the American Health Care Plan

The American Health Care Plan is an incentive-based market-oriented health care reform that combines competition with universal access to create the appropriate incentives for consumers, providers, and insurers. This reform plan is win-win for all participants relying on a deep understanding of human behavior, actuarial expertise and strategic insight. It is characterized by:

• Significant decrease in costs associated with administration of employee health benefits for employers;
  • Elimination of costs associated with perverse incentives and inefficiencies inherent in the current third party payment, procedure driven system.
  • Discourages lost time-injury claims under Worker’s Compensation.
  • Retards premium increases due to inappropriate Worker’s Compensation claims.
  • Separates the issue of wage increases from defined benefits.  (Since 2000, the premium costs have inflated by 87%, far outstripping any employee wage increases.)
  • Elimination of employee dissatisfaction with group health plan. Eliminates job lock. Creates true portability.

• Utilization of current financing sources for premiums; 

• Elimination of twenty-two cost drivers that are reversible, resulting in lowered insurance premiums;

• No new mandates for employer or individual to purchase insurance. Utilizes current mandate for Worker’s Comp to ensure all workers are covered by insurance. This will also eliminate the costs and perverse incentives of current Worker’s Comp system. Replaces employer based and Worker’s Comp policies with a single 24 hour health care insurance policy;

• Creating incentives for physicians to provide patient with price options within the context of appropriate care and information about price and quality;

• Gives all patients equal purchasing power in health care, regardless of socio-economic level;

• Allows all Americans who work, to build wealth in asset savings accounts;

• Gives patient choice of physician, hospital, and treatment; and

• More efficient allocation of health resources.

This fundamental health reform plan replaces third party payment, procedure driven medical care with a lump sum payment (used in Netherlands) to the patient’s personal asset savings account. Patient pays directly for all anticipated expenses associated with the insurable event for high value, non-discretionary care from funds derived from insurance lump sum payment.

• All initial diagnostic, routine care, discretionary care, low value choices and care associated with moral hazard paid directly by patient from the asset account with money derived from premium difference, that rolls over every year and grows with investment at compounded interest.

• Utilizes a system of risk equalization, high-risk pools, re-insurance and focused, income related insurance premium subsidy for the elderly, the poor and those with chronic illness.

• Computerized Insurance protocols eliminate administrative costs associated with lump sum payment, the individual market, and the micromanagement of medical care.

This plan respects the industry’s economics and financial viability and understands the competitive dynamic.

• The transition is designed to be as smooth as possible for both the providers and purchasers of health care.

Designing the appropriate incentives will insure high quality and efficient care built upon transparency and evidence-based medicine. Inclusion of consumer and provider incentives for preventative care, healthy diet, and life style choices.