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  • Morning Bell: Health Care Reform We Believe In

    Yesterday the nation’s largest health insurance trade group, the America’s Health Insurance Plans (AHIP), unveiled its proposal for major reform of the U.S. health care sector. AHIP President Karen Ignagni told the Los Angeles Times, “The nation is on the eve of a national discussion about healthcare. This comes around once every generation.”

    Indeed, health care reform was a major theme in President-elect Barack Obama’s campaign. During the campaign, Obama pledged to build a health care system in which Americans can be assured of access to affordable health insurance; to use the health system that members of Congress have as a model for expanding coverage; and that Americans who already have insurance would be able to keep it and at a lower cost. These laudable themes struck a chord with Americans.

    Achieving these goals at the same time will be difficult, and some truly bad public policy ideas will have to be opposed. For example, the AHIP plan insists on a mandate forcing all Americans to buy health insurance. During the campaign, Obama wisely fought against this proposal. Heritage’s new memo to Obama, “Ensuring Access to Affordable Health Insurance,” identifies that issue, and other important elements, as part of successful health care reform:

    • Use the consumer-choice system available to members of Congress as a true model. The system Obama and other federal employees have enjoyed, the Federal Employees Health Benefits Program (FEHBP), is not like Medicare or Medicaid. It is an employment-based system with important characteristics. Its “health insurance exchange” functions like a shopping mall for plans, making it easy for families to shop each year for plans and to have portable coverage.
    • Create a level playing field of competing private plans and real choice, and do not allow a “public plan” to undermine other commitments to Americans. Obama has spoken of including a government-sponsored “public plan” as one of the competing plans in his proposed health exchange, but there is no public plan in the FEHBP — and for good reason. There can be little doubt that if the government sets the rules for competition in an exchange and also runs one of the plans, the rules will be rigged to favor the public plan. Moreover, employers who currently offer coverage could switch their workers to this plan, and millions of Americans would discover that their employers had ended their existing private coverage. That would be an unacceptable violation of Obama’s “no change” commitment. Recent estimates from the Lewin Group, a leading health econometrics firm, suggest that more than 22 million Americans would experience an unexpected change in coverage with a public plan in place.
    • Reform the tax treatment of health insurance to make it more equitable and efficient for taxpaying families. Today’s unlimited tax relief for employer-organized health insurance gives large breaks to executives and other highly paid employees but little or no relief for families without employment-based insurance or with only limited coverage at the place of work. The value of this “tax exclusion” is over $200 billion, or about 10% of all the nation’s spending on health care. The tax exclusion should be limited and the revenue used to provide tax relief for those without tax help to make coverage more affordable.
    • Use incentives, not government mandates, to foster wider coverage. In his primary fight with Hillary Clinton, Obama laid out a strong case against government mandates. He showed that mandate advocates could not identify which powers they would use to enforce a mandate and he spoke eloquently of the unfairness of forcing families to purchase coverage they couldn’t afford. Any health care reform should explore the effectiveness of a combination of automatic enrollment and financial incentives to widen private coverage, and not draw up plans for more mandates or expansions of Medicaid or other public programs.
    • Promote family control and choice through refocused employment-based coverage rather than mandating employers to offer government-defined coverage. There are large gaps in the system of employer-sponsored coverage. Many smaller firms do not offer coverage at all, and others offer coverage that many of their workers don’t want or can’t afford. The solution is not to mandate that firms offer an expensive, comprehensive plan determined by Congress or else pay a tax. That would mean one-size-fits-all coverage, while changing coverage that many workers are happy with — which Obama pledged not to do. Instead, families should be able to choose and retain their health coverage from job to job. This can be accomplished through such things as arranging payroll deductions, much like their role in arranging 401(k) retirement plans.
    • Say “no” to the Daschle Federal Health Board. Even worse than congressionally mandated benefits would be mandatory coverage designed by a powerful Federal Health Board proposed by likely Health and Human Services nominee Tom Daschle. His Federal Health Board would have enormous power over medical decisions affecting every American. This is unacceptable, and would break Obama’s pledge to give Americans choice.

    While Americans express frustration with our current health system and want action to make coverage more dependable and affordable, they also want the nation’s health system to retain important principles and features. Americans demand choice, for instance, and if they are content with the coverage they have, they do not want it disrupted. Millions of Americans voted for Obama because they believed his words meant he shared these principles. Let’s hope he keeps his pledge.

