14 thoughts on “The Purple Health Care Plan”

  1. The Standard Plan

    1. All Americans receive a voucher each year to purchase a standard plan from the private-plan provider of their choice.

    2. Vouchers are individually risk-adjusted; those with higher expected healthcare costs, based on documented medical conditions, receive larger vouchers.

    3. Participating insurance companies providing standard plans cannot deny coverage.

    4. Each year a panel of doctors sets the coverages of the standard plan subject to a strict budget, namely that the total cost to the government of the vouchers cannot exceed 10 percent of GDP.

    5. Insurance companies providing standard plans contract with private providers to cover their plan participants.

    6. Americans choose doctors and hospitals included in the standard plan they choose.

    7. Plan providers compete and provide incentives to improve participants’ health and limit bad health practices.

    8. Plan providers offer supplemental plans to their participants and cannot deny supplemental insurance coverage to their participants.

    9. The government (federal and state) ends the tax exclusion of employer-provided health insurance premiums.

    10. Like all other Americans, Medicare, Medicaid, and health exchange participants are covered by the Purple Health Plan subject to appropriate transition provisions.

    The roughly 10 percent of GDP now spent or allocated by federal and state government on these and related programs, as well as on the tax exclusion of employer-provided health insurance premiums, is reallocated to help finance the vouchers.

    ***

    Based upon my first reading of the above plan, I would support it. (I reserve the right to change my opinion, of course.) It sounds like “Med Stamps”, i.e. a voucher-based system, which is an idea I have supported for several years. I particularly like the plan’s spending cap and provision for the reallocation of current funds.

    If this passes (and works as advertised), it might clear the way for real reform of the educational system, i.e. the phasing-out of public schools in favor of private schools paid for by “Ed Stamps” (vouchers).

  2. If you want it to compete or compare it with Switzerland, Netherlands,Germany or France ( the best) you should consider not 10% of GDP and raise it to 13% of GDP.
    If it works like the European ones, I am all for it.

    This should also mean that that is the only plan available, all other plans,
    Including those for members of Congress, Medicare, Medicaide,Veterans, Union plans, and company plans etc., must be cancelled and abolished!!!

  3. Bernhard,
    You do not necessarily need to get rid of company/union/veteran/Congressmen plans. You would just rephrase them as a standard plan plus the additional plan that those in the company may also optionally purchase.

  4. I doubt it can be worse, but it can be equally bad as Obamacare, and I would say it is. In fact, I would say it is monumentally stupid. Take the profound logical disconnect between points (1), (2), (3) and (7):

    “(1) All Americans receive a voucher each year to purchase a standard plan from the private-plan provider of their choice.

    (2) Vouchers are individually risk-adjusted; those with higher expected healthcare costs, based on documented medical conditions, receive larger vouchers.

    (3) Participating insurance companies providing standard plans cannot deny coverage.

    (7) Plan providers compete and provide incentives to improve participants’ health and limit bad health practices.”

    Excuse me? Compete on what basis, given that the cost to the consumer (his taxes) is completely disconnected from the value it buys (because of the “risk-adjustment”)? Provide what incentives, since you can’t deny coverage, nor change its price based on behaviour? What are you going to do, give people a balloon and a big smiley-face sticker if they promise not to smoke? Lose weight and you get a trip to Disneyland? Shop around for the best and cheapest hip-joint surgery and you get…what? Frequent-flyer miles?

    This is in no sense a “purple” plan. It’s just the same old socialized “from each according to his abilities, to each according to his needs” medicine, dressed up in marketspeak to fool the rubes. The soi-disant “insurance” industry is nothing deseving of the name, since it is not allowed to choose whom to insure, nor what price to insure at. It’s just an arm of the government, like Fannie Mae. The “competition” is nonexistent, fake, like Soviet “competition” among work teams to see who can increase production more, for the greater glory of the collective. It has zero chance of doing anything useful.

    Generally, I find it a useful rule to think that only the Left talks about “bipartisan” solutions, and only when it is otherwise losing the battle for voter allegiance, and it is almost always a sneaky attempt to present the same old tired shit dressed up in centrist clothes. Like Barack Obama running as a “post-partisan” candidate in 2008.

    There’s usually no such thing as a “bipartisan” why can’t we all be friends solution, because people aren’t stupid. Partisan divides exist because there really are profound divisions between philosophies and their implications. As a rule, only one side can win, and attempts to think otherwise are delusional or deceptive.

  5. The only practical difference between this and the current law is that everyone gets a voucher and is forced to buy coverage… instead of just being forced to buy coverage. It won’t change any of the negative externalities created by the current law which gooses demand(and prices) with forced coverage or increasing costs for carriers by requiring coverage of pre-existing conditions and eliminating lifetime caps, again goosing demand(and prices).

    There are irreconciliable problems with what Americans consider “Health Care Reform.” You can’t guarantee universal coverage without limiting services. You can’t get costs down unless you increase supply or reduce demand(or both). You cannot reduce demand by guaranteeing unlimited lifetime services or forcing coverage of pre-existing conditions. You cannot increase supply unless you… increase supply. What does any plan propose to do to increase the number of practitioners? You also cannot have anything like a free market if actual buyers are not allowed to bargain with actual sellers.

  6. Doesn’t look like it does anything to reduce the structural costs associated with the health industry.

  7. Meh, skimmed it, there was nothing about how everyone in America should eat more grape jelly and wear more purple, clicked away disappointed.

    (Lest you take me seriously, my favorite color is green.)

  8. “3. Participating insurance companies providing standard plans cannot deny coverage.”

    Insurance destruction, just not as convoluted as the disaster passed last year.

    “The roughly 10 percent of GDP now spent or allocated by federal and state government on these and related programs, as well as on the tax exclusion of employer-provided health insurance premiums, is reallocated to help finance the vouchers.”

    This is a replacement for government funded medicare/medicade? On that point it’s an improvement. Still looks like a bum deal.

  9. Short slice of a plan:

    If you wish to offer health insurance, thou shalt refund 5% of each individual’s premiums into an individual medical account administered (fee-free) by you, but owned by the individual.

    Secondly, every aspect for which you offer insurance shall be offered at an entire gamut of copay levels: 0, $5, $10, $20, $50, $100, …. $10,000… etc.

    The -first- year for everyone is… 5% higher. But for the vast majority of people under fifty, that 5% should be enough to justify a large-enough copay increase in the second year to cause the second year’s premium to be below “year zero’s”. And every successive year that one manages to remain healthy marches one progressively closer to the idea of ‘self-insuring’. (For the unlucky and elderly, the 5% just gets perpetually rolled back in – it’s a net wash.)

    By dinking around with unused first-four-digit codes from the creditcard/debit cards, it should also be possible to make “medical use only” cards/tills/etc and make the entire idea of arguing picayune crap with insurance companies passe. (“What do you mean ‘saline solution’ isn’t covered, but ‘prescription saline solution’ is?!?”)

  10. Doesn’t look like it does anything to reduce the structural costs associated with the health industry.

    Root cause analsysis is so passé (and “hard!”). If Nixon taught us anything, it’s that price-fixing solves everything; hence Obamacare…

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