Obamacare 2.0 – My Ideas to Improve the ACA

So the ACA hasn’t been repealed yet, thank goodness. Doesn’t mean the ACA is perfect, but it’s better than what we had before. The goal for healthcare though should be Medicare for All, also known as Single Payer. We should be fighting for that right now. Not in 10 or 20 years, but now. With that said though, I know most of the Democratic Party doesn’t want it because they’ve gotten bribed by the pharmaceutical industry and insurance companies, so as an alternative, I’ve come up with my own healthcare proposal that keeps Obamacare while making it better. So here it goes.

First, I leave the current structure of Obamacare in place. The exchanges, individual mandate, the insurance companies, the whole concept of a market based, competition based healthcare system, I leave that in place.

Second, and here comes the improvement part. If you read Binding Chaos/Autonomy Diversity Society by Heather Marsh, you’ll come to understand that the nation-state, not just the U.S but every nation-state, is actually a corporation, and the 50 states are all corporations too, as are the cities. So with that said, I’d put the government into the healthcare coverage game. The national government would be a health coverage option with Medicare, with the eligibility age lowered to zero. It’s not Medicare for All though, as you’d have to opt into Medicare, but anyone would be able to as an option.

Thirdly, all 50 states would create their own health coverage program which you could choose on the market. Since the state plan would be on the market, it’d incentivize each state to offer a better plan than any private plan, and better than the national Medicare plan, otherwise everyone in a given state chooses Medicare instead of their state plan.

Fourthly, every city would create their own plans. Cities are their own government/corporation, so they’d have to create their own plans too, which you could choose on the exchanges. This also means that progressive cities in red states would be able to offer better plans than their state does (Phoenix, Charlotte, Atlanta, Dallas and others come to mind).

Fifth, every employer has to create a health coverage plan, however it’d be a choice for the employees. Employees could choose their city/state/Medicare if their employer plan isn’t to their liking. Thus, putting incentive on employers/insurance companies to offer better plans than what cities/states/Medicare offer, otherwise private insurance will lose in the market.

This healthcare plan would mean that wherever you live, at minimum, you’d have three choices to choose from. The national Medicare option, your state option, and your city option. The national government would be able to negotiate drug prices, each state would be able to negotiate drug prices, and same with every city. It would create competition that enhances health coverage and lowers prices, because suddenly every city is competing against their state plan and the national plan, and the state is competing against Medicare. Insurance companies would be competing against city plans, state plans and Medicare. Also, I would have everyone below the poverty line automatically put on Medicare until if and when they escape poverty, at which point they can choose on the exchanges whether to keep Medicare or go with a private, city, or state plan. This way, even though this isn’t Single Payer which makes healthcare a recognized human right, nobody lacks healthcare because they can’t afford it.

This plan can appeal to Single Payer supporters and free market healthcare people because it means the government, from city to the national level, offer their own plans, but it also leaves in place private insurance. The national government wouldn’t be “forcing” it’s single plan on everybody. You’d be able to choose. It’d empower the states too, because they can craft their own plan. It’d empower cities too. Local elections become more important, because the local officials you elect get to shape what the city healthcare plan looks like. Red states would be able to offer their alternative plans to the national plan, and cities can offer alternative plans to their state.

This plan would be a true market based healthcare system, as the nation-state, the state, and the city are all truly corporations. While not quite being Single Payer, over time, the likely outcome of my proposed system is that most people will choose Medicare, their state plan, or their city plan, thus eliminating private insurance from healthcare. I don’t know what to call this plan, as it’d simply be an add on to Obamacare, to make it better, more competitive, and cheaper. It’d bring the uninsured rate down to under 10 million most likely, if not close to zero. My two name ideas are Multi-Payer system and Market-Payer system.

For the record, in case it’s not clear, I’m a Medicare for All person, because I think healthcare is an earthly given human right that should be guaranteed from birth to death. This is just my, uh, compromise option, with Democrats who won’t support Medicare for All, even when close to 60% of Americans support it. This is my plan to improve Obamacare to get more people healthcare while lowering the costs for everybody.

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