The first thing that would be implemented through my optimal healthcare reform plan would be to make employer-based insurance mandatory. Working individuals will be eligible for health insurance coverage and will not be able to withdraw without proof of other insurance. Employer-based insurance will become more affordable for both employers and employees through a tax credit incentive. Employers will be able to choose which plans to provide to employees through the use of a health exchange. Employees will have no fewer than two plan options available. Medicaid is often confused with insurance exclusively for the poor. This is not the case as many middle-income families rely on this insurance. For this reason, the program will be expanded to include more middle-income families who cannot afford insurance premiums. Unlike the current program, all enrollees will be required to pay some form of premium based on a sliding fee scale. This will enable these individuals to make some form of contribution to the healthcare sector. Through this healthcare reform plan, a mandate will be given that will make providers more involved in the care of their patients. Measures will be taken to help increase the number of doctors in areas experiencing shortages, along with incentives for doctors to become family doctors. Preventative care will be the focus, so annual checkups and routine procedures will be covered by all insurances. A coordination path will be created in which doctors, nurses and other providers will work effectively and efficiently in teams, analyzing outcomes and care processes to rid the system of waste (Cortese & Korsmo, 2009). In order to make insurance accessible to all Even Americans with an average card limit will not be subject to a surcharge. Through this plan, any individual earning an adjusted gross income of $500,000 or $1 million will jointly incur a 5 percent surcharge. This will help generate funds for the plan and at the same time help create a new balance. All individuals are expected to contribute to the health plan, but they will do so in different ways. No person meeting these requirements will be exempt from this surcharge. Pharmaceutical companies and insurance companies will also be subject to increased taxes. These companies currently generate a large amount of profits. For this reason they should be taxed and the money received should be put back into the healthcare system. This will also help regulate the amount of profits they receive, thus ensuring that people are not overcharged for their health insurance coverage.