Matt Yglesias and Brad Plumer are discussing Leif Wellington Haas's plan for universal health care, which breaks down into another one of these individual mandate thingies. Sigh. I feel so left out. There was a time -- not long ago! -- when I'd have been the first to tear through Haas's 78-page plan, summarize it, and issue my pronouncement for its chances. But that all caught up with me come midterms and now I'm having to -- yawn -- do schoolwork. Major bummer. But since I can't discuss Haas's attempt, why not come up with one of my own?
This here is basically a way of organizing universal health care in Matt Miller's world. You know the rules: progressive ends, conservative means. Since a surprising number of you folks, my good readers, seem to work in the health care industry, I want your thoughts on feasibility. Deal? Deal.
In short, I'm asking about progressive HSA's of the sort I detailed yesterday, but with a few modifications for enhanced progressivity. Every year, the government would deposit $1,000 worth of health credits into your account. Unused portions would roll over, up to a total of $4,000 (at which point the government would stop depositing in your account every year, starting again when the build-up had shrunk). Once health care costs for the year had surpassed $1,000, individuals would be responsible for the next $X of costs, which could be paid out-of-pocket or through account build-up. You probably noticed up there that "X" isn't a number. Right you are. I haven't forgotten that these are progressive accounts! If you make less than $15,000 and have a dependent, you pay nothing. $25,000 would give you a $500 deductible, $50,000 would stick you with $1,000 bucks, $75,000 with $1,500, $100,000 with $2,000, and so on. After you'd paid through your deductible (which, you'll recall, only comes after you used the free $1,000 the government deposited in your account), it becomes a copay arrangement, with the government responsible for varying amounts depending on your income (say 85% for high earners and 95% for low). Also, all preventive tests and screenings (think mammograms) are fully covered, they don't cost you anything.