The AMA Plan
Healthcare in the U.S. averages about $10,000 per person, which is three times more than what other developed nations pay. In Israel, for example, healthcare averages about $2,000 per person. But how can the U.S. ensure quality care that is affordable? The American Medical Accounts (AMA) plan is one solution that would be efficient and effective under a payments tax plan. Using an AMA, the federal government would deposit a monthly cash benefit in a medical savings account for individuals who would choose to spend it on insurance or directly to less costly provider groups.
Provider Groups
Provider groups are groups of doctors that collectively take care of patients in exchange for a monthly fee paid directly to them. The provider groups would not be paid per procedure and instead would be paid a steady income. This eliminates insurance companies as middlemen and lowers the cost of care. Provider groups offer the benefit of shared medical records, meaning that patients don’t have the burden of transferring records from family doctor to specialists as they do now. If someone isn’t happy with a provider group, he or she can simply switch to another group. Provider groups would use the monthly fee to pay doctors a salary and cover overhead costs. In the case of the AMA plan, the government would provide the fee that pays a provider group and would ensure the quality of care that patients receive, but leave decisions on procedures to doctors and patients. Such a plan would assure free basic healthcare to all Americans.
The Numbers
The AMA plan adds up to $1.6 trillion, and replaces the current healthcare system, which would save the nation approximately $1 trillion. This would provide healthcare for all Americans, at little to no cost to the patient, under a payments tax plan. People could pay additional fees for services not covered through the AMA. The AMA plan would cost someone earning $100,000 just $32 per year.
The current healthcare system works by pooling risk with insurance groups, and in turn those groups lower the cost of care (at least in theory). When a third party determines care that citizens receive (whether it is an insurance group or the government), the quality may be compromised. Most insurance is provided privately through employers, but the federal government funds two major subsidized programs: Medicare and Medicaid. Even with both private and publicly funded healthcare, about 12%, or 3.2 million Americans, are uninsured.
The goal would be to provide better care and more choice at a lower cost. Based on the current cost of providing Medicare and Medicaid, the AMA plan would work on the payment schedule below, with the benefit to the blind and disabled paid in addition to the age group benefit:
Demographic Group Annual Benefit
76 million children $2,500/year
64 million adults (19–34) $3,500/year
77 million adults (35–54) $5,000/year
50 million adults (55–69) $7,500/year
17 million adults (70–79) $10,000/year
11 million adults (80+) $15,000/year
10 million blind/disabled $10,000/year