• The Heritage Network
    • Resize:
    • A
    • A
    • A
  • Donate
  • The Roadmap to Real Health Care Reform

    During his State of the Union Address, President Obama declared that “there will be many different opinions and ideas about how to achieve reform, and that is why I’m bringing together businesses and workers, doctors and health care providers, Democrats and Republicans to begin work on this issue next week.” One public servant providing practical solutions is Rep. Paul Ryan (R-WI), who recently introduced his Roadmap for America’s Future Act of 2010. The Ryan bill outlines clear, sound principles to reform entitlement spending and health care. The Roadmap’s health care provisions would bend the cost curve in health spending, make insurance more affordable and accessible, and create a consumer-driven, highly-competitive system. This is how it is done:

    1. Changing the Tax Treatment of Health Coverage
    Current tax treatment of health insurance gives preference to employer-based coverage by making benefits tax free to the employee and the employer alike. Obviously, this tax policy only benefits those who receive coverage through their employer. It benefits those who also have the biggest benefit packages, usually, but not always, the wealthy. Ryan’s “Roadmap”replaces this inequitable system through creating a system of refundable tax credits of $2,300 for individuals and $5,700 for families for the purchase of health coverage. As Heritage experts have pointed out this will transform the market to respond to patients’ needs, allow portability of insurance between jobs, and further the goal of universal access.

    Replacing the tax exclusion with a health care tax credit would not only help the middle class buy insurance and extend coverage to the uninsured; it would also set in place powerful incentives to reduce the rapid growth in health care expenditures…individuals and families will have the ability to choose the health plan they want, own it, and take it with them from job to job. This tax credit would also have the added benefit of allowing individuals and families to decide how much of their compensation comes to them in the form of health insurance

    2. Promoting State- Based Reform and Exchanges
    The Ryan “Roadmap” would create a Federal-State partnership to help states that wanted to do so create State Health Insurance Exchanges, featuring high-risk pools combined with guaranteed access to care with affordable premiums. A state health insurance exchange can be designed many different ways. The key question is what is the objective of such an exchange. For consumers who want to own and control their health insurance, and take it with them from job to job, a properly designed state exchange, as Heritage’s Robert Moffit argues, can make it easy for employees , especially those in small businesses to compare and buy affordable health plans. It can unleash the free market forces of choice and competition. An exchange designed to restrict health options, as is now being promoted by the Left, is just another regulatory roadblock to personal freedom.

    3. Allow Interstate Purchasing of Health Coverage
    Congressman Ryan’s proposal would also allow individuals to use their refundable tax credits towards the purchase of health insurance policies in any state. As Moffit explains, interstate competition would lead to broader and more intense competition, greater personal choice and more affordable coverage, and would secure value for consumers’ dollars.

    The nonpartisan Congressional Budget Office evaluated Congressman Ryan’s Roadmap favorably, finding that “[The health insurance tax credit] could impose significant downward pressure on… the growth of overall spending on health care.” The Roadmap would also reform Medicare, putting it on more solid fiscal ground and molding it into a more consumer-driven system.

    Even the President has kind words to say about the Rep. Ryan’s Roadmap, calling it a “detailed” and “legitimate” plan to tackle our fiscal crisis. The question before the taxpayers is whether the president and the congressional leadership are really serious about pursuing bipartisan reform, or whether they want to continue to push the massive and unpopular House and Senate bills that are so unpopular with the American people.

    Posted in Obamacare [slideshow_deploy]

    14 Responses to The Roadmap to Real Health Care Reform

    1. republicanblack says:

      The biggest problem in this health debate is education. We the people of the united states have failed when it comes to civics and history. I myself, a republican, was all worried about mandates and unconstitutionality of the health care bill, and I was TOTALLY wrong. here is the proof,


    2. Hilary, USA says:

      Health care reform to Republicans means letting Americans go bankrupt and then die and…. taking away our right to sue doctors when they butcher our bodies. I guess I just need to redefine my concept of "freedom".

    3. Pingback: The Roadmap to Real Health Care Reform | The Foundry: Conservative … | Health Blog

    4. Pingback: The Roadmap to Real Health Care Reform | The Foundry: Conservative … - Health Blog

    5. Pingback: frankhagan.com » Republican Ryan for the Rebound

    6. Pingback: The Roadmap to Real Health Care Reform | The Foundry: Conservative … | Ffici Health

    7. Dan-Coalinga, CA says:

      Won't work, too simple, makes too much sense, too easy to understand.

