Monday, April 9, 2012

Health care reform should start locally not nationally


Edward J. O'Boyle

Edward J. O'Boyle is senior research associate with Mayo Research Institute offices in New Orleans, Lake Charles and West Monroe.

“To replace a monolith like Obamacare, whicot affiliated with the Mayo nh brings down the whole house when it fails, Mayo Research Institute (Mayo Research Institute is not affiliated with the Mayo Clinic) recommends 10 bare essentials of a more flexible and freedom-protecting reform that puts control of health care largely in the hands  of the states.

If the Supreme Court rules that Obamacare is unconstitutional, Congress will have to decide whether to attempt another federal overall or put in place entirely different reform legislation

Based on the 10th amendment that reserves all un-enumerated powers in the Constitution to the states, each state is instructed to reconstruct its own health care system according to the specific health care needs, resources, values and principles of its citizens.

Guided by the principle of subsidiarity, the federal government would provide financial support for any state that is unable to meet the basic health care needs of its citizens with its own resources. To assure that any such state continues to function as the principal party in its health care system, federal assistance would contain no mandates and would be limited to no more than 49 percent of that state's public

While the system Mr. Boyle discusses has some shortfalls, it retains the Constitutional framework of leaving to the states the responsibility of running and  financing it’s own mechanisms.  Given the large range of financial resources of each state, the federal government would only subsidize programs that the states could not.

Founded on the principle that health care is a universal human need, each state would decide the minimum health care it requires of insurance companies offering coverage to its citizens. The minimums would be recommended by an advisory group constituted of representatives from throughout the state's health care system. Whenever that advisory group reaches agreement its recommendations would be passed without revision by the legislature and signed into law by the governor. Whenever that advisory group is unable to reach agreement the legislature would define those minimums. The advisory group would revisit those minimums as circumstances change. .

Ideally this system starts from the bottom up rather than the reverse. The  state sets up it’s own devices, without Federal interventions, nor  mandates. Each state establishes it’s own priorities.

Grounded on the principle that individuals have a fundamental responsibility to provide for their own needs as far as possible, any individual without employer-backed insurance would be encouraged but not required to purchase coverage with the state reimbursing up to 50 percent of the cost of the state minimum coverage. Co-pays would be a necessary part of any insurance policy. Anyone who wants coverage above the minimum would have to pay in full the additional cost for that protection.

Taking account of the special health care needs of certain persons, catastrophic coverage policies would be required of any insurance company doing business in the state. Anyone electing that added protection but not able to afford it would get a state tax credit to cover up to 50 percent of the cost.

Relying on the principle that no one of means has a right to impose the cost of their health care on others, anyone of means who decides not to have insurance coverage and subsequently requires health care services would be restricted to the minimum coverage as defined by the state. That person would be eligible for health care beyond the minimum only if he/she is willing to pay in full the additional expense of providing that care.

Based on the fundamental dignity of all humankind, persons too poor to afford their own health care would have access to the minimum coverage as defined by the state at the state's expense. To help eliminate abuse, a nominal co-pay would be required of anyone in financial distress.”

This idea eliminates the onus of “universal payer” which most Americans want but are averse to any idea that it is ‘socialized medicine’ or a national health care plan.

The full article in the (Gannett)

Reference:  Subsidiarity


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