A Multistate-based Path Forward for Universal Health Care

The notion of introducing Universal Health Care Insurance has been focused at the federal level for quite a while. Success at that level has been mixed at best, primarily focusing on improvements in the ACA (Affordable Care Act) with even the proponents there recognizing that it only helps a subset of the problem of health care funding. As is, most everyone, even independent of partisan politics, agree that what we have in this nation is badly fragmented and uneven in its fairness, but at the federal level we cannot agree on any means to resolve even the ever-increasing perception of the cost of health care. (Afterall, we cannot possibly provide any more freebies to the undeserving.) We need to reset and take a good hard look at how health care in this country is really being funded, address today's perceptions, get the needed buy in, and then fix it.

Interestingly, the dynamics of power in this country have been changing in a way that might help move Universal Health Insurance (UHI) forward. Increasingly, we see, even from our own Supreme Court's “originalists”, that power is moving out of the federal government and into the states. Part of the value add of that is that experimentation with different concepts can be tried in individual states with populations willing to try out those concepts. And that it no less true for UHI. We have states individually working to address this, with also mixed success. But, given the dynamics of health care funding, maybe we shouldn't address it at the individual state level, but instead in a confederation of states all willing to live by the same rules.

Let's define UHI as being, then, a multistate-based concept. For these member states, let's take health care funding away from the federal government and put similar responsibilities onto this confederation. Allow them to define for themselves as a group what it is that their citizenry want for the funding of their health care. Some states have already been toying with having their own; let's just have these states and many more define the rules as a cooperative.

The issue is funding, not slogans. We are only talking about funding; health care providers continue as the business entities that they are today. How do we pay for the health care of member state's citizens and do it in a way to is perceived to be fair by all?

What might Universal Health Care backed by UHI look like? Many groups with a lot of discussion including citizens will be necessary in working out the details of UHI, but a few known items leading to a solution might include the following:

Those are the basics. As always, the devil is in the details, all of which must be negotiated. Please, though, while mulling what you would prefer, the following outlines a few things additional things to keep in mind:

Clearly, the above is just a quick overview. The devil is always in the details. But the time is now to pull together inter-state discussion and listening sessions to define what our state's citizenry would want for health care funding and how they would want their state to provide such funding.