OPINION: Achieving Universal Healthcare — Without Bernie’s Proposal To Break The Bank

Sen. Bernie Sanders’ “Medicare for All” proposal would cost an estimated $32 trillion in its first decade, according to Mercatus Center researchers, who also noted that even if individual and corporate tax revenues were doubled, the federal government wouldn’t have enough money to pay for Sanders’ single-payer system.

Because of their extremely high costs, many government-run universal health care schemes such as Sanders’ “Medicare for All” proposal are simply not realistic. But that doesn’t mean it’s impossible to create a universal health care system that would provide all Americans with the opportunity to obtain health care.

Innovative health care solutions already exist that would, if properly utilized, dramatically reduce the cost of health insurance and medical care. And the best part? Policymakers could accomplish this goal by using monies currently budgeted for health care. Taxpayers need not pay a nickel more than they are already going to, yet they can create a system in which all people access the care they need.

To keep things simple, my proposal would rely exclusively on federal funds now allotted for Medicare and Medicaid ($1.12 trillion), state budgets for Medicaid ($236.3 billion), and the budget for the Veterans Health Administration ($198.6 billion). Together, these budgets amount to $1.55 trillion for fiscal year 2019, a truly staggering amount.

Rather than rely on these gargantuan, highly inefficient bureaucracies to provide people with care, a much better model would be to disburse these funds equally to every American using health savings accounts (HSAs), tax-free accounts people use to pay for health care expenses. If the $1.55 trillion available were distributed equally to every American — minus $100 billion used for an account to help people with pre-existing conditions — each of the United States’ 330 million citizens would have access to more than $4,400 each year to use for health care. On average, each household, assuming a mean household size of 2.6 people, would receive about $11,480.

With slight modifications to existing HSA rules, households could use these funds to purchase health coverage. Family plans can come for as little as $4,440 per year, and some provide up to $1 million of coverage per incident, with no lifetime cap. This would provide families with coverage for health expenses such as surgeries, hospitalization and specialty care.

Many healthshares also partially cover memberships in a direct primary care (DPC) practice. DPC practices bundle all primary care services in a low-cost monthly membership and provide services like telemedicine at no additional cost. For as little as $912 — paid on top of the cost of a healthshare plan — the average-sized household would be able to purchase a DPC plan covering the costs of the household’s primary care office visits (where more than 50 percent of care is provided). Many DPC plans would also provide, as they do now, members with large discounts for those needing generic meds, imaging, bloodwork and other services.

Healthshare plans are highly efficient because they eliminate the bloat commonly found throughout the health insurance industry and in government agencies, and DPC plans save members thousands of dollars because they cut out the health insurance middlemen from the relationship between patients and their primary care doctors.

Even after paying for a healthshare plan and a DPC agreement, many families would still have an extra $4,200 in their HSA account that could be used to cover the cost of medications or other health products or services. Any money left over at the end of the year would roll over to the next year, giving consumers an incentive to shop around for the highest-quality services available at the lowest prices.

There are other benefits of such a model, too: By keeping money in the hands of patients, rather than under the control of government bureaucrats, most health care decision-making would be made by individuals and families, limiting moral controversies and preventing abuses by largely unaccountable government agents.

This approach would also free many employers from needing to provide health benefits to their employees — because they would have plenty of cash available to pay for their own health care — reducing their costs and freeing them to divert more of their funds toward expanding their businesses and developing new products and services, helping to spur nationwide economic growth.

Incredibly, these remarkable feats could be achieved without additional taxpayer funds. All that’s missing is the willingness of politicians to think outside the box about America’s health care problems.

Chad Savage, M.D. is a policy fellow at the nonprofit Docs 4 Patient Care Foundation and the founder of the DPC practice YourChoice Direct Care in Brighton, Michigan.