Editor’s note: This commentary is by Dawn Griffis, a retired nurse practitioner who trained in England under the National Health Service and who has nursed all over the United States since 1965. She has been involved with the Vermont Workers’ Center and Physicians for a National Health Program. She is the author of “Living and Nursing in America — The Way It Is and Was,” and lives in White River Junction.
The United States is the only industrialized country that does not offer its citizens a true universal health care package. Because of this, health care cost to the federal government and each state is higher than in every other industrialized country. It is also crippling the citizens financially, causing many to go into financial ruin, or they are not receiving vital health care treatments. This in turn leads to higher final costs, due to not being treated early, before it becomes a more serious problem costing all a huge amount of money.
Understandably all Americans recognize the problem, but are fearful and distrusting that any changes will not make matters even worse. Obamacare is a start, but it is far from what was originally proposed and needed. Political differences and one-upmanship need to be set aside for the good of the country, and its citizens; the need is to work together to make it workable for all. Put into place serious and severe penalties for any that abuses or steals from it in anyway, whether it is a company or individual. It is vital to have from the start a stringent auditing system for all branches and individuals.
This will be cost effective for all citizens whatever their role in life is, whether they are an employer, employee, retiree, or independently wealthy.
A way to universal health care, pension and benefits for everyone: via universal insurance income deduction payments.
Universal Insurance Center would be known as UIC
1. Everyone in, no one out – with no exceptions
2. Everyone is covered equally — no exceptions
3. Paid through income deductions to UIC.
4. More than just health care is covered, see below.
What is covered?
1. Health care, dental, prescriptions and treatments from birth to death.
2. Sick benefits (indefinite, or until able to return to work) with doctor’s certificate. First three days no pay after 12 days, first three days will be paid.
3. Disability benefits. With doctor’s certificate, no exceptions.
4. Worker’s comp.
5. Unemployment benefits.
6. Maternity/paternity benefits, six months total can be split between mother and father.
7. Retirement pension, from age 65 with realistic annual cost of living increases.
UIC will be for receiving and distribution of benefits, health care, pensions. This is to be located in any federal facility, preferably not on the East or West coast. The money will be distributed to the following departments preferably with UIC and the three departments all located in the same place.
UIC will receive all the monies, and will be responsible for distributing the money to the relevant departments. There will be three departments:
1. Department of Benefit (DB).
2. Department of Healthcare (DH)
3. Department of Pensions (DP).
Each department will receive money to distribute appropriately according to predetermined budget needs submitted by each entity. This will include all salaries including all operating costs.
Department of Benefits: They would be responsible for unemployment, sick leave, maternity/paternity leave, worker’s comp, and disabilities.
Department of Healthcare. Would cover all hospitals, clinics, medical, dental, home care, prescriptions and treatments.
Department of Pensions. Would cover all pensions what is now known as Social Security pensions.
For extra needs such as new construction, major repairs and latest equipment would be handled in a separate budget by each department.
Each of these three departments will distribute money to different districts located in each state. Small states or states with low population would have one district office; large or heavily populated states would have two or more district offices. There would be a district office for each of the different departments listed above. None of the federal or state governments can touch any of this money. All money that comes into UIC is only to be used by the center to go to the departments and districts mentioned to be used as designated. It is also to cover costs of their salaries and buildings.
How is it paid for?
• Payroll employer/employee deductions to the UIC.
• Self employed income deduction to the UIC.
• Independently wealthy pay according to schedule — UIC.
All money that is already in the different coffers will be distributed to each of the departments above; e.g. Social Security to DP, Medicare/Medicaid to DH, all benefits money to DB, to be in secured holdings that cannot be touched by any other government whether federal or state.
How it is now
Currently, normal deductions for any benefits come from payroll checks. Employer/employee pays deductions for Social Security, Medicare and health insurance. Not everyone has health insurance, and not everyone’s health insurance is equal, plus many have very high deductibles. In addition employers pay for worker’s comp, and pay for sick time off, if it is part of the employees benefit package, usually for a very limited time.
