Citizens' Healthcare Choices Act of 2017

Federal Petition Citizens Healthcare Choices Act of 2017
The Federal Petition Citizens Healthcare Choices Act of 2017 is the response to the inaction of an idle Congress to repeal the failing Affordable Care Act or to establish for the American Citizenry viable alternatives to the ever spiraling costs of health insurance in the United States. The failure to establish viable cost containment measures which afford the citizenry broad choices in heath insurance care savings, broad choices in purchase options, fair broader international markets, interstate commerce of healthcare insurance and healthcare products and services, fair defined coverage for various age groups and fair business environments for competitive markets to thrive . We the undersigned citizenry mandate action of the United States Congress and President of the United States to reform existing law and establish new legislation and law(s) which meet or exceed the following objectives:
Summary :
1. Concierge medicine expansion to include both primary and specialty care.
2. County group insurance pools ( low income ) with subsidies defined below specified income levels.
3. Social club membership group rate plans as optional insurance coverage.
4. International trusted sources of health insurers cleared via Department of HHS to operate in US markets .
5. Interstate open markets for health insurance.
6. Open pricing to the public domain of all coverage and costs on both foreign and domestic insurance plans.
7. All international insurers must have pricing in US currency.
8. Health Savings Accounts with greater tax deductions for high deductable coverage.
9. Hybrid plan options based upon group/pool rate structure and the income level of the insured.
10. Health care billing defined by a multiple of 15% of personal income not to exceed 5 years of repayment.
11.. Healthcare plans offered must satisfy the following four categories: ages newborn to 36 months, age 36 months to 18 years, age 18 years to 55 years, age 55 years and older.
12. Optional catastrophic coverage options will apply to all policies age newborn to 36 months, 36 months to age 18 years, over age 18 years to age 55 years.
13. Catastrophic coverage will be mandatory on all policies age 55 years and older without penalty of increased deduction or policy cost.
14. Establish Medicare part D tiers into a same drug dose accepted HHS National Formulary through sealed bids annually as both trusted foreign and domestic sources . Prices are fixed and tiers assigned by consumer cost from lowest to highest price. Low priced tiers will have first drug of choice priority. Second and third tiers will be alternate choice priority. Drug scarcity will require HHS investigation as a medication error in the National Formulary availability and distribution model.

Federal Petition: Citizens Healthcare Choices Act of 2017

Part 1: Repeal of the Affordable Care Act
Replace through Enactment of New legislation under the guidelines outlined in the Citizens Healthcare Act of 2017.
1. Full Repeal of the Patient Protection and Affordable Care Act
2. Replacement by enactment of all parts of the Citizens Healthcare Act of 2017
Part 2: Citizens Healthcare Choices Act of 2017
Summary of Care
Diagnosis rules

1. All persons seeking emergency medical services must be medically evaluated based upon the physician(s) attending understanding of a patient complaint. The patient will be informed of their state of wellness as either non life threatening at the current time, potentially life threatening condition and requires further medical care, is urgent and a potentially changing medical condition requiring hospitalization, a condition requiring more comprehensive therapy, requiring treatment or surgical intervention(s), and/or any combination of the aforementioned potential outcomes.
2. Patients have a right to referral for non life threatening or potentially life threatening condition(s) which may require further care.
3. Patients admitted, at minimum, will receive a physical assessment daily for each 24 hours of hospitalization. Within a week, the patient will receive a Summary of Care from a designated hospitalist, attending physician, designated Physician Assistant or Nurse Practitioner, listing all tests, procedures, surgeries, therapies, medications, side effects, nursing and medical goals, intended and possible benefits or adverse outcomes. The patient will be offered an informed consent of the Summary of Care as a legal document which lists all agreed upon medical care and grants permission to proceed.
4. Upon admission or first patient contact patients will be evaluated and given a Summary of Care. A physician will determine a patient diagnosis and that they are able to comprehend all medical care to a satisfactory degree. The criteria is to include the determination of the patient(s) ability to interpret their goals, therapies, medical tests, laboratory tests, surgeries, Summary of Care, all outcomes and their overall plan of care.
5. Life saving measures are defined as all medical therapies, tests, procedures, and medications used to restore heart rate, respiration, and pulse.

