An Indicrat is a Libertarian, and to a Libertarian, Single Payer healthcare is unconscionable.
However, there is a simple way to have Single Payer with all the
Libertarian principles intact, at the same time. In fact, this unique
solution proposed is the most cost reducing way possible to have quality
healthcare. For Republicans and free market people, Single Payer seems
antithetical to everything they believe, but if you bare with me through
this proposal, you will see that freer market, competition,
efficiency, and less bureaucracy is precisely what this Indicratic
solution provides, in spades.Below, we will get into the mechanism of how this will work, but we first have to first transcend the most fundamental question of healthcare: To mandate, or not to mandate that people buy health insurance?
Whether Republicans, Democrats, Libertarians, or "Other" like it or not, this country always has had a mandate for everyone's healthcare to be paid by the collective. It's a Mandate of Conscience. In this country, we don't leave anyone to die in the street. The taxpayer will pay for anyone's healthcare if they need it, citizen or not. This kind of humanity is what makes us different from many other countries around the world. One way or the other, the collective pays. The question is: What is the most effective, cheapest, and efficient way to do it?
Before I tell you that, I want to point something out. For a fireman to rescue you from a burning building, do you need fire rescue insurance? For a S.W.A.T. team to rescue you from a hostage situation, do you need S.W.A.T. insurance? Of course not. So why do you need medical insurance for a doctor to rescue you from cancer, or a broken leg? Most will argue it's better to have privatized insurance because the free market and competition works better than government. However, you can have an even better competitive, free market for healthcare without insurance companies complicating everyone's lives.
This is how it would work…The government pays a percentage of a person's medical bill which is based on the person's net worth at the time they received the care. Our government's ELECTED OFFICIALS (not bureaucrats that don't answer to the voters) decide what deductible gradient there should be for any level of net worth. So for instance, a billionaire would have an infinite deductible and would get no financial assistance from the government while a totally broke, homeless person of course, would have a deductible of zero (which is always the case anyway). So everyone between these extremes would pay a deductible based on their net worth, a gradient scale, that WE THE PEOPLE decide is fair, through our ELECTED OFFICIALS. If they screw it up, we kick them out. The people are in control. And it's fair.
Because insurance distorts the market by raising the costs of healthcare, people that receive government subsidies would have to get their care first from any available "Free Market Medical Provider" that doesn't accept insurance. These providers offer excellent quality care and procedures for a fraction of the price of normal insurance health care providers. Taxpayers would be less burdened by government subsidy recipients being directed to these low cost providers. These free market providers are a growing force in the healthcare business represented by the Free Market Medical Association.
In order to keep our own deductibles low, "We The People" will naturally go to the healthcare providers that have the cheapest, most effective and efficient services. So in order to get customers, doctors and hospitals will have to compete and innovate in a free market in order to succeed, that's Capitalism! A patient can choose their own doctor or hospital. "We The People" retain our freedom of choice. Just as economist and Nobel Laureate Milton Friedman always advocated in his book, "Free To Choose".
This is akin to the school voucher program which is a great success. The money is attached to the child/parent, not the service provider. The parents choose which school to give the money and their child to. This fosters competition and innovation in our education system which leads to a better, more efficient product. In the same way, the government money for health care is attached to the patient, not the health care provider. The patient chooses, and the free market prevails. The patient still has a deductible to be concerned about, so the incentive to demand the cheapest, most efficient service is still in place.
People will always think with their pocket book. So healthcare providers can not take advantage of this system by jacking up prices or ordering too many tests. Patients won't stand for it. So, the hospitals and doctors that do the best jobs will get rich, and the one's that do the worst jobs will go out of business. Hence, a free market place where the best man wins.
Also, it would be ELECTED OFFICIALS, not unaccountable bureaucrats, that would be in charge of an auditing and rating system of healthcare providers. So the incentive to have a rating system that pleases "We The People" would be in place. This same department would be in charge of determining a patient's deductible.
But what bureaucracy would manage all of this? That is addressed by the flat tax solution to this problem. We can shrink the IRS with a flat tax. No more massive bureaucratic manpower would be needed to deal with our ridiculously complex tax code of loop holes and deductions. That manpower can be shifted to the healthcare Department. The infrastructure and accountants are already in place.
