PLAN PROPOSAL
Designing a comprehensive healthcare framework for the United States requires balancing universal access with the country’s existing infrastructure and economic realities. The following proposed framework—the "American Unified Care Model" AUCM, is a hybrid system designed to provide a universal floor of coverage while maintaining a regulated private market
for choice and innovation.
1. The Core Pillar: Universal Basic Coverage, UBC
The foundation of the AUCM is a federally funded, state-administered basic coverage tier. This "Universal Floor" ensures that no citizen or resident is left without essential care:
* Eligibility: Automatic enrollment for every US citizen and legal resident from birth.
* Essential Benefits: Covers primary care, emergency services, preventive screenings, maternal health, and mental health services.
* Cost at Point of Service: 0 co-pays for primary and preventive care to encourage early intervention and reduce long-term costs.
* Funding: Funded through a dedicated "National Health Levy" (a payroll tax) and the consolidation of current federal subsidies.
2. The Multi-Payer Marketplace: Regulated Choice
To preserve the innovation and choice valued in the US, the framework allows for a "Second Tier" of private insurance:
* Supplemental Insurance: Private insurers offer plans for services not covered by UBC (e.g., private hospital rooms, elective procedures,
or advanced dental/vision).
* Employer-Based Options: Employers can still offer "Premium Plans" as a benefit, but they must contribute a portion of those premiums
toward the National Health Levy to support the universal floor.
* Standardization: All private plans must use a single, unified claims and billing interface to reduce the $250+ billion currently spent on
administrative waste.
3. Cost Control & Sustainability
A primary challenge in the US is the high cost of care. The AUCM addresses this through structural price regulation:
* National Drug Negotiation: The federal government uses the collective bargaining power of all UBC enrollees to negotiate drug prices,
similar to models used in the UK and Australia.
* All-Payer Rate Setting: To prevent price gouging, a federal commission sets maximum allowable rates for hospital procedures, which
apply to both the public and private tiers.
* Investment in Preventive Care: By removing cost barriers to primary care, the system shifts focus from "sick care" to "wellness,"
reducing the prevalence of expensive chronic conditions like Type 2 Diabetes and Heart Disease.
4. Digital Infrastructure: The National Health Stack
Modernizing the back-end of healthcare is essential for efficiency and patient outcomes.
* Unified Patient ID: A secure, blockchain-verified digital ID that allows a patient’s records to follow them between any provider in the country.
* Telehealth Integration: Universal broadband access and a standardized Tele-Health platform ensure rural populations have 24/7 access to specialists.
Comparison of Healthcare Costs
The primary goal of this framework is to move the US closer to the spending-to-outcome ratio of other developed nations. Currently, the US
spends significantly more per capita without achieving universal coverage.
Where:
* P = Price of services
* Q = Quantity of services
* A = Administrative overhead
The AUCM seeks to lower P through negotiation and A through unified digital systems.