How can you and/or the government figure out how this would work? It is not that difficult. It can be figured out if it would be cost effective for you, no matter which category you fit under, it is explained below.
What you pay now is where we need to start:
Employees/independently wealthy
Add what is paid out of each paycheck to Social Security, Medicare and health insurance.
Allow for deductible payments to insurance companies, co-pay etc.
Medication and treatment costs.
Allow for when you are ill and all sick pay has been used up, if you even have that benefit.
Once you have that total you have what your current expenses are.
Employer and self employed
Add what you pay as part of your employees deductibles e.g. Social Security, Medicare and health insurance.
Add what your cost is for worker’s comp for all your employees.
Add what you have to pay towards unemployment benefits.
Add what you have to pay to cover sick benefits.
Once you have that total you have what your current expenses are.
Now how to pay for it through UI: this is very simplified:
The wealthy will do this differently and will be explained at the end.
Employee
Take your monthly income before deductions.
Deduct a preset figure that is considered minimum needed or considered poverty level income: e.g. $25,000 for single person.
A scale will be set to allow for families of two or more.
Then a pre-determined percentage of what is remaining will be the only deduction to pay for all the benefits above.
The balance of the paycheck, anything above, the above deductions is used to calculate amount liable for income tax according to size of family.
People that earn over a pre-determined amount that has been set as a cap, after all the above have been deducted will pay 1 percent annually above the cap to the UIC example: if an annual amount of $100,000 is set as a cap after all deductions has been applied then #7 applies.
If they earn over the cap annually, they would pay 1 percent on anything over the cap.
See sample below.
Employer
Would match what the employee paid above fitting into same scale as employee, but at a small additional percentage point more; see #4 above, the employer would pay 1-2 percent more than the employee to cover for workers’ comp, unemployment, sick pay, and maternity/paternity benefits.
The employer would exactly match the 1 percent as shown above in #6.
The employer does NOT have to pay for the sick pay as they do now, that will be paid by the Department of Benefits. If an employee is out sick for an extended period of time, or on maternity/paternity leave, they can hire a replacement in a temporary status, with same benefits and commitments as the regular employee. This way it does not compromise your business operation.
Independently wealthy:
The same as 1 through 7 above to a cap of $5,000,000.
Above that number .5 percent above cap to $25,000,000.
Above that number .25 percent above cap to $50,000,000.
Above that no deductions.
Employee sample: remember just a sample and shown for a single person!
Earn annually:
A single person less than $25,000 pay nothing, but will be entitled to full benefits, with all the required certificates if unable to work.
For families of two or more a separate scale will be set.
Single person earning $55,000 annually:
– $25,000 deductible
= $30,000 to be used to determine amount to pay for benefits, if the amount set to be deducted from payroll was 11 percent then it would be as follows:
$30,000 x 11% = $3,300 annually or $126.69 every two weeks
If the earnings were at maximum of $100,000 then it would be:
$100,000 – 25,000 = $75,000
$75,000 x 11% = $8,250 annually or $317.31 every two weeks.
Sample of how cap, etc., works:
If the earnings were $500,000 annually then it would be as follows:
$500,000 – 25,000 = $475,000 – $75,000 = $400,000 will be at 1% annually.
$75,000 @ 11% = $8,250 annually or $317.31 every two weeks
$400,000 @ 1% = $4000 annually or $153.85 every two weeks.
For a total of $12,250 annually or $471.15 every two weeks.
The employers would be the same as samples above, up to the cap of $100,000 except the employer’s percentage would be either 12 percent or 13 percent depending on what was set.
Note: Currently not every worker full- or part-time is entitled to vacation time. Those that are, for the most part, it is very limited; most of this is because of the cost. But it is very detrimental to the employee’s health and welfare. This needs to be dealt with separately.