Also, the government and taxpayer will pay less to doctors and hospitals that accept cash in exchange for a reduced bill. So, the government should have in place a fast cash payment capability like a food stamp card. This would greatly reduce many healthcare fees, therefore costing less for both government and patient than it would to not pay the heath care provider right away.
But what about customer service, like the quality of the food or bedside manners? For that, the patient fills out a simple one page questionnaire on the service provided which gets sent to the government to help factor into the rating and auditing system. Those completed questionnaires would be also available to private organizations that also wish to rate healthcare providers. So this is more incentive for doctors and hospitals to do a good job.
In this system, the government has no micro-management authority over doctors and hospitals. The government will have no say in how doctors treat their patients or where their patients can go to seek service from a licensed healthcare provider. The free market will decide that. The only thing the government does in this system is determine deductibles for patients, as well as rate and audit healthcare providers in the same way health inspectors grade restaurants.
Doctors and hospitals that have the best track record of efficiency, low costs, effectiveness, and best customer service will get the best grade. This is not the government picking winners or losers because "We The People" still choose where to go. Also, private organizations can work with healthcare providers to rate them as a way to balance any incompetence, maleficence and corruption the government may have in its assessments. These private institutions will create the checks and balances just like we have in the framework of our Republic.
Of course, in the event of an emergency, the patient will go to the nearest hospital, but most care is not an emergency, and therefore, healthcare providers will always have an incentive to compete and produce the best possible care.
Now, where does the money come from to pay for everyone's medical bills after the deductible has been paid?
Well guess what, everybody in this country already pays in taxes more than enough money to pay for everyone's healthcare. The government already has enough money. The problem is the government egregiously wastes our money, and does not prioritize our money. Government bureaucrats are the worst custodians of money than anyone else in this country. Even heroin addicts spend their money more efficiently. Now, before we get into the waste itself...
If we dropped the income tax to a flat 10% and kept Capital Gains and other taxes at a competitive level with other capitalist countries around the world, our government would be more than well funded if it ran efficiently, without having to pay for everyone's healthcare. However, to pay for everyone's healthcare, we tack on another 10%, bumping the income tax to a flat 20%, and you've got Universal healthcare covered. The Progressives will be happy because the top richest 1% will be paying this tax and infinite deductible without any government assistance. So they will be paying their "Fair Share" that the Progressives always whine about. And the Libertarians will be happy because you have a low flat income tax.
So, the only thing left to do is to stop the waste. We spend billions of dollars locking up harmless pot smokers and prostitutes. What is more important, locking them up, or providing for people's healthcare? We've spent billions on a department of education that, since it's inception, has not gotten test scores up at all. Most of the Department of Energy is a complete waste. HUD, is another abysmal failure. We have an enormous amount of waste in duplicate government programs and massive fraud within government programs. But instead of tackling that, we put Cheech and Chong in jail. And instead of collecting tax revenue from prostitutes, we spend massive amounts of tax dollars and valuable time prosecuting them, all the while letting the pimps take the money.
So how will this government healthcare payment bureau be efficient? Well, one of the few government programs that does run efficiently is the Food Stamp program now known as the supplemental nutrition assistance program or SNAP. According to the General Accounting Office (GAO), efficiency in management of the federal Food Stamp program has reached its best level in history. And according to the USDA, in the fiscal year 2010, the program’s national average level of payment accuracy was 96.19%, an all-time high. That means that only 3.81% of payments were either too high or too low. By 2012 it has reached a lower error rate of around 2%, even better. It is a 78 billion dollar program, and 92% of those dollars go directly to the recipients. That level of efficiency is quite good by corporate standards.
The SNAP program does have fraud, waste, and abuse. But so does every system. There's plenty of insurance fraud, as well as waste. So we shouldn't throw this baby out with the bath water. We should fix the corruption as well as benefit from this program's efficient model. This SNAP program has 46 million customers as of 2012. If this can be done for almost 1/6th of our population, then it can be for over 300 million. That would relieve all Americans and our government, from having to deal with the complicated mess of insurance companies. Less red tape frees individuals. Imagine that, no more insurance companies...gone! Our lives would be so much simpler!