    8. jpdnp, MN says:

      I am not a republican, I am an American, and I thoroughly enjoyed the read you cited about your "worry about mandates and the unconstitutionality of the healthcare bill" referring the reader to http://bit.ly/constitnmandate for enlightment. Thank you!

    9. Bobbie Jay says:

      Hilary, what exactly are you referring to? You wrote: Health care reform to Republicans means letting Americans go bankrupt and then die and…. taking away our right to sue doctors when they butcher our bodies. I guess I just need to redefine my concept of “freedom”.

      part of your concept of freedom should include personal freedom to choose and decide regarding your personal health. Surely your sense of reason tells you, if you get your health care from government, you are also giving up your freedom to choose and decide on your personal health. This freedom will be greatly reduced or removed all together. Government will ration health to save money. Or spend frivolously to increase crisis. Government draws attention to obesity yet the majority of those obese are the ones getting government tax paid food subsidies. If food was at their own expense, there wouldn't be a problem. Better choices would be made.

      It's your personal duty to carry out your personal responsibility to survive. America gives that opportunity, where your health is between you and your doctor. Not you, your doctor and government bureaucracy. It is your freedom to live the way you choose. Don''t trust government to make the choices regarding your best interest. It will be in government's best interest.

    10. Bobbie Jay says:

      correction first line second paragraph- part of your concept of freedom should include your freedom to personally choose and decide regarding your personal health.

    11. Lioness, Wisconsin says:

      Anything which allows the Federal Government a hand in health care needs to be rejected. The States have the capacity and support of their citizens to taylor healthcare for the needs of their particular populations without picking up the bills of other states.

      Healthcare to Democrats means bankrupting the whole country with no consideration for the genius of the States to solve their own problems without taking on the national debt and sending their citizens taxes to other states.

      Obamacare is a distraction from the States getting down to business and finishing the job many of them have already started to do well.

    12. Pingback: Gleeman’s Daily News—02/11/10 - News - emrupdate.com

    13. Patty Zevallos, Spri says:

      Healthcare reform can start now with no high price tag

      Obama and Congress are taking the entirely wrong approach to healthcare reform. We can be doing so much right now to improve healthcare without suspicious price tags. There is nothing wrong with carrying out reform in two phases: the immediate and low price-tag phase, and the longer-term, let's-find-the-money-first phase.

      What can be done now, with little public opposition:

      One group plan
      Everyone would have access to insurance if all insurance companies were required to offer a plan to individuals as though they were all in one large company group plan, with the same rate and no exclusions. There is no cost to taxpayers; premiums are paid by the insured.

      Guaranteed coverage and insurance market reforms
      Few would argue with such provisions. The health insurance industry has been such a Wild West that companies could promise anything and provide nothing. They suffered no bad consequences when they blatantly breached contracts with subscribers. Other than enforcement, there would be no cost to taxpayers.

      Essential benefits
      An independent committee would define an "essential benefit package" as a minimum quality standard. It would include preventive services with no co-pays or deductibles, mental health services, and oral health and vision for children. It would cap the amount that consumers have to spend per year, and cost taxpayers nothing. Insurance companies could add features to this basic package. Now they can get away with not paying for basic services because most people do not have a choice of plans, and insurance plans are far too complicated to easily compare.

      Individual responsibility
      It is time for the government to be honest about the lifestyle factors that cause many of our healthcare problems. According to an article at preventdisease.com that is based on research reported in The New England Journal of Medicine, "preventable illness makes up approximately 80% of the burden of illness and 90% of all healthcare costs," and "preventable illnesses account for eight of the nine leading categories of death." This is the single most important factor in lowering healthcare costs and making people healthier. But in most ways it is not a role for government. It is up to individuals to change their habits. However, the federal government certainly shouldn't be making the situation worse. That means telling the truth about the fast food and prepared food industries. And it means requiring that government agencies and contractors use part-time and telecommuting work arrangements so people have time to exercise and prepare food at home. A national campaign aimed at employers, encouraging them to use flexible schedules for workers, such as part-time and telecommuting, could do a lot of good, with the government itself taking the lead. Cost to taxpayers: nothing. In fact, there are potentially huge savings in lowered healthcare costs.

