NCPA - National Center for Policy Analysis

"For The Good Of The Many," Doctors Propose Universal Program

January 19, 2001

The American Academy of Family Physicians says that "...the current operation of individual insurance plans and the general U.S. ethic of individualism run strongly counter to the philosophy of 'universal good.'" Therefore, their draft plan to guarantee free basic health services for all individuals in the United States would move away from the private insurance model.

For coverage " achieve universality would almost certainly require, for the good of the many, that certain individuals be constrained to behave in ways that did not necessarily meet their own narrow individual health or economic interests."

  • The proposal calls for the establishment of a "public/private oversight entity" similar to the Federal Reserve Board to determine which medical services would qualify as "basic" and thus be included in the coverage plan.
  • The plan would guarantee coverage of "basic medical services" to all people living in the U.S., including illegal immigrants, without deductibles or co-payments.
  • It would also cover "catastrophic" levels of medical care, with no individual paying more than $10,000 per year out of pocket, depending on their income.
  • Employers or individuals would need to purchase private insurance for services falling between basic and catastrophic care.

The draft plan calls for federal and state medical programs, such as Medicaid, Children's Health Insurance (CHIP) and Veterans Affairs programs, to be left in place.

Funding for the basic coverage would come from a payroll tax of 3 percent for employers and 1.5 percent for employees. Although the funds would be collected by the public/private oversight board, each state would receive funds on a per-capita basis and would be given "flexibility" in determining how to administer the basic coverage plan.

Source: "A Strategy to Provide Health Care Coverage for All: A Proposal for Discussion and Comment," American Academy of Family Physicians, January 11, 2001.


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