would not be covered by taxpayer subsidized health plan.
5. The taxpayers are only on the hook for the Model T and the HSA.  Beyond the basic Model T, insurance companies may offer particular groups of individuals plans with supplemental packages of benefits to supplement the Model T.   There could be Daimler, Packard, Volvo, Mustang, Expedition, and Corvette plans each with very different benefits.  The insurance company is under no obligation to offer everyone the same set of supplements.  Which supplemental benefits are selected will be determined by individual customer preference and insurance companies and not through either government regulation.  Costs of insurance in excess of the voucher amount would be the responsibility of the individual purchaser.
6. Once each person has purchased their preferred health insurance package, they will put the balance of the voucher amount, if any, into the Health Savings Account.  HSA funds not spent in one calendar year would roll over and into subsequent years.  All HSA funds would be deposited in an account in an FDIC insured bank or with an approved HSA servicing company where they may earn interest.  Those funds could be accessed through a debit card, or, or by submitting bills for reimbursement to an approved HSA servicing company.  The funds will remain the property of the insured individual, but may only be used for their own health care expenses, or, in the case of adults, for their spouses or their children.  In contrast to the criteria for the Model T Plan, however, allowable HSA expenses will be very broadly defined.
7. Individuals currently in the VA system or the Medicare system could, at their option, remain in those systems.

Chana Cox is a Senior Lecturer Emerita at Lewis and Clark College, and she has a Ph.D. from Columbia University and a BA from Reed College. She has been a featured speaker at U-Choose events.