Good for consumers, providers and employers

A proposal to replace all health care financing
systems in the United States with one that:

• Provides health care security for all
• Offers real choice for both consumers and providers
• Decreases overall health care costs
• Reduces managed care
• Frees employers from responsibility for health care
• Lowers employers’ expenses

Advantages for Consumers

You Always Have Two Options
The Copay Option and The Independent Option
You can 
• use either Option any time 
• switch Options at any time
• use different Options for different providers

Copay Option Independent Option
Similar to Medicare but also includes a pharmacy benefit and nursing home care 
Pays a base amount to Independent Option providers, and you pay the gap between the base payment and the providers’ charges.

• First visit/year has no copay
• Small copay for most visits
• Medication costs limited to an affordable gap payment
• No charges for patients with low incomes or expensive catastrophic illnesses 
• Choice of quality providers because financial incentives assure that providers will choose to serve Copay Option patients 60% of the time.

• Greater choice of providers
• Providers may offer increased benefits, such as immediate appointments, longer visits.
• Gap payments are affordable because financial incentives keep gap payments low so that patients will choose to see an Independent provider nearly half the time.
Additional Advantages for Consumers Real health care security:
You are always covered by both options regardless of employment.

 Emergency room care: Always available on the low-cost Copay Option.

 Gap payments lower the total cost of health care: Pharmaceutical companies and providers will lower their prices to compete for customers who want a smaller gap payment.

 Balanced Choice costs less than people already spend on health care: Because Balanced Choice lowers costs and makes the health insurance industry obsolete and unnecessary, it saves enough money to more than pay for the added benefits.Advantages for Providers• Choice of which Option to use when accepting each new patient
• Ability to transfer patients from one Option to another with adequate notice
• Freedom to raise rates for Independent Option patients
• Assurance that treatment for all patients is covered 
• Relief from administrative complexity and bookkeeping of multiple types of insurance
• Great reduction in managed care
• Assurance that both Options reimburse an appropriate amount, based on the market, not the government
• Prompt reliable payment and reduced write-off costsAdvantages for Employers• Improves employers’ ability to compete in the global marketplace because there is no longer a responsibility to provide health care
• Lowers the overall amount employers contribute to health care costs
• Eliminates employers’ responsibility for workers’ compensation or auto accident related health care costs
• Protects employers from future increases in health care costs