Minimal Requirements for Mandatory, Universal Health Care Insurance

The discussion of national health care reform has not mentioned (in what I have read) whether a number of issues are being discussed which concern me.  I list the following items to bring them some attention.

Mandatory, universal health care insurance should include coverage for all persons of:

• insurance portability (eliminate COBRA, focus benefits on the person and/or family and/or household, have no difference in payment schedule whether employed or not)
• nondeniability (should be extended to the items below)
• hospice care (for patients whose care requires professional skills and resources that family assisted living cannot provide)
• dental care
• vision care
• alternative medicine (i.e., complementary medicine including naturopathy and homeopathy)
• national licensing of alternative medical doctors
• national licensing of conventional medical doctors
• mental health (behavior health) care, also involving 
  • restoration and expansion of dedicated, residental, mental health hospitals
    • This program would require modification of legal rights of mentally ill persons to "choose" not to be hospitalized
  • restriction of community-based mental health care to supporting care provided by residential, mental health hospitals 
  • moving mentally ill persons (such as dual-diagnosis drug offenders) from prisons to dedicated mental health hospitals
• shift from an industrial medicine paradign to primary care medicine, focussed on continuity of care, preventive medicine, lifestyle issues, and whole life well-being
• folding Medicaid programs into the national mandatory program with provision of realistic doctors' fee schedules for the low-income and welfare persons
• maintenance of consumer choice for benefit schedule (for instance, not all families need hospice care benefits)
• deductibles and or co-pays for all persons--everyone should pay something out of pocket for their medical care and medical insurance; no one should get it "free" from taxpayers unless everyone does (and I oppose "free" for all as medical communism). 

I would prefer reforms based upon private insurance based on:

• risk pools without a public option, including high risk and low-income or welfare pools into which all insurance carriers would contribute
• policy distinction between everyday medical care and catastrophic medical care.  

If a public insurance option is inevitable, as it appears to be, I would prefer that the inclusion of the public insurance option be structured so as not to force out private insurance.

I have blogged about some of these issues here.