Let's cut right to it:
The Republicans are crying foul about a lack of bipartisanship while they are not ones to be complaining. If the shoe was on the other foot, no one can claim the Republicans would even attempt to be bipartisan. The Democrats are at least providing some opportunity for bipartisanship. Their recent suggestion that they might go it alone comes after months of trying to involve the Republicans. That may be the most feasible thing to do now, but leaving politics out of it, the following would be a truly bipartisan proposal:
Democratic ideas:
- National health insurance exchange (otherwise known as a one-stop shop for health insurance plans)
- Public option on a level playing field with private insurance similar to the one laid out by Captin Sarcastic of Freedom Democrats here
a public healthcare insurance option [as] a non-profit corporation that could not be bought by private industry (as so many of the effective not-for-profit insurers have been). This corporation would have the full faith and credit of the US Government, and would be empowered to negotiate on behalf of their insured. Interestingly, this non-profit might well be designed similar to the Federal Employees Health Benefit Plan, which essentially negotiates with private insurers, but gets far better rates, and far better coverage than individuals, smaller groups, or even large groups can negotiate [because] of [the] number of [insured] they represent. The FEHBP represents 15 million members, making it the largest health insurance plan in the world, outside of national healthcare across most industrialized nations. This non-profit could also have the option of self-administering, eliminating the private insurance companies if they find that would be more efficient. The effect on private insurers would be simple, they would be both competitor and partners with this new public option, and their need to control costs both in their private offerings (to compete) and their negotiated government rates (to win contracts), would serve the interests of the public, putting their corporate interests in profitability in line with the public interests of better value in healthcare.
If the private offerings are better, then they will win, and the public option will languish and people won’t choose it, but hopefully, the competition will create better value. If the public offerings win, the private insurers can still prosper, but only if they control costs and win contracts with the federal plan
- Guaranteed issue (no preexisting condition discrimination)
- Individual mandate to buy catastrophic insurance
- Allow Medicare to directly negotiate drug prices with the drug companies (if not consolidated below in #3 below)
- Voucher for semiannual physicals to all citizens
- Allow prescription drug importation from Canada
Republican ideas:
- Allow people to buy insurance for what they see fit by abolishing mandates (such as mandating people buy coverage for alcohol treatment, in vitro fertilization, etc...when buying insurance)
- Allow insurance to be bought across state lines
- Consolidate Medicaid, SCHIP, and possibly Medicare into a means-tested health voucher (recipients could use for either private insurance or the public option)
- Tax health benefits through employment as income. EDIT: Or give insurance purchased on the individual market the same tax breaks as employer-sponsored insurance
- Streamline the process of putting a prescription drug on the market. Keep FDA tests for drug safety, but allow prescription drug to go on the market without an effectiveness test (the effectiveness tests would still remain for those who wish to have the FDA seal of approval)
- Streamline the process of obtaining a medical license, keeping safety requirements
- Enable community health clinics to be on a more level playing field
Other ideas:
- Disclosure, disclosure, disclosure. Both by insurance companies of their claim refusal rate, and by doctors, hospitals, medical services, and pharmacies of their pricing (including negotiated deals with insurance companies)
- Require insurance companies to pay back the total of all premiums paid and interest to anyone they decide to drop, and only allow dropping if they can demonstrate that the person in question intentionally engaged in deception
- Make insurance only proactive. In other words, they can't discriminate based on preexisting conditions, but they do not have to cover incidents that have already occurred (to use an analogy, you can't buy car insurance for an accident that already happened). They have to cover any complications and incidents that occur later though
I think this would be a bipartisan proposal that would solve many of our current problems. Any thoughts or suggested additions?