Healthcare Reform Plan Part 2

Catastrophic Care Insurance

Individuals who cannot or chose not to purchase a robust insurance plan could instead choose catastrophic care insurance. This insurance would cover required medical procedures performed in hospitals. It is precisely these major events that have caused uninsured individuals to file for bankruptcy. While policyholders would have to pay for their doctors’ visits, any major surgeries or illnesses that require hospitalization, would be covered by insurance. This option, which would be less than the statewide insurance pool plan, would enable those who cannot afford a full insurance plan to have protection against catastrophic events. It is my belief that multiple private insurance companies will be able and willing to provide this type of plan and thus enable individuals to purchase insurance on a pooled basis regardless of whether they are employed. Additionally, this can be an option provided by employers to their workers.

The one scenario when a public plan may be appropriate is in the event private insurers are unwilling to provide statewide catastrophic insurance, which I do not believe would be the case in light of the fact that this type of insurance currently exists in the market. While I am loath to see a government-run plan for a variety of reasons, including inefficiencies, wide-scale bureaucracy and challenges of implementation, I believe the following scenario could work if we do have a government-funded public option. Under my proposed government-funded plan, payments to doctors would be provided at the Medicare-approved rate. In the event that there are not enough physicians willing to participate or accept Medicare rates for this group of catastrophic care insureds, I propose the following.

The government should create a program to provide free medical education to doctors similar to what is currently offered to armed forces recruits. In return, doctors would have to work 4-6 years in hospitals or clinics that treat insureds that are members of a government run catastrophic plan or Medicaid. This program would serve multiple goals. One, it would ensure that there are enough trained medical professionals available to treat the government insured plan members and provide a greater pool of doctors to treat Medicaid patients. The costs of providing this care should be sharply reduced, because salaries for doctors during this four to six years of service would be commensurate with what doctors are paid during their required time in the armed forces after they graduate. This should dramatically reduce the amount of the cost of care as well as create a reliable source of practitioners to treat this patient base. By implementing this plan, the government would be able to ensure that there would be enough doctors to service a growing patient populace and control the cost of medical care provided to this group of patients.

The implementation of these two proposals should lead to more insurance options being available to individuals, small and large employers, and people with pre-existing conditions.  The benefit of this plan is that the costs of implementation are spread across the populace equally. Employers (both large and small), individuals and private health insurers will all contribute in a more equal fashion to help reduce costs. Small businesses gain by being able to provide insurance to their employees at a price in line with larger employers, individuals and freelancers will be able to purchase insurance not contingent on employment status and private insurers gain by not having to compete with a government funded entity.

Tomorrow:  Part 3 Tort Reform

Tags: , , , , , , , ,

3 Responses to “Healthcare Reform Plan Part 2”

  1. 9nine9 Says:

    Here’s my issue with this: If people can’t afford regular visits to doctors, they may end up suffering from something “catastrophic” that otherwise would have been detected earlier.

    • David Brill Says:

      The benefit of the catastrophic option is that is does not prevent individuals getting primary care treatments or other wellness exams. These wellness visits are not that expensive (especially on a once or twice a year basis). Remember this type of insurance does not prevent lower income individuals from receiving Medicaid. What this does afford is a safety net in the event of a serious medical injury that could bankrupt an individual.

Leave a comment