Health Care Can Be Cured: Here's How

(2 of 3)

What kind of agency would administer this Medicare-like plan for the rest of us?

The idea of a single-payer plan run by the U.S. government carries with it far too much political baggage to ever get off the ground. What's needed is a fresh approach, a new organization that is independent and free from politics. For in addition to covering the basic costs of all Americans, a new system would need to institute programs to improve America's overall health that focus on preventing illness and disease as well as on treatment and do so without breaking the bank. How does the U.S. come up with such a mechanism?

One possible answer: loosely copy and then expand on what already exists in another setting the Federal Reserve System, which oversees the nation's money and banking policies. The Fed is one of America's most ingenious creations, a public agency that is largely independent of politics. The Fed's board members are appointed to 14-year terms by the President with the consent of the Senate, meaning that neither the White House nor Congress can substantively influence the Fed's policies.

Call this independent agency the U.S. Council on Health Care (USCHC). Like the Fed, the council would set overall policy for health care and influence its direction by controlling federal spending from managing research grants to providing medical coverage for all citizens. Unlike the Fed, it would be funded by taxpayers. The money could come from two taxes: a gross-receipts levy on businesses and a flat tax, as with Medicare, on all individual income, not just wages.

This would not represent an additional cost to society but would rather replace existing taxes and write-offs. It would cut costs for corporations and raise taxes slightly on individuals at the top of the income ladder. The council's mission: implement policies that improve health care for everyone, not just those suffering from certain diseases. In short, make the unpopular decisions that the market cannot make. The council could establish regions similar to those of the Fed.

The geographic subdivisions could take into account cultural and regional differences. That would allow for health-care delivery to be fine-tuned at the local level and ensure that regulations take into account the differences between metropolitan and community hospitals. That is not to suggest that a single-payer system overseen by a Fed-like independent organization would instantly correct everything that's wrong with market-driven health care. What it would do is provide the framework to reach that goal. For starters, it would:

Guarantee that all Americans receive a defined level of basic care, including a fixed number of visits to doctors, routine lab work, immunizations for children, coverage for all childhood illnesses and all hospital charges.

Establish flexible co-pays for basic care that would vary depending on income as well as usage. Those people who seldom seek medical attention could have their co-pays waived. So too could those at the bottom of the income ladder.

Pay all costs to treat any catastrophic illness, such as cancer and other devastating diseases.

Restore freedom of choice by allowing patients to choose their doctors and their hospitals.

Redirect health-care spending by allocating money for disease prevention as well as treatment.