Introducing FlemCare

Countless noble evergreens have given their lives for the cause of health care - the various mega bills that have been littering congressional committee rooms are but the last vestiges of the pulp they sacrificially yielded to the cause. Would that a spirited lawyer would represent these silent giants of wood and dell in their struggles against the ravages of health care.

Alas, no champion has stepped forth: We must save them by throwing a wrench of simplicity into the gear-works of bureaucracy. After much deep thought (for about 5 minutes), I have come to my eureka moment. I hereby propose for your consideration "FlemCare: Health Insurance for Everyman." It doesn't require two reams of paper per copy; it operates on a very simple premise that can be captured in a single sentence - Allow every individual to enjoy the full benefits of the health-care he reckons worth having.

I will parse this principle, the FlemCare Prime Directive, momentarily. First note two operational requirements for FlemCare to work well. (1) "Group health insurance" premiums would be considered income and subject to income tax. (2) Individual health insurance premiums would be exempt from income tax (up to a certain amount). This would give everyone with income a "tax discount" for purchasing individual health insurance. By giving a tax advantage to individual health insurance plans, FlemCare creates an environment conducive to individual choice, where every individual gets Goldilocks insurance - "just right!"

Okay, let's break down the core principle: Allow every individual to enjoy all the benefits of the health-care he reckons worth having. Note first the phrase "reckons worth having." It represents that an individual makes some quantifiable determination of the value of a health-care package. He attaches a number to it, a price he is willing to pay for what he receives. A package is "reckoned worth having" when a man buys it. "To allow every individual to enjoy the full benefits" means to give him free and unhindered access to the services for which he has paid. If a man purchases a "$100 discount on every prescription," he has a contractual right to receive that benefit.

Remove restrictions limiting the number of insurance companies that can compete in any given state. Remove requirements about the types of coverage that have to be included in their products. Allow insurance companies to sell insurance as car companies sell cars. Allow them to develop SUV's, sedans, pickups and sports cars. Allow them to create "options" that can be added to a plan based upon the customer's needs. Allow insurance companies to price plans according to a risk assessment for each individual. If they want to offer a non-smoker a cheaper policy, let them. (As is currently the case with life insurance.) Allow companies to market packages they believe will sell and allow buyers to purchase plans they want.

Under FlemCare, everyone goes out and buys the insurance plan he considers to be a bargain and suited to his needs. As a bonus, he gets a tax break on premiums. This feature of FlemCare accomplishes something important. It requires the government to support health care by a "loss of tax revenue," NOT through an increase in revenue.

So here's what everyone does under FlemCare: Individuals purchase what they want and enjoy a tax break for doing so. Insurance companies compete for the business of individuals by providing superior products at competitive prices. The government requires that insurance providers market their products using some sort of straight-forward and standardized "benefit and cost summary," kind of like a new car sticker or the "Good Faith Estimate" you received when you applied for a home mortgage. The judicial system would make sure that individuals receive the benefits they have purchased and that companies compete fairly. The government would also operate the "FlemCare Reallocation Plan" and "FlemCare Grace" described below.

Under FlemCare, you do not have to be a US citizen to participate. Individuals are free to purchase coverage and companies are free to sell coverage to all US citizens and residents. This solves the "illegal aliens" problem. If they want to buy insurance and get a tax break, let them.

What about those who have a pre-existing condition or some other situation that makes them "uninsurable?" An enterprising insurance provider might establish themselves in this niche market by providing a product line suited to the needs of their customers and priced at a level appropriate to the risk. But, to be sure, there will be some who cannot afford the high rates their risk category would call for. What should be done?

Those who cannot afford or elect not to purchase health care would fall under the FlemCare Reallocation Plan. Here's how it works: Whenever someone without health care receives uncovered care, their medical providers should be paid by drawing from the recipient's government entitlements like welfare, unemployment, and social security. For example, Joe is 59, has no insurance and incurs a bill for $10,000 at the local hospital. The government would pay his bill but recover the expense by delaying his social security eligibility date for about one year. It would be as if Joe got an advance from social security to pay his hospital bill.

Granted, an uninsured cancer patient could easily incur costs that bar him from drawing social security until he is 92. But that was his choice when he elected not to buy insurance. The marvelous advantage of this plan is that it results in a "zero net cost" because money for health costs is offset by corresponding reductions in other government entitlements.

What makes FlemCare so different from all the current proposals is its rigid insistence that individuals receive the benefits and consequences of their choices. This is clearly a biblical notion: "For each one will bear his own load" (Gal 6:5). "Health-care" which insists that everyman has a right to something he has not earned moves all men toward indolence. Not very healthy!

