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Reforms - Coggle Diagram

- - - - health insurers: buying health plans
      - health systems: reducing charity care costs
      - pharmaceutical firms: buying drugs
      - Medical device firms: using devices
  - - - Congress cannot fine but can TAX w individual mandate
- - - - individual mandate
      - cover all costs of expansion
      - Reinstate ACA cost control provisions: cadillac tax and independent payment advisory board
    - - US can negotiate drug prices starting 2026
      - pharmaceutical firms penalized if drug prices faster than inflation
      - caps on out of pocket payments
    - - indenticall medicare pllan
      - tax raise for high income
      - Commonwealth fund: 5% cut in spending of coverage to legal citizens; 18% increase if all citizens
      - challenge: lose choice; oppose wait; gov has too much power
      - supplemental private insurance feasible; but equity issues
    - - medicare option for everyone
      - medicare popular due to low provider reimbursement
      - commonwealth fund estimates: extend insurance; no change in spending
    - - Catastrophic insurance
        
        everyone buy catastrophic iinsurancce with 50k deductible
        
        varies by age
        
        gov subsidizes for low income
      - personal health savings account
        
        pay for medical care under catastrophic pla deductible
        
        money would be re directed to person's own account
        
        people borrow against future HSA contributions
        
        gov makes HSA contribution for low income; voucher for preventative care;
        
        patients motivate physicians and hospitals to post prices, reduce prices, and improve quality
- - - - Values
        
        trust in gov
        
        distrust consumer choices
      - Cost Containment
        
        fee and price controls
        
        gov negotiation
      - Redistribution
        
        expand public program
        
        expand eligibility
        
        single payer program
    - - Values
        
        trust in market competition
        
        need financial incentive
        
        consumer sovereignty
      - Cost Containment
        
        markets and competition
        
        eliminate state mandates
      - Redistribution
        
        refundable tax credits
        
        income related public programs
        
        cap amount of health insurance premiums that are tax exempt