How about cap a household's healthcare-related spending at 10% of income?

[Blue3]

How about a simple solution to the healthcare debate:

* cap a household's healthcare-related spending at 10% of income

* hospitals/pharmacies/health-insurance/doctor's-offices/etc. ("places of health care") are required to mail/email a tax document to each person they did business with that year that summarizes that person's total healthcare-related spending (similar to an employer mailing you a W-2 form for tax purposes once a year), as well as categorized into what was a pharmaceutical cost, what was a hospitalization cost, what was a co-pay, what was a monthly insurance payment, etc.

* if a household's healthcare-related spending exceeds 10% of income, then the government gives them a check back for every dollar above 10% of their income for that year as part of their annual tax refund

* to afford healthcare costs until refund time, an individual can choose to either
1. pay it upfront at each interaction, and possibly be refunded later if the total goes over 10%/income, or
2. charge it only to their personal account that shows up as part of that annual healthcare-expenses tax document, with the government paying it for you in the meantime, and be told how much you have to pay them after tax/refund time (so if a person keeps choosing this, they will actually end up having to pay the government what they owe instead of getting a refund, which would be total healthcare costs minus whatever amount might or might not go over 10% of their household income)



The private system stays in place (Medicare and Medicaid could even be replaced by this system), individuals don't get a free ride and still have to pay as much as 10% of their income, but it's capped at 10% so no one is dying or going bankrupt or not being treated because they can't afford it.

For the households that do go over 10% of income on healthcare spending, the refund to those individuals can partially be generated by a tax on "places of health care" that have higher rates of patients going over 10% of income because of them (perhaps different tiers depending on their rate) (and this is to check them, so they can't take advantage of the new system), and the rest from general revenue (and with the possible abolition of Medicare and Medicare payroll taxes, that could justify a slight increase in federal income taxes).

This system would also make it easy to see where those cases of households that owe over 10% of their income for healthcare-related expenses are, and what the causes for that are, so better policies can be put in place to treat those causes instead of only treating the symptoms.

[KingSweden]

This is a great idea. I'd partner it with the abolition of employer-sponsored health care, thus eliminating that distortion. Having income tiers might not be terrible (I.e. the wealthiest are capped at 15%, for example).

It'd increase portability and encourage health care competition. Obviously, because it's a good policy idea, it will never happen in the United States

[JA]

Don't like this idea.  For some of us that means tens of thousands of dollars.  Our income is already redistributed enough.

No, it's not.

[Intell]

Don't like this idea.  For some of us that means tens of thousands of dollars.  Our income is already redistributed enough.

It's really not.

[Blue3]

Don't like this idea.  For some of us that means tens of thousands of dollars.  Our income is already redistributed enough.

I'm not sure I understand your complaint?

If your healthcare-related expenses exceed 10% of your income, you don't have to pay for any more. It's capped. Not that you would be charged at 10% of income.

This system would probably also replace Medicare/Medicaid, and maybe several functions of the HHS, and cut down on bureaucracy while supporting the private healthcare system.

[Virginiá]

Does this system address the price gouging and other unscrupulous activities from the healthcare industry? If not, then no, definitely not acceptable. I'm not very fond of any reform that doesn't at least attempt to address this part of the problem.

[Blue3]

Does this system address the price gouging and other unscrupulous activities from the healthcare industry? If not, then no, definitely not acceptable. I'm not very fond of any reform that doesn't at least attempt to address this part of the problem.

Last paragraph:

This system would also make it easy to see where those cases of households that owe over 10% of their income for healthcare-related expenses are, and what the causes for that are, so better policies can be put in place to treat those causes instead of only treating the symptoms.

By treating healthcare-related expenses like taxable income, it will make it extremely easy to track down any and all cases of price-gouging, and it would give new motivation to fiscal conservatives to do so.

[DC Al Fine]

Does this system address the price gouging and other unscrupulous activities from the healthcare industry? If not, then no, definitely not acceptable. I'm not very fond of any reform that doesn't at least attempt to address this part of the problem.

Last paragraph:

This system would also make it easy to see where those cases of households that owe over 10% of their income for healthcare-related expenses are, and what the causes for that are, so better policies can be put in place to treat those causes instead of only treating the symptoms.

By treating healthcare-related expenses like taxable income, it will make it extremely easy to track down any and all cases of price-gouging, and it would give new motivation to fiscal conservatives to do so.

This all sounds good, but what is the "part two"? Anyone who hits their cap doesn't have much of a reason to cut costs. Someone needs to keep prices down, whether it's an insurance company, or individuals or the government capping prices.

[Virginiá]

Does this system address the price gouging and other unscrupulous activities from the healthcare industry? If not, then no, definitely not acceptable. I'm not very fond of any reform that doesn't at least attempt to address this part of the problem.

Last paragraph:

This system would also make it easy to see where those cases of households that owe over 10% of their income for healthcare-related expenses are, and what the causes for that are, so better policies can be put in place to treat those causes instead of only treating the symptoms.

By treating healthcare-related expenses like taxable income, it will make it extremely easy to track down any and all cases of price-gouging, and it would give new motivation to fiscal conservatives to do so.

But that assumes that new policies will actually be implemented in the future to address such instances of price gouging. Any large healthcare reform should address that issue as thoroughly as possible at the same time, less they punt it and we find ourselves never reigning those bloodsuckers in because the political will is no longer there; no doubt drowned under a wave of lobbyists and campaign contributions.

Anyway, I'm mostly locked into solutions like Medicare-for-all. I see that as the next step, and I'm quite tired of this whole debate. I wouldn't be likely to support this.