Part 3: Citizens Healthcare Choices Act of 2017
Obligations of the insurer
Outline of Care

1. Honor all payments within the insurance policy regardless of defined Outline of Care for the insured for any persons covered and medically diagnosed for all emergency life saving therapies, tests, procedures, and medications used to restore heart rate, respirations, and pulse.
2. Honor all payments within the defined insurance policy Outline of Care for the medically determined Summary of Care for all policy insured persons.
3. Insurance coverage may not exclude payment for medical coverage of Summary of Care for any pre-existing medical condition.
4. A comprehensive Summary of Care and itemized list of provided services will be delivered to the insurer upon request.
5. The Summary of an Outline of Care will list in comprehensive language for the insured coverage for all pre existing conditions or acquired illness, injury, hospitalization, tests, procedures, therapies, evaluations, preventative medicine, follow up care and monitoring of wellness and all progress towards wellness.
6. Physicians attending (or their designated credentialed representative) will upon each medical examination, issue a Conclusion of Evaluation statement(s) as either: Care Complete, Required Continuation of Care, Follow Up Care, Chronic Condition of Care-Eligible, Long Term Care-Eligible, Rehabilitation-Eligible, ETOH/Substance addiction or Dependency -Eligible, Homeless with or Without Mental Capacity-Eligible, Mental Health-Eligible, Palliative Care-Eligible, Hospice-Eligible, Condition With Terminal-Eligible.

Part 4: Citizens Healthcare Choices Act of 2017

Outline of Care
1. The insurer will define a mandatory Outline of Care in language the insured can comprehend to provide health care coverage for pregnant female patients to include the following: prenatal care, birth, well baby care to age 36 months, post partum care, elective vaccines and Well Child Care from 36 months to 18 years.
2. The insurer will define a mandatory Outline of Care in language the insured can comprehend to provide health care coverage for persons 18 years to age 55. A mandatory exception clause will accompany all health insurance policies for catastrophic disease or injury resulting in a Long Term Care- Eligible, Palliative Care- Eligible, or Hospice Care- Eligible evaluation and their full health care coverage.

3. The insurer will define a mandatory Outline of Care in language the insured can comprehend to provide health care coverage for persons 55 years of age and older. Mandatory Outline of Care to include preventative Cancer Screening, other preventative screenings, Colonoscopy, Pap smears, Breast exams, and Mammograms. A mandatory exception clause will accompany all health insurance policies for catastrophic disease or injury resulting in a Long Term Care-Eligible, Palliative Care-Eligible, Hospice Care-Eligible evaluation and their full health care coverage.

4. Outline of Care will list insurance coverage of all diseases, therapies, treatments, evaluations, testing, laboratory work, MRI, CAT SCAN, Ultrasound, Nuclear Medicine, and Xrays. Include cardiac monitoring and evaluation, glucose monitoring, health care education, all radiation cancer therapy, chemotherapy, and FDA approved medicinal treatments. The insurer will provide coverage for the following age related diagnoses : Chronic Continuation of Care, Conclusion of Evaluation as either Care Complete or Required Continuation of Care, Condition of Care Required Long Term Care Eligible, Rehabilitation Eligible, Mental Health Eligible, Palliative Care Eligible, Hospice Eligible, Condition with Terminal Diagnosis. Outline of Care will list healthcare coverage for specified Mental Health Eligible, Homeless With or Without Mental Capacity Eligible, ETOH and Rehabilitation Eligible, and ETOH and Substance Addiction or Dependency Eligible.

Part 5: Citizens Healthcare Choices Act of 2017
Expansion of Care
Interstate Purchase Options
Foreign Purchase Options
Monopoly Protections

