First, the new program:
universal health care must be provided. Poor and (increasingly) middle-class people simply cannot afford health insurance, and minimum-wage employers do not offer it; fewer and fewer employers of any kind are offering
family coverage. Congressman James McDermott, a physician, has introduced into almost every session of Congress a proposal for a "single-payer plan" that would provide universal coverage to all Americans without increasing total health care costs for the country. Almost one hundred members of the House of Representatives have usually signed on to this bill. A single-payer plan would make the United States government into the sole "insurance company" to offer health care. (Regardless of what one thinks of the Federal government in other fields, it handles
insurance very efficiently and cheaply. Social security is run with an administrative overhead of less than 3% compared to 15% - 20% in private insurance companies.) Doctors would still bill the "insurance company," but there would be only one company to bill, the government.
The administrative savings from such a plan would be enormous.
35 Not only would overhead be less for the government than for for-profit insurance companies, but overhead would also be less for the doctors and hospitals. The current Byzantine system of private insurance, each with different exclusions and levels of coverage is an expensive nightmare for health care providers. In separate studies the Congressional Budget Office and the Office of Management and Budget (OMB) have demonstrated that the administrative savings would be enough to provide comprehensive health coverage for all of the uninsured in the country. In other words, we could give everyone insurance for the same total cost that now leaves over 43 million people uncovered!
Second, the
Earned Income Tax Credit (EITC), already functioning as a well-accepted program, could be expanded such that no person working more than thirty hours a week would earn less than the poverty level for his or her family size. There are now millions of poor people who have a full-time worker in the family. None of these families would be poor. A further provision of the EITC could give an extra credit to parents of small children to make childcare affordable.
Third, through a combination of the EITC and an expanded
unemployment insurance, employees who are laid off should also receive an income that leaves them above the poverty level.
Finally, the
Supplemental Security Insurance program, which provides disability benefits to those permanently disabled, must be carefully expanded in two ways. First, eligibility must be expanded so that everyone who really cannot work (for whatever reason) qualifies. This would require only a change in regulations, not a change in the law, for coverage of all those who are disabled is the mandate of this program. Due to meager budget appropriations and other political factors, however, the regulations and the milieu of the decision makers in practice deny coverage to many disabled persons. Causes such as disabling back pain (often impossible for the claimant to "prove"), mental conditions that do not meet certain criteria, disability due to addiction, and many other disabling conditions are in practice not considered eligible. Second, the level of coverage must be increased to the level of the EITC discussed above, ie all individuals and families should have incomes above the poverty level.
