All citizens will receive the same benefits of the Basic Plan. Those above poverty line, through payroll deductions or taxes, will pay the same monthly premiums to HHS. The SUPPLEMENTAL plan allows the option of paying for non-essential care, either out of pocket or by purchasing policies from private insurance companies that provide amenities not covered in the Basic Plan.
Benefits offered by private insurance plans will not be dictated or restricted by federal or state laws. There will be no obligations to cover preexisting conditions, gender or age specific services. Only federal requirements of insurers will be for solvency and for clear and statement of services provided.
The Supplemental Plan Investment
So liberated in a free market, America’s private health insurance industry should flourish. The Supplemental Plan’s collective private investment may be greater than the government’s investment in the Basic Plan. There will be a predictable demand for policies that provide quick access to enrollees’ chosen specialists, hospitals, procedures and drugs. For instance, a private insurer might advertise and sell policies that cover cosmetic and bariatric surgery, acupuncture, faith healing or any service that does not endanger the public. More commonly, they will reserve places on surgical waiting lists for customers who want expeditious joint prostheses, spine fusions, elective C-sections, etc., and those willing to pay for luxury accommodations.
Some may complain that it is unjust and un-American to provide health care with different levels of freedom and comfort for the poor and the wealthy. On the contrary, it is consistent with American justice that those who have earned or been given more wealth have more latitude in using and expressing it – whether in choices of fine wine, cars or houses. Equality in health care is justly limited to necessity, safety and effectiveness.
A person with a private supplemental policy will first seek a desired procedure by referral from his or her primary care provider (PCP). If the procedure is one approved by HHS, the PCP will recommend its approval. When the procedure is performed, the provider will first bill and be paid by HHS its Basic plan allowance. The insurance company is then billed for the supplemental balance.