    Quick Hits:

    Posted in Ongoing Priorities [slideshow_deploy]

    20 Responses to Morning Bell: Health Care Reform We Believe In

    1. Dennis Aderholt Soci says:

      Competion is what we need in the insurance business. I think at this time people in one state can not buy insurance offered in another state, and many that have insurance can only use it in their home state. I know several persons that have traveled a great distance to seek medical care, when it was needed then. This was because their insurance was not honored in anothe state, or if it was the co-pay was beyond the persons reach. This is wrong, but then a mandated program ran by the government is not the way to go. It will be either not affordable, or will not cover what is needed with out a high co-pay. WE DO NOT NEED OR WANT SOCIALIZED MEDICINE IN THIS COUNTRY!!!!!!

    2. Natalie Mitton, Denv says:

      I am a health insurance agent. The health care system in this country is focused on the dramatic and costly, powered by the big bucks entities, AMA, FDA, and pharmaceuticals. One of the reasons health care costs less in Europe is this: a significant percent of the time doctors use less costly, effective wholistic approaches. The big $$ in this country want to shut off lower cost alternatives. Examples of money motivation abound: cholesterol myths, low fat diets fueling carb addiction and overweight and so on. Reform needs to start where the money is, not with insurance coverage. Answer: cover treatment using homeopathy, massage therapy, herbal medicine, essential oils etc.

    3. Edward Foster says:

      Employer-provided health insurance is an offshoot of WWII when wage controls were imposed and employers competed for employees by giving them "free" health insurance. A parallel situation occurred in Japan after the war when employers attracted rural employees by offering to reimburse them for their transportation costs. Now, Americans expect health insurance to be provided "free" by their employers and Japanese expect to be reimbursed for their transportation costs. Why not go the next step backwards and provide company food, company housing, etc. as was done in the coal mines? The health-insurance problem will go away when company-provided insurance is banned and workers are given the equivalent in cold hard cash and can choose to buy their own coverage.

    4. Michael J O'Bri says:

      Heritage is spot on again with this one. The last thing we want in this country is socialized medicine. Let’s look at the socialized modern countries in Europe. The life expectancy of a Russia male is 58.9 years, women live substantially longer, and 70% of all pregnancies are terminated. In Brittan, doctor waits times are a disgrace, services limited, while most executives and professionals join a private health club where they have immediate access to private doctors. The same health care model used by our elected officials should be available to all of us. Tom Daschle will try to force his utopian dream of Medicare and Medicaid upon the masses, as we do not deserve the same as our elected officials. We must keep in mind that Daschle has extreme liberal ideas regarding the role of government in our lives. We should be reluctant about his nomination, given his views. Health care must be portable accross state lines.

    5. Ken Jarvis - Las Veg says:

      Medicare should start at BIRTH FOR EVERYONE.

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    9. mike hutchings texas says:

      what if health insurance at all levels and medical expenses were tax deductable and also made non taxable over the counter for medicines.would that not decrease costs to the goverment or is it really control they want.also nationwide plans to cut administration costs.an idea for displaced goverment workers. send them home and pay them. your out the money but they would be out of the way. i think the big three auto companies did this. whoops never mind

    10. Delfin J Beltran MD, says:

      Government controlled medical care was inititated by FDR when Edwin Witte, Wisconsin legislative bill writer wrote the Social Security Bill for FDR in 1934-36. That bill included a full take over by the government. Not even the politicians of that day could accept medical care controls and succeeded in getting the camel in the tent with a limited old age benefits bill. Edwin Witte addressed my U. of Wisconsin Medical School class of 1953 and told us that the government would own us. Medicare and the ensuing bills directed at infecting government money and consequent control over health has resulted in the financial failure of what has become the current social engineer project called Healthcare, a grossly expanded intrusion into the daily lives of the governed pseudo-validated with the attitude that he who pays the piper calls the tune. Pseudo- because it is a taxpayer expenditure not enacted by the laborers who earned the money that has been stolen from them by the tax-collector to satisfy the gross legislative mistakes of political hacks. If you all loved the current round of 'bailouts' you are absolutely going to love a government single payer socialized healthcare system that is bankrupt to start with. Heads up the 'Reds' are at it again. The current Dept of Health has already start the "care rationing" regulations by refusing to pay for DVT and infections that occur in the hospital setting. This level of corrupt medical diagnosis is only their beginning to remove your right to life.

      Delfin J Beltran MD

      50 years of private medical practice.

      I know them well and they are not in favor of your good health. The cheapest form of therapy is death is currently being taught to some MDs by their employers, " Do not make a diagnosis as that requires treatment and treatment costs money." The corrollary is 'the cheapest medical intervention to disease is death'

    11. Tom Sheehan, Dalton, says:

      One thing I haven't heard in all the discussion on health care is how 50 million new health care beneficiaries can be accomodated by the current health care system without "swamping the boat." It would seem that person (man) power, materials, and facilities would have to be pumped up first or no one will have adequate health care.

