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I Know How to Fix American Health care

Op-Med is a collection of original articles contributed by Doximity members.

America needs a plan for universal health care. We have an increasing wealth gap, stagnant wages, and yet exponentially soaring medical costs. The working class have already been priced out of health care. When what’s left of the middle class can no longer afford their premiums, we will have socialist health care thrust upon us as a society. Although some would cheer this proposition, the problem with most socialist health care policies is that they smother innovation, deprive patients and their families of choice, and suffer from insidious bureaucracy. They also tend to become more and more costly over time, until they can barely stand under their own weight, even as they provide, at best, middling health care. I think the National Health Service, Britain’s health care system, is a testament to this. 

As a solution to this no-win situation, I propose here a method for the creation of a universal health care system that would guarantee health coverage to everyone, but would incorporate individual choice and free market mechanisms to reduce costs to their lowest possible levels. As a wonderful side effect, it would also create an increasing cushion of health care funds for the next generation of this country while simultaneously increasing retirement savings.  

I call it the Universal Savings Account, or USA for short. Functionally, it would act like a Health Savings Account (HSA) for each individual citizen, but it would be funded annually by the government, as well as by optional individual contributions. Every year, the government would place funds into each citizen’s USA with the goal of $10,000 per citizen per year (although $3,000 per year would likely be adequate). Those funds, which can only be spent on health care, would be ample for the purposes of covering health care insurance, deductibles, and various out-of-pocket expenses. Just like a normal HSA, the money in the USA would belong to the individual. The funds therein could be invested and would be tax free, so long as they remain in the account. They could also be transferred from person-to-person, without penalty, to help others in a time of need, or to give to loved ones upon death. If a person is lucky enough to be healthy – and hasn’t had many medical problems – he/she could then also use five percent of the saved funds per year for retirement at age 60. 

This idea solves several socio-economic problems:

First, everyone will have enough money in their USA to pay for routine medical care, something most people don’t have right now. Because they will be paying mainly out-of-pocket with the cold hard cash in their USA, they will finally have the bargaining power necessary to seek out the highest quality medical care at the best price, rather than relying on private or public insurance middlemen. This will drive health care prices down, something we haven’t seen in recent decades and normal low-deductible insurance, which seems to make money by denying people health care whenever possible, will be a thing of the past because people will only elect to purchase cheaper, catastrophic insurance. 

Second, if we require current Medicaid and Medicare patients to use the funds in their USA prior to utilizing Medicaid/Medicare, we can gradually reduce reliance on these inefficient services while still allowing patients to keep their current coverage. 

Third, it will help people save for retirement since five percent of the funds can be used yearly for everyday expenses after age 60. This is especially helpful since Social Security is, unfortunately, an unsustainable program which grows more costly every year (but at the same time confers fewer and fewer benefits to its recipients). 

The Universal Savings Account system guarantees health care for all, solves America’s health care problem, and also addresses problems with runaway entitlements – all while keeping individual choice intact! It stimulates free market advancements, leading to cheaper and more effective medical care. With the Universal Savings Account, the economic challenges of health care funding are transformed into an opportunity to create, rather than consume, and to pass health care wealth directly on to loved ones, thereby securing the wellbeing of Americans with each passing generation.

Sean Rogers, MD, is a physician in Bridgeport, West Virginia. His hobbies include jogging, kitesurfing, and bringing Big Pharma to its knees. 

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