The problem with all the varieties of universal healthcare that I have heard are threefold:

1. They create disparities in market pricing which inevitably prevent innovation funding from big companies (R&D is cut first usually) and often decrease certain comparative advantages/disadvantages to the point of companies going out of business or significantly downsizing resources.

2. Only low income people benefit from the plans and usually middle and upper class get burned with either higher taxes, higher premiums, or worse plan benefits.

3. It will raise the public debt by something like double what it is now.

One idea that I had could definitely benefit the aforementioned 3 points without taking away from the good it would do in replacing terrible Medicaid and Medicare programs that currently exist. Psychologically speaking, people learn best with incentive-based training, meaning a reward for every favor. So, why not propose a tax incentive to large hospital conglomerate facilities and the big name healthcare brand names (like Johnson and Johnson). In exchange for this tax incentive (from an industry that doesn’t provide too much tax income in the first place compared to commodities, infrastructure, financials, etc), hospitals will setup low co-payment based clinics for US citizens who are in need of hospitalization, care or meds. These clinics could provide training for new interns and accept the usual philanthropy and also create an environment where phase 3 drug tests could exist for necessary conditions. I’m definitely not saying that low income people should bare the brunt of terrible staff and experimental drugs, so there will still be resident doctors there, professional staff, non-profit staff, etc and experimental drugs could only be used on those patients who approve it.

Co-payments would be low, as if you had insurance, and overnight visits would be at motel housing rates + food. Invasive procedures would be 4-tiered just as the current insurance companies do for drug coverage, except that the tiers would be determined from least to most cost/risk surgery options. These prices, too, would be subsidized by a co-payment fixed at an average ratio to what an average salaried person would pay for this surgery with an average priced insurance plan in an average hospital (yes, this means statistically priced).

The contractual agreement between hospital / healthcare companies and the government would be % based categorized into various types such as physical, invasive (tier 1-4), ER, etc for each of the patients as well as the number of people accepted into phase 3 drug experimentation programs. An agreed upon pricing algorithm would take into consideration all of these factors along with some external factors to come up with necessary tax break (or subsidy) for each company.

In this way, you keep R&D for new innovative drugs alive along with allowing low-income people to be hospitalized without significantly taking away from middle and upper class income. In addition, it keeps pricing competitive with market price because the co-payment is priced well compared to the income of the person. Below a certain income, you would qualify for this type of help and above it, you would have to pay for private health insurance.

The one thing people will say is: “Why am I paying for someone else’s insurance? I’m working hard for my money.” One must note that the services in these clinics are not going to be top-of-the-line doctors (unless they are philanthropists and/or non-profit doctors) and the meds will most likely be generic.

Furthermore, instead of subsidizing all costs and regulating the pay to doctors, facilities and drug makers, you could change the growth process like described above. For example, interns mostly start out in these clinics receive slightly better compensation than interns that start off in nice hospitals. These interns become trained by existing residents/non-profit staff, and eventually become residents themselves. From this point, their pay is still averaged higher than those residents in hospitals. Residents can transfer to other hospitals if they want but the pay might not be as good (depending upon what the hospital will want to pay). Anyway, you get the picture…

Finally, the government budget deficit will be a lot smaller because instead of paying for each person’s healthcare, we’re essentially using a trickle-down effect to flow down specific rates to low income / senior citizen people. We let the multiplier effect and market pricing do a little more of the work instead of directly covering low-income people and we don’t lose out on the large growth from the middle and upper class as well as corporations that can keep our economy growing.

I think this is a much better avenue that takes the middle road to finding a much more viable solution for everyone.