Governor Mike Huckabee wrote a book called "A Simple Government". Whether you've read the book or not, the title says it all. How we pay for healthcare does not need to be a complicated, convoluted mess. We don't need health insurance companies wasting our time making us fill out paperwork and shopping for better prices. And we don't need our government wasting time and our money trying to regulate those insurance companies that we don't even need. By eliminating health insurers we eliminate a whole chunk of government devoted to regulating those insurers. This is insane, and it is a complete waste of this nation's time and energy that could be spent on better more productive things.
Republicans and Democrats are wasting time arguing over this stupid mandate issue, all the way up to the supreme court, when we already have an indispensable Mandate of Conscience that will never go away as long as we are good. The problem is waste. Solve that, and we will be the richest country on earth.
This Mandate of Conscience actually dictates that we should have a Single Payer system through taxes, and the reason why is this…
Our nation is two parts, private and public. In the private sector there is choice, we get to choose what we want to do with our lives and our money. In the public sector, which is ruled by government, there is no choice. Everyone must obey the same laws and pay their taxes, no one has free choice in the public sector. Well, our Mandate of Conscience is not a choice, we will pay for an illegal immigrant, drug addict to get a bullet removed, whether we like it or not. There is no choice. And because there is no choice, no opt out for the taxpayer when it comes to paying for another's healthcare, that means paying for healthcare is under the purview of the public sector. This is just like it is for F.E.M.A., the military, fire and police. As long as we are a nation with a conscience, there is no getting around this. And the sooner we wake up to this fact, the better we will all be.
FOOTNOTE:
What do we do about religious rights? For example, under this Indicratic system will Catholic's tax dollars be in the same pool of revenue that can be used to fund an abortion? And will an Atheist's tax dollars be in the same pool of revenue that funds "Faith Based" initiatives?
There are two ways to solve this constitutional challenge to defend individual rights. One way I call "Universal Understanding" and the other way I call "Conscience Exemptions". Lets examine each...
1. "Universal Understanding" means that we all accept that in our republic, we all have to pay for some things we don't approve of. For instance, a Catholic might be a smoker that is against abortion while a non smoking, pro choice person can make the argument that their taxes should not go to fund the healthcare consequences of an elective, dirty habit such as smoking. We can agree as a society that changing the lifestyles of people will never come from simply trying to defund their lifestyles through government. Changes only come from education and memes, and that's where we should fight our ideological battles, not in the tax code. Whoever has the better ideas will win, not who has the most politic power to defund or fund government entitlements. "Universal Understanding" is a more free market based solution rather than a government solution. It allows for the free market of ideas to prevail and makes for a much simpler tax code that we can all enjoy.
2. "Conscience Exemptions" means that under a flat tax regime (which is the best tax code to have in order for Indicratic healthcare to work) there can be an exemption for religious belief.
So, when you are filling out your simple flat tax form to submit to the government, there will be a box that you can check to subtract from your total payment the percentage of which would go to fund abortions based on current statistics. So depending on your tax bracket you could be paying anywhere from a fraction of a penny less, to several dollars less, depending on how rich you are.
Conversely, to be fair, there will be a box to check, and a line to input, any EXTRA amount pro-choice people would like to pay to offset the religious exemption, because in fact, it is also a deeply held matter of conscience to many people, that women have the right of choice, and have proper access to fulfill that right.
Also, the same options on the tax form can apply to "Faith Based" initiatives as well. The religious can put more money in, and those opposed to government funding religious organizations can pay their percentage less.
And when all the tax forms are collected, the General Accounting Office can add up all the deductions and extra additions and apply them to the next year's budget.
Now, as we can see, the "Conscience Exemptions" option is a futile exercise and a waste of time and resources. But it does however, absolutely protect individual choice, a freedom intended by the Founders of the United States.
How do we as a society then chose which path to take, "Universal Understanding" or "Conscience Exemptions"? We decide the same way we elect our president, democratic vote every four years.
So one 4 four term we can try "Universal Understanding", and if voters decide they'd rather try "Conscience Exemptions" for the next four years, then so be it.
~Dhruva Aliman
