Atlasian National Healthcare Bill (Law'd)

[Franzl]

I'm sorry...but under no circumstances will I accept an entirely government run single payer healthcare system.

I'm pretty open to discussing a public option, however.

[Franzl]

The poor statistics are likely a result of lack of access to healthcare....for those that have access, the U.S. probably does have the best system in the world.

I think either a public option or direct subsidies are definitely necessary to ensure that all Atlasians are able to get the healthcare they need.

I don't see why we can't reach near-universal coverage without the government having direct control.

[Franzl]

     Someone please introduce an amendment to strike section 1, clause f.

Yeah that's my intention.

I introduce the following amendment:

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[Franzl]

I really like your ideas, Yankee.

I'm not really informed of the economics of government subsidies as opposed to an outright government plan...but I do believe that one or the other is certainly necessary to guarantee that everyone has coverage.

On one hand I tend to support the creation of a competing government plan, but I'm rather uneasy about what that would do to competition on the healthcare market, assuming that the government has the ability to affect prices and quality of service. Perhaps by mandating that only people under a certain income level be eligible for government healthcare would prevent the goverment from abusing its ability to lure people into its system.

On the other hand, I think subsidies for the purchase of private insurance would be more market friendly, and would make sure that no disadvantages such as lack of incentives for new technology, especially in regards to disease prevention, that might be the result of a government plan, are created.

[Franzl]

It's a plan I'll probably end up accepting...my only hope is that the public plan doesn't unfairly eliminate competition with private sector so far that it eliminates alternatives.

[Franzl]

I don't see why a certain contribution can't be justified.....why can't somebody be expected to pay....let's say, 5-10% of his income in exchange for membership in the national healthcare system. Obviously it would remain free for people with no income.

[Franzl]

I object to Marokai's amendment being accepted as friendly and request a vote once 24 hours are up.

[Franzl]

As already stated, I don't see why we can't expect premiums to be paid based on income in exchange for government health services.

I'm not sure yet whether the government program should be open to all. I tend to think it should actually...it's not like Bill Gates would take the public care, is it?

[Franzl]

With Afleitch and Hashemite on board, we appear to have the necessary votes to bring this to a tie that BK would have to break.

Some of us are prepared to filibuster under certain circumstances. I'll propose something in a little while....see if it goes anywhere.

[Franzl]

Your proposals are more than welcomed, but cannot, and should not, demolish the public plan or start slicing off portions of incomes off of those enrolled. (Which, I'll say again, is what you  made sure to ask me to not include less than 24 hours ago.)

I'm aware of that....but I've changed my mind on collecting some sort of premiums. If this public plan is to be open to everybody irrespective or income or employment status, I think it's fair to charge a fee. That doesn't mean that premiums would be the only revenue source for healthcare....of course not, but it's surely a good way of helping to pay for services, especially in our current economic state. This would not not have an unfair impact on the poor, as it would be a small percentage of total income, and people with no income wouldn't be paying anything.

[Franzl]

Section 1- Eligibility and Benefits

a. All individuals residing in Atlasia are eligible covered under the Atlasian National Health Care Program entitling them to a universal, best quality standard of care.
b. The health care benefits under this Act cover all medically necessary services, including at least the following:
1. Primary care and prevention.
2. Inpatient care.
3. Outpatient care.
4. Emergency care.
5. Prescription drugs. I'd like something like a maximum $25 fee or something for any prescription drug filling.
6. Durable medical equipment.
7. Long-term care.
8. Palliative care.
9. Mental health services.
10. The full scope of dental services (other than cosmetic dentistry).
11. Substance abuse treatment services.
12. Chiropractic services.
13. Basic vision care and vision correction (other than laser vision correction for cosmetic purposes).
14. Hearing services, including coverage of hearing aids.
15. Podiatric care.
c. Such benefits are available through any licensed health care clinician anywhere in Atlasia that is legally qualified to provide the benefits.
d. No deductibles, co-payments, coinsurance, or other cost-sharing shall be imposed with respect to covered benefits from patients enrolled in the National Healthcare System, but additional insurance from private sources is not forbidden.
e. All private and public hospitals and doctors are required to be participating providers, and are not permitted to deny care on the basis of one's enrollment in the Atlasian National Health Care Program.

Section 2- Finances

a. The Atlasian Government, through the Atlasian National Health Care Program's regional offices, shall be financially obligated to cover all costs from services and benefits provided to the enrolled by the participating providers.
b. Licensed health care clinicians who accept any payment from the Atlasian National Health Care Program may not bill any patient for any covered service.
c. Funding for this Act shall be appropriated from existing sources of Federal Government revenues for health care, such as income taxes and additional sales tax on all alcohol, tobacco, and marijuana products. In addition, members of households making between $25,000 and $39,999 shall pay premium equal to 5% of their income. Members of households making between $40,000 and $59,999 shall pay a premium equal to 7.5% of their income. Members of households making $60,000 or more shall pay a premium equal to 12.5% of their income. In addition, the income tax rate of individuals making greater than $200,000 shall be raised by 1.5%.
Section 3- Administration

a. This Act shall be administered a Director appointed by the President and confirmed by the Senate.  The Director may hold other office.
b. Medicare and Medicaid shall be phased out, with all necessary personnel and services being transferred to the Atlasian National Health Care Program upon its establishment.

Section 4 - Other reforms

a. All patients shall have computerized records, and all medical providers must be able to read, process and use these records.

b. People with private insurance shall be legally able to obtain private health insurance anywhere in Atlasia.

c. A committee shall be formed to suggest ways to cut costs by reducing bureaucracy, and shall report its findings within 6 months of implementation of this program.


I hope NCYankee can come up with some more ideas as well.

[Franzl]

Yeah, I agree with you there, didn't consider dependent familiy members.....I'm certainly willing to accept that.

[Franzl]

Aye

[Franzl]

A quick review of Franzl's proposals.

Amendments to Section 1 are to dissimilar to what was introduced later into the NHS in Britain, namely that there were prescription charges that were not cost prohibative and were waived entirely for people on low incomes, senior citizens etc. So that is not unreasonable.

Striking out the full scope of dental services is however unreasonable. All dental 'check-ups' should be free for and secondly all treatment, including orthodontic treatment should free for minors. Immediate emergency dental work should also be free fo including reconstructions as a result of injury.

Amendments to 'd' help clarify wording, however it should be assured that all persons are presumed to be 'enrolled' within the national system unless their insurance allows them to make use of private healthcare in all or specific circumstances. Likewise should an individual choose to waive treatment offered privately (because sometimes state care is materially 'better' - particularly secondary care) they shall not incur any charges in the national healthcare system as a result.

On Section 2, I agree with the need to widen the method of funding, but feel that a system of National Insurance (see - http://en.wikipedia.org/wiki/National_Insurance) may be preferrable.

Just a question about National Insurance: Is there any difference to simply cashing in on premiums except the employer matching a certain amount? Or am I missing something?

Concerning the possibility that somebody with private insurance should be eligible to get state care if he wants it...I would have to respectfully disagree with that. I think it should be reasonable to demand "all or nothing", and that anybody that refuses the state insurance system should be responsible for his health insurance privately. Of course he should be eligible to switch to government insurance entirely if he so desires.

I'm willing to put the dental care you described back in.

[Franzl]

AYE on the amendment, and I accept Purple State's proposal.

[Franzl]

Unfortunately, I was only able to work on this when debate first began several weeks ago, but I have reviewed the progress and the final product seems reasonable and good.

AYE