|
||
|
SEARCH BY KEYWORD
|
 Category: All > Health InsuranceClinton ReduxSeptember 21, 2007
Senator Hillary Clinton's release of her universal health coverage plan dominated the news this week, with journalists and policy experts dissecting the 10-page outline of policy ideas she offered. Our articles section below has several links, including a piece I wrote for USA Today in response. Bottom line: The plan is carefully focus-group tested, without the hubris of 14 years ago when the White House dropped 1342 pages of legislation on the desks of members of Congress. The language now stresses choice, allowing people to keep the private plans they are in, and promising no new government bureaucracy. The lightening rod in the proposal is the federal mandate that everyone would be required to have health insurance and that employers would, for the first time, be required to pay. Government unavoidably would get into the business of defining what an acceptable policy would be, determining how much people and companies would have to pay for this government-defined coverage, and setting enforcement provisions for those who don't comply. There is every indication that the insurance required would be the Cadillac coverage that members of Congress have. Drug companies would be required to offer "fair prices" (read, price controls), insurers would play by a much more stringent set of rules, and competition in the Medicare program would be a thing of the past. So she offers an individual mandate and a defacto employer mandate, plus expansion of existing government programs such as Medicaid and SCHIP, creation of a new Medicare-like program, steps toward price controls, new federal subsidies, and much more stringent regulation of one-sixth of the economy. And all of this would be accomplished without new government bureaucracies. There are several ideas in the plan that the free-market policy community supports, including refundable tax credits for lower-income people to help them buy coverage, the beginnings of a cap on the exclusion that exempts job-based health insurance from income taxes for employees, and an insurance buying pool that looks like the Federal Employees Health Benefits Program. There?s something for everyone. We should be very glad that the voters have more than a year to decide what they think about the plan. **************** SCHIP: Congressional negotiators are closing in on a deal on the State Children's Health Insurance Program, with the House reportedly grudgingly agreeing to go along with most of the provisions in the Senate bill. But either version moves SCHIP beyond its mission. The reauthorization and expansion legislation still threatens to become a Christmas tree of government health insurance expansion well into the middle class. I was on a panel on Wednesday morning at the Urban Institute opposite my friend, health policy expert Stan Dorn, to discuss reauthorization and expansion of SCHIP. I argued that we need to focus the program on the many children under 200% of poverty who aren't enrolled, arguing that it would be a disservice to them to give states strong incentives to focus on expanding coverage to kids from higher-income families and crowd out the private coverage they already have. Why would we do that? While I argued for preserving the focus of the program for poor children, Stan argued on behalf of federalism, saying that states need the flexibility to expand coverage to higher-income populations. I agreed and said they can do that now as long as they use their own money to pay for it. We had a good debate and actually revealed many places where two people from the right and from the left can agree. Urban Institute President Bob Reischauer did an excellent job of introducing the subject and moderating our discussion. Kaiser has a webcast which you can view at: www.kaisernetwork.org. Some quick items:
Grace-Marie Turner RECENT NEWS ARTICLES AND STUDIES: Market Forces in Health Care The Market Is the Answer Sen. Hillary Clinton's new health reform proposal promises more choice, lower costs and no new government bureaucracies?but it also provides countless opportunities for government micromanagement of the health sector. The centerpiece of her plan to achieve universal health coverage is an individual mandate. This inevitably means that government would decide what kind of health insurance we must have, what must be covered and what penalties we will face if we don't comply. Although the plan offers refundable tax credits to help those with lower-incomes afford coverage, she misses an opportunity to allow health insurance to become portable by freeing up the tax subsidy that ties health insurance to the workplace for 175 million Americans. Dr. Hillary Will See You Now National Review Online asked several healthcare experts to comment on Sen. Hillary Clinton's health care plan:
The Impact of Recent Republican Health Insurance Reform Proposals Parente and Feldman find that combining the most recent models of consumer-driven health plans with a reform of the tax treatment of health insurance would substantially increase overall health insurance coverage. They estimate that adopting President Bush's plan for a standard health deduction -- which levels the playing field between employer-purchased insurance and individual insurance -- could reduce the ranks of the uninsured by more than 20 million people as early as 2009. A different universal tax credit proposal by Senator Tom Coburn (R-Okla.) and several Senate colleagues would have similarly powerful effects in reducing the ranks of the uninsured and be more cost-effective. Coverage growth under both policy scenarios would diminish over time if health care premium growth continues to significantly exceed real economic growth, but changes in the tax treatment of health insurance would provide substantial improvement over the status quo. Republicans Can Win on Health Care Conservatives must put forward reforms aimed at putting the patient in charge. Government can help poorer and older Americans get quality health care by leveling the tax playing field, providing tax-free savings for health costs, increased portability, greater transparency, and building on the progress already made by putting patients in charge and letting competition work. Health Care Spending U.S. Health Care Spending: Comparison with Other OECD Countries In 2004, the U.S. spent more than twice as much on health care as the average country in the Organization for Economic Cooperation and Development (OECD), at $6,102 per person. The U.S. has nearly twice as many CT scanners per capita as the OECD average and three times as many MRI machines. The U.S. also performs far more heart procedures per population than the average OECD country, an above-average amount of organ transplants per capita, and is one of eight countries in which wait times for elective surgery are reported to be low. Health Spending by State of Residence, 1991 - 2004 The study finds that the New England and Mideast regions claimed eight of the top ten states in per capita health spending in 2004, consuming an average of $6,345 per person. The states with the lowest per capita spending were typically located in the Southwest and Rocky Mountain regions, accounting for an average of $4,244 per person -- nearly 20% lower than the U.S. average. These states also tended to exhibit lower-than-average per enrollee Medicare and Medicaid spending. State Issues Shape Up SCHIP Congressional lawmakers will actually be harming needy children if they move to expand SCHIP to cover kids in higher-income families, as both houses have voted to do. If Congress were truly concerned about covering low-income children, then it would acknowledge that two-thirds of America's uninsured kids are already eligible for either Medicaid or SCHIP, but aren't enrolled. SCHIP funds would be better spent helping parents purchase the health coverage they believe is best for their children, including adding them to policies offered at their workplaces. UPCOMING EVENTS: Biotechnology and the Patent System: The Economic Implications of the Proposed Patent Reform Act of 2007 Should the Government Insert Itself between Dying Patients and Unproven Therapies? State Children's Health Insurance Program: It's Role in Covering Children and the Coverage Debate The Budget Deficit and the Soaring Costs of Health Care SiCKO and Its Malcontents: Health Care on Film How American Healthcare Really Works Health, Technology, and the Common Good Community Forum on Colorado Health Care Reform ABMA Manufacturers Conference & Trade Fair Benefits of Innovation for Public Health in Developing Countries: A Focus on Latin America Universal Health Care Coverage in the United States Health Care Cost and Access Challenges Persist Health Policy Matters is a weekly newsletter containing summaries of timely and informative studies and articles on free-market health reform. It features research and writings by participants in the Health Policy Consensus Group, articles of interest from the health policy world, and announcements of coming events. Health Policy Matters is published by the Galen Institute, a not-for-profit public policy organization specializing in information and education on health policy. For more information about the newsletter and our organization, please visit our website at www.galen.org. If you wish to subscribe to this free weekly newsletter, update your address, or be removed from our list, please send an e-mail message to galen@galen.org. The views expressed in this newsletter are the opinions of the authors and do not necessarily reflect the views of the Galen Institute or its directors. CommentsNo comments Add Comment |
|