Ken Nelson

I don’t like my old health care plan. It is certainly better than anything Congress is doing, but unlike Congress, I can learn, adapt and improve.

First off some principles:

• The bill must be Constitutional as interpreted by the founders
  This precludes, for instance, requiring people to buy insurance.
• Health insurance does not mean health care.
  Health care is seeing a doctor. Health insurance is having somebody else pay for the visit. Having insurance, especially public rationed insurance, doesn’t mean you get more health care.
• Insurance causes health care usage to rise.
  The tragedy of the commons strikes again. Health insurance should only cover financially catastrophic expenses.
• Dropping health care costs gets more people health care
  Duh. If something costs less, more people can afford it. Also, more people can afford to subsidize others.
• Model inflationary parts of health care on non-inflationary parts.
  Parts of our health care system, for instance cosmetic surgery, constantly innovate and help more and more people, but do not have rising costs. Maybe we can learn something from them.
• The plan must not involve any significant government spending.
• The plan must fit on a sheet of paper.
  

  Ken’s Health Care Bill (as actually worded) Insurance Changes Health insurers may sell the same policies nationally. States may not set any requirements on health insurance policies. A 13 person board (chosen and paid for by the President) determines the definition, for purposes of this bill,  of “catastrophic care insurance”. This board should draw from 1/2 each from the medical and insurance industries but be chaired by a member of the Supreme Court. Tax Changes Only catastrophic insurance is tax deductible (whether purchased individually or by provided by an employer). Directly paid health care expenses may be deducted after exceeding 2% of the taxpayers adjusted gross income. Regulatory Enactment The Executive Branch will alter any existing regulations needed to implement this bill.   All regulation modifications will be posted to www.healthcareregulations.gov for at least a 2 week review period before enactment.

This plan moves most of medicine to pricing more like cosmetic surgery, while keeping insurance in the role it serves best – catastrophe protection.  National competition raises innovation and lowers cost of insurance.   Those who can’t afford services still get urgent care (as they do today), the cost of which the rest of us absorb. But we do not absorb their non-urgent care costs.  Because we pay for more things directly, we use less and shop wiser thus lowering systemic costs.  Because the bill is simple, everyone can understand it and know what is coming.

The net result of the bill is an innovating, lower cost, health care system that still provides urgent care to all.