The solution to the healthcare problem

pResident Obama is going about it all wrong, taking half-steps here and half-steps there, when the solution is staring him in the face. We already have a public healthcare system called Medicare A, B and D with options for either Medicare Supplemental insurance or Medicare Advantage. (Medicare Advantage allows one to sign up with a private insurance company which takes over all Medicare coverage and the government pays the company for Medicare A, while the insured continues to pay for Medicare B himself.) Both Medicare Supplemental and Medicare Advantage require the insurance company to qualify as a Medicare provider and meet certain standards. Simply put every U.S. citizen or legal resident into the Medicare program (mandatory, not voluntary) and private insurance will only be allowed for Medicare Supplemental or Advantage policies. Abolish Medicaid completely (taking a huge burden from the state and Federal government). Raise the current medicare payroll deduction from 1.45% of all earned income to 3.5% of earned income above $25,000, and means test Medicare A (Medicare B is already means tested). Start phasing in Medicare A premiums at the $40,000 income level (including Social Security income) and charge the full premium for incomes above $60,000. (The premium is already established by the amount the government pays Medicare Advantage insurers.) Provide a phased-out tax credit similar to the Earned Income Credit for out-of pocket medical expenses (deductibles, Supplemental, Advantage, non-insured expenses) that starts phasing out at $30,000 income and disappears at $60,000. Finally, put a cap on malpractice punitive (not actual) damages (like we did here in Texas, with great results). This accomplishes several things: 1. Everybody is covered. 2. The low-income insured will pay nothing or very little, subsidized by the higher-income insured. 3. Both the government and the private companies offering Supplemental and Advantage coverage will receive a tremendous financial benefit by covering everybody, instead of only the less healthy (seniors) and sick-but-too-poor-to-pay (Medicaid). 4. Medicare already has no pre-existing condition restrictions, so that problem goes away, as does the "portability" problem when losing or changing jobs. 5. Employers will see a huge drop in their group health plan expenses for employees because thay only have to offer Supplemental or Advantage coverage. 6. This plan should pay for itself from premiums and payroll taxes paid by the higher-income insured, plus a rather large savings in the premium costs themselves because of #3 above. 7. Because Supplemental and Advantage coverage will continue to be via private insurance, we won't destroy an entire industry and we won't have a single-payer system, other than the one we already have under Medicare. -- Fight organized crime Don't re-elect anyone

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