Dr. Rice developed the plan while the Affordable Care Act was still being debated in Congress. He said he has achieved the objectives of maximizing quality and access to care while minimizing costs and complexity.
Under Dr. Rice’s plan, everyone would pay into a health insurance system through flat income and sales taxes, which would be held in a state or regional health fund. Each person would be allocated a healthcare budget based on their likely health needs — for example, $500,000 for a healthy young adult over the course of his or her life.
Dr. Rice said patients would incur a monetary penalty if they skipped preventative care backed by evidence, such as vaccines, mammograms and colonoscopies. Patients would receive a bonus for comparison shopping for non-emergency care, forcing physicians to lower their prices to compete, he said.
A state board would determine which procedures should be covered and determine whether prices set by physicians and hospitals were reasonable. Dr. Rice said while physicians would probably object to price competition, increasing healthcare costs necessitate a drastic change.
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