Jim Hartung

For over 80 years, systems engineering has helped America
lead in science, technology, industry, and business.

Now, systems engineering can help us address our most difficult
social, economic, envronmental, and political problems.

Question 3

Question 3: The book Rational Tax Reform uses SE to develop a new approach for universal health care, “Medicare Choice”. What are its key features?

Answer: The key features of Medicare Choice are (1) anyone who wants Medicare will receive it, and (2) anyone who opts out will receive premium support instead (for any other health care insurance they choose). Medicare Choice would be operated like a business with a firm cost target, and funded with a value-added tax of 13%.

Additional Information: The figure below shows the Medicare Choice cost target and current health care expenditures in the United States and in other major developed countries. The Medicare Choice cost target is 14% of Gross Domestic Product. This is about halfway between current U.S. health care expenditures and health care expenditures in other developed countries (which all provide universal health care). The book, Rational Tax Reform, describes in detail how this cost target can be achieved.