[Blue3]

Does this system address the price gouging and other unscrupulous activities from the healthcare industry? If not, then no, definitely not acceptable. I'm not very fond of any reform that doesn't at least attempt to address this part of the problem.

Last paragraph:

This system would also make it easy to see where those cases of households that owe over 10% of their income for healthcare-related expenses are, and what the causes for that are, so better policies can be put in place to treat those causes instead of only treating the symptoms.

By treating healthcare-related expenses like taxable income, it will make it extremely easy to track down any and all cases of price-gouging, and it would give new motivation to fiscal conservatives to do so.

This all sounds good, but what is the "part two"? Anyone who hits their cap doesn't have much of a reason to cut costs. Someone needs to keep prices down, whether it's an insurance company, or individuals or the government capping prices.

The government has an interest in making sure costs are cut that go over the cap. And the refund would be partially-funded by a tax on "places of healthcare" that have high rates of people surpassing that cap because of them to check prices.

Also, I thought of this today, so I'm open to any proposals that people want to add to this idea.

Does this system address the price gouging and other unscrupulous activities from the healthcare industry? If not, then no, definitely not acceptable. I'm not very fond of any reform that doesn't at least attempt to address this part of the problem.

Last paragraph:

This system would also make it easy to see where those cases of households that owe over 10% of their income for healthcare-related expenses are, and what the causes for that are, so better policies can be put in place to treat those causes instead of only treating the symptoms.

By treating healthcare-related expenses like taxable income, it will make it extremely easy to track down any and all cases of price-gouging, and it would give new motivation to fiscal conservatives to do so.

But that assumes that new policies will actually be implemented in the future to address such instances of price gouging. Any large healthcare reform should address that issue as thoroughly as possible at the same time, less they punt it and we find ourselves never reigning those bloodsuckers in because the political will is no longer there; no doubt drowned under a wave of lobbyists and campaign contributions.

Anyway, I'm mostly locked into solutions like Medicare-for-all. I see that as the next step, and I'm quite tired of this whole debate. I wouldn't be likely to support this.

Well, what's your proposal for price-gouging? I just thought of this idea today.

And this can be the model for single-payer, and make the transition to it be very smooth. Future debates can be about raising or lowering that 10% cap. Maybe in a decade or two it would be lowered to 8% or 5% or 2%. 0% would be single-payer.

[Dr. Arch]

It's truly astonishing that Atlas is having a more productive discussion with more viable proposals than our Congress. Not speaking ill of Atlas, but good grief our government is in a sad state.

[Virginiá]

And this can be the model for single-payer, and make the transition to it be very smooth. Future debates can be about raising or lowering that 10% cap. Maybe in a decade or two it would be lowered to 8% or 5% or 2%. 0% would be single-payer.

I'm not necessarily saying your idea is bad or anything, but I definitely don't think it's as good as something like Medicare-for-all (or a similar solution)

When I say I'm tired of this debate, I mean this healthcare debate has been dragging on for too long and been too costly, and it is particularly aggravating when so much of the world has blown past us on this and we are still squabbling over this.

Whenever Democrats even try to restructure healthcare in America, we tend to take a beating in the next election. The fact is, another big change really needs to be something final like universal Medicare because the party is likely to get hit hard as America adjusts, unless it somehow goes really smoothly. I'm not willing to have Democrats get chewed up election-wise again for some sub-par plan. I'm done with these small steps. I don't want any more baby steps to single payer-type solutions.

Just my 2 cents anyhow.

[Indy Texas]

Don't like this idea.  For some of us that means tens of thousands of dollars.  Our income is already redistributed enough.

It's a cap, not a fixed peg. If you spent less than "tens of thousands of dollars" then you wouldn't pay that much.

[Famous Mortimer]

Don't like this idea.  For some of us that means tens of thousands of dollars.  Our income is already redistributed enough.

It would be even worse for a person for whom it was only thousands.

[pbrower2a]

There would also have to be caps on how much use people would make on medical coverage.

[Frodo]

Switzerland already does this, I think. 

[Meclazine for Israel]

Does this system address the price gouging and other unscrupulous activities from the healthcare industry? If not, then no, definitely not acceptable. I'm not very fond of any reform that doesn't at least attempt to address this part of the problem.

Trumpy will negotiate harder with the big pharmaceuticals.

[parochial boy]

Switzerland already does this, I think. 

Sort of, the co-pay/excess is capped as a function of your income, but insurance is still very expensive. Someone on a low income will very likely pay well over 10% of their income on healthcare if they have any sort of health problem.

Based on the Swiss experience, I don't think capping healthcare would be a solution, as the cost of healthcare in Switzerland is still well above what it is elsewhere in Europe, and is possibly the major political issue at the moment.

[True Federalist (진정한 연방 주의자)]

This would require a massive level of taxation and/or government control of health care considering that healthcare is currently 17% of GDP.

[Blue3]

This would require a massive level of taxation and/or government control of health care considering that healthcare is currently 17% of GDP.

How many households do you think spend more than 10% of their income on healthcare right now, and what kind of households are they?

[True Federalist (진정한 연방 주의자)]

This would require a massive level of taxation and/or government control of health care considering that healthcare is currently 17% of GDP.

How many households do you think spend more than 10% of their income on healthcare right now, and what kind of households are they?

Depends, are we counting the pre-tax dollars used on employer-offered health insurance as part of the household's budget?  If so, then quite a few.  For that matter, a low-lifetime-income person on Social Security can easily have more than 10% of their Social Security going to pay their Medicare Part B premiums.