|
||
|
SEARCH BY KEYWORD
|
 Category: All > Health Care BasicsCandidates and Health Care ReformMay 13, 2008
by Grace-Marie Turner in the Seattle Post-IntelligencerSens. Barack Obama and John McCain are gearing up for a general election battle -- barring a surprise surge by Sen. Hillary Clinton -- in which they will offer very different visions for health care reform. Obama -- like Clinton -- sees a much larger role for government in the one-sixth of our economy represented by the health sector. Obama would mandate that all children have health insurance, would require employers to pay for insurance for their workers, would impose significant new federal regulation over health insurance and would expand government programs such as Medicaid. McCain has a very different vision. "The key to real reform is to restore control over our health care system to the patients themselves," he said recently. He would focus on new financing tools to help people buy health insurance that would be portable from job to job, new mechanisms for those with pre-existing conditions to get coverage, and he would emphasize prevention and better care coordination, especially for people with chronic illnesses. Obama and McCain agree the key to health reform is getting costs under control. "The reason Americans don't have health insurance isn't because they don't want it, it's because they can't afford it," Obama says. As a result, neither candidate supports a universal mandate for health insurance. But Obama would lock in the employment-based system with new mandates on employers. McCain sees a world in which, "Americans (have) new choices beyond those offered in employment-based coverage." He believes that "Americans want a system built so wherever you go and wherever you work, your health plan goes with you." McCain would boost options for individually owned health insurance by making everyone eligible for a refundable tax credit to help them buy health insurance. He would allow people to purchase health insurance across state lines and would give states new incentives and resources to make sure everyone has access to coverage. He says that bringing millions of new buyers into the health care marketplace will expand competition and force insurers and providers to offer more affordable options. Obama believes government should require insurers to accept all applicants and would force insurers to charge basically the same premium for everyone, regardless of age, gender, occupation or pre-existing conditions. A healthy young person would pay about the same as a 62-year-old with heart disease and diabetes. Obama wants a national "pay or play" mandate, forcing employers to cover a preset percentage of their workers' health insurance or pay a fine. Some businesses would be partially subsidized, but that would mean significant federal oversight of all employer health spending. He would expand Medicaid and the State Children's Health Insurance Program and would create a new program modeled on Medicare. That would force private health plans to compete with a taxpayer-supported public insurance program, which has federal policing authority and the ability to impose price controls -- hardly a level playing field. Congress will wrestle with the intricacies of reform, but in this election year, the vision is the key, and the contrast between the visions that Obama and McCain offer is stark. The bottom line question will be whether individuals or government will be in control of health care in the future. Grace-Marie Turner is president of the Galen Institute, a nonprofit research organization focusing on free-market solutions to health reform. She is speaking Tuesday at Washington Policy Center's sixth annual health care conference at the Sea-Tac Doubletree Hotel. For more information call 206-937-9691 or visit washingtonpolicy.org. CommentsBart Ingles at 06/15/2008 13:10:422) The second flaw in our national health care debate is the failure to address the problem of adverse selection in a reasonable way. The Democratic candidates want to mandate guaranteed issue and full group rating, which is overkill and a transfer of wealth that goes well beyond pooling of risks. But the Republican candidates have always ignored or minimized the problem. A better approach between the two extremes, which might actually work politically if not in an election year, is to restrict the proposed tax credit to insurance plans that meet criteria similar to those required of small business group insurance plans. These plans are subject to HIPAA regulations, notably HIPAA Title I. In place of guaranteed issue and universal group rating, these regulations provide for guaranteed transfer (you can't be refused because of a pre-existing condition if you are coming directly from another insurer), and group ratings within reasonable limits (most notably age banding, but may also segment the pools by sex and by industry). Insurers routinely refuse to issue private policies to people who have at some time been diagnosed with conditions such as depression, hypertension, or asthma. And I don't mean excluding pre-existing conditions or higher rates, I mean flat refusal to issue coverage. While I don't advocate banning insurers from doing business with whom they choose, I don't believe such restricted policies warrant a tax credit. This is why some qualifications are necessary when considering tax-based reform. Bart Ingles at 06/15/2008 12:28:47I see two major flaws in our national health care discussion, and I don't expect to see much progress until both are addressed. 