A Free Market(ish) Approach to fixing Healthcare

As promised if a bit late. Blame Facebook's ultra shitty search function and my laziness & apathy for convincing people of politics online in general.

Instead of an individual mandate(which is unconstitutional) Congress may pass a tax exemption for every dollar spent on healthcare directly (unlimited, no minimum) or insurance(with a cap) by Citizens. Remove the 10% of income minimum per item on medical expenses etc..

HSA's should be exempt from capital gains and contributions should be tax exempt from income tax. Regular income schedule/capital gains should apply if taken out for other expenditures.

As we already have "Universal Healthcare" although haphazardly and terribly planned through a mandate to treat and a combination of medicaid/unpaid medical bills etc. I actually propose keeping the pre-existing condition clauses of the ACA. I realize this will increase premiums for those of us without pre-existing conditions but it should reduce the amount of money paid to the government to then pay for medicaid expenses and/or help drive down costs for unpaid bills. I also think the concept actually impedes a free market by locking individuals into their current healthcare provider thus not allowing for competition.

One size fits all policies would be eliminated. All young and healthy people should be able to purchase cheap high deductible catastrophic insurance if that's all they want to purchase. Overall, that would bring in more people into the "universal" net and reduce one of our major failures which is catastrophic bills having to be paid by the state or the hospital. This would reduce costs to the rest of us paying normal premiums.

Caps on donations to charities serving high risk pools should be reduced(think St Jude's Children's Hospital) and I actually view federal funding of research hospitals as a good thing as well as prize funds for cures/breakthroughs in research. Pure research(where you might not know what you will get) is a place where the market forces aren't necessarily great without patent or other government protection. We should also stop letting the rest of the world bully our pharma industries as we are essentially subsidizing all medical pharma research for all the "socialized" medical programs of the world. I'd probably also be fine with rolling high risk pools into medicaid but putting them on a voucher system so that they can purchase their own medical care in an open market with competition.

Open up competition across state borders for Health Insurance to help manage costs through competition. Create some standardized rules/best practices around administration etc. through use of the interstate commerce clause. We already do this in plenty of industries. Think DOT or clean air act, mandates are federal, rules are made and enforced at a state level within the guidelines of those federal mandates.

Is this ideal? Fuck no. Would it be an improvement over the current system? I think so. It's full of compromise, doesn't really touch medicaid or medicare, and is *maybe* politically feasible. Probably not in today's hyper-partisan atmosphere though.

Disagree with something? Great! That's what I've got so far. It's a working draft. I'm happy to take feedback and improve it with your help. Policy wonks welcome.