1. The insurer may provide the insured, newborn to any age group(s), an optional Expansion of Care that would include healthcare insurance coverage for catastrophic events which will provide a detailed Outline of Care coverage equivalent to include the following physician diagnoses: Individual or Group Catastrophic Heath Crisis, Chronic Continuation of Care statement, Conclusion of Evaluation as either Care Complete or Required Continuation of Care, Chronic Condition of Care Required, Long Term Care Eligible, Rehabilitation Eligible, Mental Health Eligible, Palliative Care Eligible, Hospice Eligible Condition With a Terminal Diagnosis.
2. In the interest of Cost Control and Equitable Market Competition, all laws restricting the
Insurer sale or the insured restriction of purchase of healthcare insurance between the several states shall be abolished allowing for full interstate insurance markets to evolve.
3. In the interest of Cost Control and Equitable Market Competition all healthcare insurance providers will have open pricing and an open Outline of Care available to the public domain.
4. Monopoly protection will be enacted so that small business insurers can compete with large corporate insurers with offered potential healthcare insurance pricing and Outlines of Care and operate all business transactions within all available open markets.
5. In the interest of Cost Control and Equitable Markets all healthcare insurance providers may offer policies that provide Outline of Care for defined age groups and income levels.
6. Foreign insurance providers may participate in United States markets and must follow all fore-mentioned business practices and laws. All foreign healthcare insurance business transactions will be in US currency.
7. Foreign insurance providers will meet or exceed US Department of HHS standards of minimum coverage for all age and income groups.
8. Foreign produced medications will meet or exceed FDA approved USA equivalent medication(s) which will be made available for sale through established USA pharmacy and drug distribution systems both governmental and private.
9. All foreign produced medications will be through HHS and FDA trusted sources with open listed prices to the public domain.
10. All foreign produced medications will be priced in US currency.

Part 6: Citizens Healthcare Choices Act 2017

Concierge Medical Practice
Hybrid Concierge Medical Practice
Group Care Medical Practice

1. Concierge Medical Practice is a private contract for primary care medical services offered by a physician or defined physician group when an agreed upon offered services is provided through a single monthly fee or rate.
2. Hybrid Concierge Medical Practice is a private contract for primary care medical services offered by a physician or defined physician group when an agreed upon offered service(s) is provided through a single monthly fee or rate and which is supplemented by additional insurance coverage for services not provided by primary care.
3. Group Care Medical Practice is defined as any two or more physicians establishing a medical practice within the same facility or group of facilities offering same services to the same group of patients.

Part 7: Citizens Healthcare Choices Act of 2017
Medicare Part A changes
1. Medicare coverage will apply payments secondary to supplemental insurance payments for patients covered by both or alternate supplemental insurance.
2. Patients that have only Medicare Part A as their only insurance plan will be billed all primary diagnosis and all subsequent additional diagnosis related costs by a scale that does not exceed their annual gross income per their last reported taxable income not to exceed 15% of their gross income over 5 years for all those necessary procedures per professionally medical decided healthcare goals.
3. Recognizing advancement and refining of medical and nursing practices, an Annual Review of medical necessary coverage may be submitted to Congress by the Secretary of Health and Human Services to provide timely and best practices coverage for all Medicare patients.
4. Hospital coverage begins upon admission including all associated costs related to admitting diagnosis.

Part 8: Citizens Healthcare Choices Act of 2017
Medicare Part B no changes
Medicare Part C Medicare Advantage plans no changes

Part 9 Citizens Healthcare Choices Act of 2017
Medicare Part D changes
Establish Medicare part D tiers into same drug dose accepted National Formulary through sealed bids annually as both trusted foreign and domestic sources. Prices are fixed and tiers assigned by consumer cost from lowest to highest price. Low priced tiers will have first drug of choice priority. Second and third tiers will be alternate choice priority. Drug scarcity will require HHS investigation as a medication error in the National Formulary availability and distribution model.
Part 10 Citizens Healthcare Act of 2017
Foreign produced medication(s) will be allowed into the USA from trusted sources determined by FDA for sale and distribution through existing drug and pharmacy outlets and markets. All medication will be priced in US currency.

Part 11: Citizens Healthcare Choices Act of 2017
Heath Savings Accounts

It is recommended there be no limit on tax deductions for high deductable health insurance. Persons applying savings into these accounts should not be penalized for doing so. Monies applied to these accounts can be accessed for medical billing purposes, payments to deductibles or medical bills. Accounts may be closed and or funds accessed by account holder(s) at anytime for any reason. The following account structures will be included in the final legislation as viable savings models for healthcare:
Health Savings Account HSA
Flex Savings Accounts FSA
Health Reimbursement Accounts HRA
Cafeteria Plans
Medical FSA
Health FSA

Part 12: Citizens Healthcare Choices Act of 2017
County managed local community group rate insurance
Group rate insurance pools based upon income and participation.
Counties may organize for their client/patient participation in the establishment of group rate private health insurance pools for Medicare A, B, C, D and personal health coverage. Counties will screen group health insurance to create low rate health insurance offerings based upon citizen income.