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Models of Payment for Universal Health Care

Explore diverse models such as Market-Based, Tax Credits, Expanded Eligibility, Vouchers, and Single Payer for universal health care financing. These models employ different mechanisms of funding, eligibility expansion, and private sector involvement to ensure affordable and accessible healthcare for all. Gain insights into the pros and cons of each model to shape the future of healthcare financing.

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Models of Payment for Universal Health Care

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  1. Models of Payment for Universal Health Care Scott Tyson, MD

  2. Market-Based Model • Insurance based platform, with price control coming from market demands • Continue with multiple insurers or limit total number i.e. Clinton plan • Insurers would create quality affordable products. • Everyone would be required to have an insurance policy. • Funding could be public, private, or both, publicly and privately administered. • The Massachusetts model is the best known example of this.

  3. Tax Credits • At present, only businesses can get tax credit for insurance purchases. • All insurance products, regardless of purchaser, would receive a tax credit. • Funding would be public and private, thought actual funding would be through lost dollars rather than actual outlays, privately administered. • There is no real precedent for this on a state level, but HSAs and MSAs are a model of this.

  4. Expanded Eligibility for Public Programs • There are requirements for eligibility for most public programs • These would be opened to include say 200, 400% of federal poverty. • There might be increased coverage for certain products through public programs i.e preventative care. • Funding would be primarily publicly funded to expand availability and access, publicly and privately administered. • IL is the closest to this, certainly on a pediatric level.

  5. Vouchers • As an extension of the MARKET BASED MODEL, people would be given a voucher to purchase an insurance product. • This could come from the employer, government, payroll, or a combination of these. • All people would receive a voucher to go and purchase an insurance product with the market determining price, availability, etc. • Funding would be public and private, privately administered. • No state model per se, but HSAs and MSAs could be framed under this.

  6. Single Payer • All funds would be pooled. • All fees would be paid from a single fund. • The private market would be limited to uncovered services or services that were at least comparable. • Publicly funded, privately administered.

  7. Overview of Models • In all of these models, save the single payer system, the premise is the market should be allowed to set prices, compete to help contain costs, and provide the products. • Each uses varying ways of increasing the number of covered lives. • Each is a universal healthcare model, if allowed to expand fully. • Each would involved the private sector to varying degrees as administrating, funding, and dispensing the products.

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