A Government Sponsored High-Deductible Consumer-Driven (HDCD) National Health Plan Could Provide Universal Health Coverage and Simultaneously Reduce the National Health Expenditures (NHE) in the United States of America
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Rather than a tweaking of an inefficient system, why not rethink entirely how the United States (US) Government allocated the $1.155 trillion ($1,815 - $660) spent on non-Medicare healthcare funding in 2016. The US Government could allocate $325 billion to provide every family in the country with a high-deductible consumer-driven (HDCD) health plan limiting each family to an annual out-of-pocket maximum of $14,300. The US Government could then use the remaining $830 billion to provide each family with a $12,205 contribution to a Health Savings Account (HSA). This would leave each family with an annual total out-of-pocket maximum of $2,095 which is about a twelfth of the combined amount that employers and employees are currently paying for health insurance. The portable HSA managed by the employee would incentivize employees to control costs since unused HSA funds, in any given year, could be rolled and available for use in future years. This would reduce administrative costs, likely reduce overall demand for healthcare, and subsequently reduce the cost of care.
Bureau of Labor Statistics (2017) Consumer Price Index - https://www.bls.gov/cpi/
Kaiser Family Foundation Report (2016) Calculations using NHE data from Centers for Medicare and Medicaid Services, Office of the Actuary and National Health Statistics Group - https://www.cms.hhs.gov/NationalHealthExpendData/
Congressional Budget Office (2015) Updated Budget Projections 2015 to 2025, Report 49973, Washington, DC: Congressional Budget Office.
Office of Management and Budget (2017), Budget of the United States Government FY 2016, Historical Tables, February.
Kaiser Family Foundation Report (2016) Employer Health Benefits Survey.
(https://www.kff.org/health-costs/report/2015-employer-health-benefits-survey/)