“One of the worst decisions we made was placing the burden of insurance costs on employers.”
In the past employer provided medical insurance was part of a benefits package to attract employees. I worked 18 years for an employer that provided an excellent benefits package. I also worked a year for an employer that provided virtually no benefits other than an hourly wage — no medical benefits, no accrued vacation time, no holiday pay. I was paid overtime because it was a state law. The federal government meddling in medical coverage (Affordable Care Act) resulted in one positive accomplishment — insurance for those with pre-existing conditions. One undesirable impact is employers reducing their percentage of full time employees to avoid insurance costs. Another is forcing individuals to purchase insurance when they didn’t want it or need it.
“But how to go about implementing such a thing, and how do we remove the insurance burden from employers?”
Worker cooperatives and employee owned businesses not motivated by max-profit may want to provide insurance coverage to the employees. Government mandated employee insurance coverage is unconstitutional in my opinion and probably a burden for small or startup businesses. Large corporations could bargain better insurance rates than an individual, pass them on to their employees, and pay part of all of the premiums as they have in the past.
“First, we would need to eliminate Medicare and Medicaid entirely and replace both with something similar to a group health plan thus replacing the employer with the government.”
Medicare pays $billions in fraudulent claims annually. The government has little incentive to prevent such fraud because it is not accountable and is paying with the taxpayers’ money.
“As a result, the government’s group buying power and competition for contracts would allow the government to negotiate with insurance companies to lower and/or lock-in premium prices.”
Group buying power and competitive contract awards is an effective process to reduce costs. I experienced it while working for a defense contractor. There were basically three types of contracts: firm fixed price; cost plus fixed fee; and time and materials. Firm fixed price was the greatest risk to the contractor while time and materials was the greatest risk to the government. When competing contract awards it is imperative to specify the performance requirements. Otherwise, a desired helicopter may be delivered as a drone.
Why is it necessary for the government to be the health insurance purchaser? Does that mean no other organization can purchase insurance? If so, I strongly oppose your plan. As I recall ACA was determined to be constitutional because a liberal interpretation categorized it as a tax. Hopefully, your plan would be legally challenged and deemed unconstitutional.
“Any unwarranted costs transferred by insurance companies to residents would be tax deductible and would not be subject to credit reporting. The government could then fine or sue the company for those revenue losses, and end their contract with them the next fiscal year.”
Who would determine “unwarranted costs”? Currently, the insurance company reviews the claims submitted by the medical provider for reimbursement. The medical provider enters a code for a specified procedure and the insurance company determines if the code is appropriate and the fee is as previously negotiated. The patient receives a summary from the insurance company which may not be detailed and may not define the codes. With Medicare my summaries are provided quarterly while my secondary insurance provides a summary about ten days after service was provided. If I have a question regarding the charges my secondary insurance personnel are much more responsive than Medicare personnel. In your plan I assume I would always be dealing with government personnel instead of the insurance provider.
