A comprehensive (moderate) health care solution

Here is my comprehensive health care policy.
It is the perfect compromise between the failing status quo and the socialistic and inefficient version of Canada.
We should have a government run insurance business to compete against those in the private sector.
This would be paid into by individuals who chose to be enrolled.
It would provide health insurance with high deductibles (around $2000) for cheap.
The profits would be kept to a lower level than most insurance companies
(maintained at around 30-40% of those profits from 2008- adjusted for inflation and demand). (Or started at 70% of those profits and dropped 5% a year to 30-40%).
(Maybe, the government could also offer $50-$200 dollar deductible plans- this however would be started at 85% of the 2008 profit levels for similar plans offered in the private sector and would decrease 3-5% each year down to 50% by cutting prices – this would then make the increased demand for health services come at a slow enough pace so as not to overburden providers and create long lines.)- It would also give private companies time to adapt and compete.

I must say that those government insurance companies must be, for the most part, ran like companies in the private sector and must contain at least as much fraud detection and prevention capabilities.
The profits that the government does make should go toward medicare and Medicaid as well as tax cuts or tax credits to private companies who lower drug prices and deny less people coverage.
One benefit to getting insurance through private companies is that they will pay for more than just what is ‘necessary to lead a healthy and productive life.’
Which brings me to a reform for Medicaid and medicare. We need to limit when doctors give the best implant or hip replacement which would cost 40,000 and make sure they just give what is ‘necessary to lead a healthy and productive life.’
We also need to combat diabetes which is the largest drain on our Medicaid. We need to remember though that cheaper foods are those most likely to lead to obesity, so we need to work on combating poverty and making healthy foods more affordable…and desirable.
We also must promote and educate people about living wills, which will allow them to be taken off life support if there is little to no chance of improvement.
We must also allow the FDA to consider cost effectiveness when approving new drugs.
We must also not allow pre-existing conditions to have too much effect on payments and certainly not on coverage. (perhaps excluding treatment for suicide attempts after the first- but not excluding treatments to prevent it from happening again.)
We must also build the individual insurance market and portable insurance so that people are less dependent on their jobs.
Last, we should provide malpractice insurance and lawyers available non-profit through the government.
(I realize the private sector could not compete against this, so people from the private sector should be hired to run it.)

Here are some additional thoughts from Newt Gingrich’s book “Real Change”

We should perhaps end Medicaid and provide low income families with vouchers or tax credits to buy their own insurance (this will not work on it’s own of course, due to pre-existing conditions rules that insurance companies employ).
As Jeb Bush implemented in Florida, each state should have web sites like Floridacomparecare.gov and myfloridarx.gov which enables consumers to choose the best performing and highest value hospitals and medications.
Also, more companies should put employees on programs like Healthways myhealthIQ health risk management program which “gives financial rewards based on quantifiable, improved biometrics.” It also provides coaching.
Hospitals must transfer to more IT systems to replace the paper system- this will prevent medical errors, increase efficiency, and save money.
The federal government must lead the way in creating a reimbursement model that takes quality of care (and results), and not just quantity, into account.
We should insist that everyone obtain insurance or post a bond.
We should create a national pool for those who suffer catastrophic illness or disease.

A comprehensive Social Security Solution

My solution is taken from my own ideas as well as others.
The solution is thus:

1. We should institute a 0.45% tax on all stock trades (half charged on buy, half charged on sell) of U.S. citizens in any market- starting when the U.S. market revives (I’d say when the Dow reaches 11,000 or the S&P reaches 1,200).
This would amount to about 77 billion each year (if the stock market didn’t grow at all) and will certainly keep social security solvent for many more years.
I suspect it would also decrease volatility in the market.

2. We should also consider the possibility of turning control of the social security funds over to a private company that has a contract with the government. (Of course we would include things like having caps on executive pay etc).
They could invest a certain percentage of the money in low risk operations, and keep the rest in bank CD’s.
(We could also keep their dealings secretive, and allow them to legally do insider trading

3. We must tie social security benefits to the inflation rate, and not the wage growth rate: which currently significantly outpaces the inflation rate.

Here is a good site to read:
http://www.nextinning.com/socialsecurity2.php
The following ideas are derived from it.
4. ‘We must keep congress’ hands off of the social security trust fund’ should mean that regardless of a government surplus we do not allow any money to be taken from the fund to pay off other government debt, or any other thing.

5. If my other plans are put in action then I would say we should perhaps forgive a significant portion of the government’s debt in bonds/IOU’s to the social security trust fund.

6. I do like this authors ideas for a transition to a privatized system under the subheadings “A gradual move toward privatization” and “But Wall Street is a rigged lottery.”
I desire to implement this with my other plans (possibly excepting the plan to turn control of the social security funds to a private company with a government contract). However, I desire to make the transition somewhat slower than what this author may have in mind, and I would perhaps only allow college educated people nearing retirement to invest. (Or perhaps we could create a mandatory test on investment, saving, and budgeting that people must pass).

I also believe these ideas (slightly modified) from wademan on solutionslab could be incorporated in with my own:
7) Social Security income begins at: 1) 59 1/2 yrs old (65% of entitlement); 62 yrs old (75%); 65 yrs old (85%); 70 yrs old (95%): 75 yrs old (100%).

All US workers, regardless of citizenship status are mandated to pay into Social Security system by payroll deductions, but will not qualify for Social Security unless they are a legal US citizen. (I would change this by having non-citizen workers pay a reduced rate of contribution- perhaps 50% of the normal benefits. I would also say non-citizens may only collect 65% of what they contributed, and former non-citizens may only collect at most 125% of what they contributed to the system unless they have been citizens for 30 years?)

9) Set up a donor program to be marketed to the American people to donate money and resources to go directly into the Social Security Fund–like a charity. ( not likely to do much, but I don’t think it could hurt.)

10) US government opens “stores” in several select cities that sells surplus government/military items, donated items, or items that would have normally been part of govt. waste, for a profit. Part of the income from the “stores” go into Social Security (25%). This would also help to create jobs as well.

11) Raise tax on all imports into the US by 1%, with 25% of the increase going directly into Social Security Fund, other 75% into National Defense, Homeland Security and other departments.

Thank you for reading.  I would appreciate being notified of any other solutions which may be incorporated into the others.
-Matt Ricks (aka MRLocke)