If I had to do a national healthcare, I would make health insurance like car insurance, where it only covers catastrophic health costs. This would drastically reduce the amount of interference between insurance companies and doctors, and allow the free market to help shape pricing. The premiums would be tied to a base salary. People could choose to pay more or less base percentage to reduce or increase their premiums. For example, if one chose the base rate of 5% of their salary, a person making $30,000 a year would have to pay $1500 out of pocket before being able to claim catastrophic health insurance. If they had a good HSA, they might opt to increase that amount to 10%, which would reduce their premium.

I would give every citizen $1000 that went into an individual HSA. This would be used to help pay insurance costs and basic healthcare. That's 350 billion, annually. This is a number that could be manipulated based on the data. I started with $1000 as a random number, but I am not sure what number would be optimal. This would primarily be used to cover basic healthcare and rollover each year. This would allow people who were healthy to form a surplus of money and give them flexibility in their premiums. I would also consider adding an ability for communities to pool money, though that adds a layer of complexity that might cause problems (but could also help drive down insurance costs).

I would not mandate health coverage, but I would allow insurance companies the right to deny pre-existing conditions. This threat, combined with the HSA, should be enough incentive for a majority of Americans to pay down insurance. To further drive down insurance costs, I would open up competition across state borders. Also, I'd give companies a tax credit based on how much they help with their employees premiums.

People born with major disabilities would have the option of enrolling in medicare/medicaid. The NHE is up to 3.5 trillion, and I believe my plan, only using 300 billion of that, would take a lot of people off medicaid and put them into this new system. Medicare costs wouldn't change.

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