    12. Bill, Phoenix, AZ says:

      I believe that health insurance should be available similiar to auto insurance. Each family/Indv should be able to shop companies for the type and amount of coverage they need. The Federal Gov't would offer a tax credit to each family/Indv. And then the indv could negotiate for allowances from his employer who would not have to provide for health insurance coverage to employees saving the employer money that he could offer as incentives; much like an auto allowance. This will allow families/Indv to choose the coverage they would like, the gov't is giving incentives through tax credits and the employers are offering allowances to help cover the employees costs. It is a true win situation for everyone.

    13. Duke Lynch CA says:

      Health Care is a personal responsibility…it should be taught in the home and at school including knowledge of the body,its systems, their functions and care…and recognition of common dysfunctions and their treatment. Clinics with combined (dual) practices of Naturopathy (systemic treatment) and traditional Medical (symptomatic treatment) should be encouraged. Religious institutions should broaden their spiritual concerns to include the physical through gynamsiums encouraging the parishoners to exercise and practice healthy body maintenance. Insurance should be kept at the catastrophic level combines with government help.Insurance gives the greedy a tool to fleece the ignorant and irresponsible. It should not be involved with normal maternity and family care, obesity, drugs, smoking and all the other character weaknesses of society. And I won't argue about it.

    14. Todd Norgaard, Carme says:

      The employer based system has been a disaster in that it has separated the patient from an active role in negotiating for health services. The medicare/medicaid model is even worse. The patient has lost all function in the exchange, becoming the product rather than the customer. Health decisions need to go back to being an exchange between doctor and patient, where healthcare choices and costs are openly discussed.

    15. Pingback: Health Care Reform We Believe In « Conservative Thoughts and Profundity

    16. Pingback: Morning Bell: Health Care Reform We Believe In » The Foundry

    17. Laxmi Wadhwa, India says:

      Family Floater Health Plan takes care of all the medical expenses during sudden illness, surgeries and accidents. For the first time in India, one single policy takes care of the hospitalisation expenses of your entire family.
      http://www.icicilombard.com/app/ilom-en/personalp

    18. Ardell Nagle Rexburg says:

      It is a total mess with the health care system. Cost is rising at alarming rate. Part of the cost is prescription cost. The are medicines for problems that I have never heard of. Also there are the insured who go to the doctor for a simple hang nail. Another problem that no matter how you deal with problem of coverage is doctors visits. Use to be they would sit and visit and to about the problem and how you needed to care of it. Now you sit waiting for an hour or so before you see the doctor and he or she spends 5 or 10 minutes give you an expensive pill which may or may not solve the problem. I live in a small town and and their is a small number of doctors I would trust.

      So if we are going to improve the health care we need to involve a reform of those giving the care.

    19. Kevin E. vonMoses, G says:

      Is it just here in Arizona, or is the health care system overwhelmed everywhere with illegal indigents who crowd Emergency Rooms with the sniffles at five times the cost of a healthcare provider…

      Provide the care, send 'em home and take the expenses out of the Foreign Aid we glibly pass out to the parent country.

    20. Jeff McCombs, PhD, H says:

      More attention needs to be paid to the root cause of health care cost inflation in the period of discussion before us. Until the public understands the cause of our problems, consensus on a solution will be hard to obtain. Specifically, the historical base of the US health care system, and the base of the Medicare and Medicaid programs, is insured fee-for-service medicine. The patient and the patient's trusted agent, the physician, make treatment decisions which do not reflect the full cost of care. The third party payer (Medicare, Medicaid, an indemnity health insurance plan) has very few options to control these decisions. Moreover, government plans are loathe to apply effective methods, such as drug formularies, etc. The end result is we devote 16% of the GDP to health care and are less healthy than many other countries who spend far less. Any government run, single payer system would have to repeat these mistakes unless we want a "VA for all" system similar to the system in Britian.

      An effective solution to the mis-aligned incentives in the insured fee-for-service health system is to transfer the fiscal responsibility for the cost of treatment decisions from the patient (ie, insurance) to the physician. Its called an HMO. Research has clearly demonstrated the beneficial impact of 'capitated' financing on cost, quality, prevention and the implementation of state of the art information technologies, all of which everyone agrees are under-used in traditional fee-for-service medicine.

      So, how do we get there? Government cannot run HMOs, but it can create a marketplace in which all citizens have access to health insurance and then let the various plans compete. This is essentially what the Heritage Foundation recommends, though the average citizens may not understand the reasons for this recommendation.

      I do have one recommendation for change in the system proposed by the Heritage Foundation. We have to have a minimum coverage package for all plans. For example, if we allow plans to limit their maximum payout, then the young and healthy consumers attracted to these plans who have a serious accident will end up with no insurance and no resources. While flexibility of coverage is a good idea, such as large deductibles, we need to insure that all citizens who suffer a catestrophic event have coverage rather than falling back onto a societal safety net.

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