It's no secret that the U.S. health care system is ailing, and our nation's citizens are demanding change. In 2005, Americans spent nearly $2 trillion on health care, according to the National Coalition on Health Care. The coalition predicts this amount could mushroom to $4 trillion by 2015.
"Yet despite these fantastic sums of money being spent, the health status of America's citizens looks sickly when measured against the tallies in other industrialized countries," Ezekiel J. Emanuel, M.D., Ph.D. writes in "Healthcare, Guaranteed: A Simple, Secure Solution for America" (PublicAffairs, 2008).
Emanuel, a breast oncologist and the chair of the Department of Bioethics at the Clinical Center of the National Institutes of Health, served on President Clinton's Healthcare Task Force in the early '90s. In 2003, he joined forces with Victor Fuchs, a renowned health care economist, to build a health care reform proposal.
"Over the last five years, we have worked together intensively to elaborate upon, refine and test the reform proposal now called the Guaranteed Healthcare Access Plan," Emanuel writes. "All other industrialized countries around the world provide quality care for every one of their citizens at a lower per capita cost than in the United States. If they can do it, certainly we Americans can."
In this book, Emanuel explains why our current health care system is failing and how we can fix it. He also outlines the Guaranteed Healthcare Access Plan -- and following is a list of elements included within the plan.
Insurance with a 100 percent guarantee
The Guaranteed Healthcare Access Plan essentially guarantees that every single American will receive health coverage. "Every American receives a health care certificate that covers his or her health insurance. The certificate covers a standard set of benefits, the same benefits that members of Congress now receive," Emanuel explains. These benefits include everything from hospitalization and prescription drugs to preventive screening tests and mental health care.
"Using their certificates, Americans will choose their health plan, their doctor, and their hospital," Emanuel writes. "They will also be able to choose whether to buy a 'platinum' plan at their own expense with additional services." He points out that this coverage is more extensive than Medicare and far superior to the insurance most Americans currently receive.
Networking together ... under supervision
Under the Guaranteed Healthcare Access Plan, private insurance companies and health systems will build networks of hospitals, doctors, and other providers. Of course, these health care networks will be closely monitored by the government.
"There will be a National Health Board with 12 regional boards to oversee and monitor the system," Emanuel says. "The boards will regularly review the standard benefits covered, monitor the health plans, and oversee the workings of the system."
Cutting employers from the equation
Emanuel and Fuchs' reform plan also removes employers from the health care equation. "There will no longer be a need for employer-based health insurance. The Guaranteed Healthcare Access Plan will belong to the individual, ensuring complete portability," Emanuel explains.
Emanuel believes that eliminating employers has multiple advantages. First of all, no premiums will be deducted from workers' paychecks. "Instead, the health certificates will be paid for by a dedicated value-added tax (VAT) -- one that functions much like a sales tax," he writes. Plus, employees would never feel like they're stuck in a certain job because of their insurance plan.
Additionally, Emanuel says these changes will allow employers to focus on what they do best -- their business.
Whether you are a health insurance agent, life insurance agent, or financial advisor, you should pick up a copy of "Healthcare, Guaranteed," as your clients are probably asking some difficult questions about the health insurance industry. And with health care reform looming, you may want to start preparing for some changes in your own business.
Amy Bell is a freelance writer and frequent contributor to the Agent's Sales Journal. Visit her Web site at www.writepunch.com or email her at amy@writepunch.com. "Healthcare, Guaranteed" can be purchased at Amazon.com.
