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FEATURE
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Universal Catastrophic Coverage: Will it T
Work?
Dr. James Veltmeyer is a prominent La Jolla physician voted “Top Doctor” in San Diego County in 2012, 2014, 2016 and 2017. Dr. Veltmeyer can be reached at dr.jamesveltmeyer@yahoo.com 18
he recent decision by Texas federal judge Reed O’Connor striking down the socalled “Affordable Care Act” ( aka “Obamacare” ) offers Washington policymakers of both parties a unique opportunity to revisit the entire healthcare debate and craft a new plan that will actually improve people’s lives while controlling costs. We should look back several decades for a possible solution. In 1971, Harvard Professor Martin Feldstein who later went on to be President Reagan’s chief economic adviser, proposed a possible way out of America’s seemingly intractable health care dilemma. It was called Universal Catastrophic Coverage (UCC ) and its objective was to provide all people with health care coverage when they really need it, in life-threatening emergencies or major bankruptcyinducing medical events, like cancer, heart disease, and newborns with genetic defects. UCC was not intended to cover the costs of routine or preventive care, like annual checkups, basic blood tests, sore throats, or runny noses. No less than the great University of Chicago and Nobel Prize-winning free market economist Milton Friedman endorsed UCC in 2004 in an article he wrote for the Hoover Institution. Under one version of Universal Catastrophic Coverage, all individuals not eligible for Medicare or Medicaid would receive a uniform, high-deductible catastrophic health insurance policy from a private company. The level of the deductible would be based on family income. The higher one’s income, the higher the deductible. UCC would protect people from financial ruin in case of a devastating health care event, while allowing individuals to purchase “supplemental” insurance ( such as Medicare recipients do ) to pay for routine medical expenses. They could also rely on their Health Savings Accounts or on a monthly membership in a direct primary care ( DPC ) provider practice. The estimated cost of such a universal catastrophic policy: about $2,000 a year or $160 per month. The vast majority of individuals would pay for this themselves, potentially using savings from the elimination of employer-paid coverage and higher wages. Those who cannot afford this amount would receive a voucher from the government to pay for it. Membership in a DPC practice would permit individuals to contract with a direct primary care physician of their choice for a low monthly fee to access basic medical care, including 24/7 access to the doctor through unlimited office visits, e-mail and text, lab tests, x-rays, and even some medications. There would be no copays or deductibles. The monthly fees might vary, but are normally in the range of $50 to $100 per month per patient. Obviously, older patients who need to see their doctor more often would be charged at the higher end of that scale and younger people at the lower end. Children are even less, sometimes as low as $10 or $20 per month. Patients seeing their direct primary care provider on a regular basis ( as there is no per office visit charge but only the monthly fee ) are less likely to be hospitalized, have surgeries or be admitted to the ER. Doctors are free to spend additional time with their patients FEBRUARY 2019
Tampa Bay Wellness