      Pushing for results
      It is time for ratings. Netflix movies are rated. EBay sellers are rated. This is established technology. It is time for a central web site that shows us ratings for healthcare providers. Some sites do this now, but there are too many with too few ratings and it is chaotic. An insurance company doing ratings of its providers is not an unbiased source. How good is that doctor / hospital / radiology lab anyhow? How effective? How organized? How long a wait? How polite? How accurate a bill? This costs little and offers so much in savings and making healthcare very effective quickly. No more money is wasted on ineffective providers. People get well much sooner. Providers change their methods to get better ratings. Cost to taxpayers: very little. Such a site would also reveal the really bad eggs . . . moving on to . . .

      Making sure healthcare providers really do their job
      States are supposed to enforce this now, but often don't. According to a press release from Public Citizen's Sidney Wolfe, MD, "Most state medical boards are doing a dangerously lax job in enforcing their state medical practice acts and adequately disciplining physicians." In another article, Dr. Wolfe said that from 1990 to 2002, just five percent of U.S. physicians caused 54 percent of the nation's malpractice lawsuit payments, basing his numbers on information from the National Practitioner Data Bank. A constant stream of reports show that hospitals are covering up mistakes. If states were doing their job, there would be little or no malpractice lawsuits. This is far more important than tort reform. With ratings, state regulators, properly funded and monitored, could spot and check on providers who are doing a poor job before they do something really really wrong. Such a practice would eliminate payments to incompetent providers and lower malpractice cost. Cost to taxpayers: very little.

      Emphasizing primary care
      Healthcare reform needs to enhance the partnership between patient and primary care doctor. The primary care doctor is the one who needs to be on top of what is happening with a patient, with whatever record-keeping system works best for him or her (usually a hybrid of paper and database. All-electronic record-keeping is not reliable yet). Primary care doctors need to be paid as much or more than specialists and be paid for phone call and record-keeping time instead of just doctor visit time. Many doctors are forced to use a more expensive visit when a phone call will do because they don't get paid for phone time. Cost to taxpayers: nothing

      Looking close at hospitals
      Hospitals need to be very closely audited. Not only are there often bogus charges on bills, but the charges are far far beyond costs. No one really checks this, so they keep doing it. Employees wander around hospitals that don't seem to be doing anything. Hospitals charge for unnecessary tests, with no one making sure that tests are based on research. Anyone who complains is ignored. Medical institutions are roach motels for our hard-earned dollars. Dollars check in but they don't check out. Cost to taxpayers: very little.

      A simple little thing
      Refrigerator magnets can save millions. Yes, you read that right. A magnet can list the phone numbers, hours, and locations of urgent care centers that can be used during weekends and evenings instead of much more expensive emergency rooms. We now waste millions on non-emergency problems being treated in emergency rooms simply because people don't know where else to go. Cost to taxpayers: very little.

      Another simple little thing
      Money is wasted on mailed Explanation of Benefits forms from insurance companies when this information could be provided for free via a secured web site. Cost to taxpayers: nothing.

      These no- or low-cost changes would greatly improve care and save millions. They are the first step. There is no reason to delay them in order to get a “comprehensive” healthcare reform. No reform can possibly work without them in place first.

      Patty Zevallos

    14. Pingback: Oregon State Program Helps Pay for Health Insurance for Low Income Residents | Individual Health Insurance New York

    Comments are subject to approval and moderation. We remind everyone that The Heritage Foundation promotes a civil society where ideas and debate flourish. Please be respectful of each other and the subjects of any criticism. While we may not always agree on policy, we should all agree that being appropriately informed is everyone's intention visiting this site. Profanity, lewdness, personal attacks, and other forms of incivility will not be tolerated. Please keep your thoughts brief and avoid ALL CAPS. While we respect your first amendment rights, we are obligated to our readers to maintain these standards. Thanks for joining the conversation.

    Big Government Is NOT the Answer

    Your tax dollars are being spent on programs that we really don't need.

    I Agree I Disagree ×

    Get Heritage In Your Inbox — FREE!

    Heritage Foundation e-mails keep you updated on the ongoing policy battles in Washington and around the country.