There is one more aspect to FlemCare, "FlemCare Grace." For those who are facing a medical crisis without insurance, the government could maintain a website discretely summarizing their situations. Here is where grace would find a place in FlemCare. Individuals would be encouraged to make donations to these needs. Because of its commitment to "improved health care," the government would treat the donor's gift as tax deductible and the income to the recipient as tax exempt. The lost revenue would be the government's way of saying, "We want to match someone's gift with a nice little bonus. We want you to be taken care of enough to ask for less from you."

Our Senators and Representatives have championed the cause of the uninsured. "FlemCare Grace" would give them (and all who have a heart of genuine compassion) a very direct way to address the need. I would be delighted for our congressmen to lead the way by giving extravagantly toward the grace plan from their own pockets. Now that would be leadership!

Tell your friends and neighbors about Flemcare where every individual enjoys the full benefits of the health-care he reckons worth having! Tell your congressman about FlemCare! Tell me what you think?

Comments

[Randy]

"It requires the government to support health care by a "loss of tax revenue," NOT through an increase in revenue. Uh, sounds more like DreamCare than FlemCare. Also, your original two requirements seem to contradict this principle.(1) "Group health insurance" premiums would be considered income and subject to income tax. (2) Individual health insurance premiums would be exempt from income tax (up to a certain amount). So on one hand, I am taxed for something I am currently not taxed on, and on the other you somehow get a tax break if you don't participate in a group plan? Fails my redistribution test. I pay too much tax now. Sorry, don't want to pay more to incent others to use it.

[John]

I have also given much deep thought - also about five minutes - concerning FlemCare, and see a couple of flaws. First, you're actually proposing less revenue flow to the feds. Aint't gonna happen. You're also proposing removal of restrictions on which insurance companies can compete in various state markets. These limits on competition have been secured with millions of dollars of contributions to various re-election campaigns. This idea will never get serious consideration by those who desire to remain in office.

I think the only answer to this issue is term limits. And, of course, this will never happen because it asks that men and women with power decide to give it up!

Yes, I'm being cynical. But I sincerely believe that, as the Mogombo Guru would say, "We're all doomed." I believe we're witnessing the beginning of the end, and that it's only a matter of time before all of mankind will be clamoring for a saviour. He'll bring order, but the cost will be high.

[Dave]

I think we are all in a dream if we think our health care situation is ever going to get fixed. FlemCare is more personable....LOL. I just want to know, if I have FlemCare or our wonderful GovernmentCare if they come up with a dead end agreement, can I get car and home owners insurance in one package???? Kind of a one stop shop. Just write one check for all...LOL

[Austin]

Overall, this article echoes questions I have yet to get answered: what is the state of health insurance now? and what are the reasons it is however it is? My instinct is that insurance is a mess because the free-market has been distorted by whatever regulations are already on the books--that a modicum of de-regulation is the superior answer, rather than extending the federal octopus' reach by magnitudes.

But, there's something else to consider as to the author's suggestion, laudable as I think it may be on the merits.

Let's assume that legislating a system of national healthcare is not a constitutionally permissible use of congressional power under the interstate commerce clause. If the interstate commerce clause is not an appropriate conduit for federal influence, why should congress be able to make an "end run" on the commerce clause's check on federal power through the tax and spend clause? Creating tax incentives is another way of behavior modification.

If direct manipulation is off limits, an indirect method of achieving the same end should be too: if national healthcare is unconstitutional under the interstate commerce clause, it is impermissible under the tax and spend clause.

[James Fleming]

No shortage of comments on this one - especially off-site! FlemCare seems to have tapped into the Town Hall angst of the masses. First, I wrote this with ZERO delusions that it or any approach which connects choices with consequences will be adopted. I also agree that the very notion of government provided health care is, at best, on dubious Constitutional ground. I also recognize that providing a tax break for health care premiums does involve "incentivizing" but I see legitimate uses for this method - for example, there is merit in allowing charitable contributions to be tax-deductable.

I remain drawn to two simple principles that FlemCare illustrates: Our national good will become forfeit when we sever the connection between choices and consequences. Government benefits are far more efficiently administered through the reduction of taxes than their increase.

[Bubba Matthews]

I'm sorry to lower the quality of the conversation but the name FlemCare makes me think I've got a bad cough and something yucky stuck in my throat

[Ralph]

It's a shame that the governments idea of healthcare is coming to fruition. To those who think they will be getting improved healthcare just look to the north (Canada) where they are sending people across the border because their system can't support all the people needing care. Once this gets passed the taxes will begin immediately, but the actual care will not for 4 years (read the fine print). It doesn't seem like a very solid deal for anyone that I can see. One can only hope sanity prevails.