Health Care Addendum:

Let me speak to my idea (although I can't claim credit) of a "triple-payer" health care system.

First of all, the term "triple-payer" is a direct restructuring of the term "single-payer." Neither single nor triple-payer systems are adequately described by those terms.

Here's the basics...See what you think.

1. The federal government would not provide health insurance coverage, simply create the nations largest health care group with very specific coverage. Many states and localities already do this to keep down costs.

2. Private and "public" health insurance providers would send blind bids (along with "capacity statements"*) to a central Health Care office for review.

3. The third lowest "per capita" bid (could be neither the highest or lowest bid) from across the nation would be chosen. An offer to buy coverage up to the capacity limit set forth by the individual health insurance providers would be sent by the federal government. Companies would then accept or reject participation in the program. Providers, whether or not they participate, could still sell insurance as a supplement privately.

4. Individuals would then "buy" insurance from the provider of their choice (certain regions would have limited options). Premiums would be based on income, payable to the federal government, and there would be a maximum contribution. Coverage would be mandatory (for those of you keeping track, I've changed my position here).

5. Ideally, the plan would be free from deductibles although a co-insurance of 10-20% would be reasonable for all procedures. Every person would receive one free physical and three urgent care visits per year. Insurance would be individual and portable. No pre-existing conditions.

Pros: Obviously, a health care plan based on income makes this truly Universal and affordable. There would not be an inordinate amount of increased taxation. Employers could still cover workers by paying the "premium tax" on behalf of the employee as part of a salary package. Private insurance companies would not be shut down or made illegal, thereby salvaging a major portion of the economy from collapse. A co-insurance policy allows doctors and hospitals some leeway in the amount of charges. No more Medicare.#

Cons: It's not a "free" system based on a progressive tax model like other countries offer. It is possible that insurers could learn to work together and "game" the system during bidding, driving up overall costs to the government. Regions lacking in accepted bids would likely be "farmed out" to providers in other regions (technology makes this less of an issue, however). Oh yeah, no more Medicare.#

Overall, I think it's a good plan. It takes what is best about the American health care system and tries to incorporate a level of price control and cooperative buying to save the taxpayer trillions of dollars. Like all health care plans, it has faults, but I hope members of Congress and the President seriously consider something like it.

* A "capacity statement" simply estimates the number of people a provider can reasonably cover. It should also include business statistics like workforce and years in service.
# Medicare is a beautiful idea but a horribly inefficient bureaucracy. This new plan takes over the job with few real changes to the individual. No income = No premium.