1) Conflation of goals: We don't seem to be able to distinguish between the goals of making the health care system more fair, accessible, and affordable, and of providing a social safety net for people who couldn't afford health care even if we had a perfect system. This includes not only people like Steve, who essentially want us all to become Medicaid recipients. Even among proponents of tax-based reform, there seems to be confusion about what the tax credit is supposed to do. This leads to groups like the Kaiser Foundation proposing a 100 percent, dollar-for-dollar credit (essentially a voucher) for everyone in order to reduce the uninsured rate as close as possible to zero. A better approach would be to deal with the social safety net function separately, using vouchers or other programs better suited for the goal. Then tax-based reform would be free to pursue other goals, such as tax fairness and better market access, by offering a much smaller tax credit in the 25 to 35 percent range. -continued- Matthew Heath in Birmingham, Alabama at 05/27/2008 23:36:49Steve; Do you understand that our entire country and economy is a consumer driven economy. Your entire life is a Steve Driven Plan. You do not know what CDHP even means or looks like. Shut up, no you do not! Our healthcare industry is a government/employer driven plan. Maybe that’s why 5/6 of your consumer driven economy and country work well and healthcare does not. "You're on your own. Go fend for yourself. And if you need good health care, stay young and healthy forever or go make a lot more money." This comment is painted with ignorance and what makes it worse it that you don’t know your ignorant or you wouldn’t be. Since you don’t know and never will, you will always be this way. What a shame. Steve, would you mind moving to Canada or Cuba? Then you will be happy. "Grace-Marie Turner, John McCain and the big insurance corporations all have a clear policy on health care: "You're on your own. Go fend for yourself." Steve! Our entire country is a, your own your own, go fend for yourself. It’s called Capitalism and Democracy. Ever heard of it? Yeah, you’ve heard of it and you think its evil. You’re a Looser.
Grace-Marie Turner at 05/22/2008 08:17:26The deck is stacked in today's health care system against lower-income, working Americans and families who want and need health care and health insurance, and the Galen Institute has been working for years to make the system fairer for them. Most of the uninsured make too much to qualify for public programs like Medicaid but too little to have the good, higher-paying jobs that come with health insurance. We are working to advance policies that will level the playing field so they get real money to help them buy the health insurance and health care that they want -- not the coverage that politicians or bureaucrats dictate they should have. Putting patients in charge of choices will give them new power and control over their health and health care. Grace-Marie Turner President, Galen Institute anonymous at 05/15/2008 05:50:49I guess you want "Nationalized Health care" where the government provides health care for everyone. Here is what you'd get: Poor quality, rationed care with ever increasing expense. In this system, you get inadequate care or no care at all, but you have access to it! You just have to wait several months for an MRI or over a year for your cardiac bypass. This is called socialism and guess what? It doesn't work. It is pie in the sky. Consumer-directed care will keep costs lower, availability higher, and will increase quality. Most (not all) will have access to the highest quality care there is. With you Nationalized system everyone has access to lousy care which essentially amounts to no care with ever diminishing quality. Be careful what you wish for.Steve Nesich at 05/14/2008 02:03:21Grace-Marie Turner, John McCain and the big insurance corporations all have a clear policy on health care: "You're on your own. Go fend for yourself. And if you need good health care, stay young and healthy forever or go make a lot more money." Using weasel words and phony phrases like "Consumer-Directed Health Care" and “access” to coverage (as opposed to coverage itself) is how Turner and McCain try to obscure the truth and confuse people. Beware of the shill talking about "access" to health care. It's a sham. What people like Turner and McCain really mean is that they're carrying the water for those insurance companies making billions at the expense of your family's health and financial security. Add Comment |
|
anonymous at 06/15/2008 13:17:27
Insurers routinely refuse to issue private policies to people who have at some time been diagnosed with conditions such as depression, hypertension, or asthma.
To clarify the above, such refusals of coverage are routine even if the applicant is currently covered, e.g. someone planning to leave an employer and seeking coverage to replace existing employer-provided coverage.