VARIOUS FLAVORS OF HEALTHCARE REFORM
From VOX, recently,
I received a very interesting article
which attempts to spell out the eight
plans for universal health care so far cooked up by Congressional
Democrats. Though there’s no chance of
any one of them being adopted under the current administration, it was
clarifying to read it, because it helped to identify what I wanted to see in
healthcare legislation, and what I most definitely did NOT want to see there. I
figured that it might do the same for you, so I thought I’d present the gist of
it here. The article sums up the eight plans in the diagram I reproduce below:
Please note
that all eight plans – as Vox reports them – assume the Government’s regulation
of health care prices. So even if the least generous of the plans was adopted,
the result – presumably – would be better than what we have now.
Plans Number
1 (the House of Representatives’ HR676),
and number 2 (the Senate’s S1804) both are paid for strictly by tax
increases, and would offer broad coverage for everyone, with no co-pays, deductibles, or
pre-existing conditions. As such, they
are the only true single-payer bills being considered. In fact there are only
two differences between them both, which we will consider later.
Note that insurance
companies are deliberately excluded here – a consequential decision for the
drafters, since traditionally, employers offering health insurance can deduct
that expense from their taxes, which means, as Vox says, that “companies’
dollars stretch further when they buy workers’ health benefits than when they
pay workers’ wages.”
Taking that
into account is Plan Number 3, Medicare Extra for All, proposed by the think tank, Center for
American Progress. This would achieve universal coverage for all legal
residents through a combination of private and public insurance – at least for
the next few decades. The plan would let
employers continue to offer coverage to their workers so long as it met federal
guidelines. At the same time employers would be offered a similar, tempting
option: to stop offering coverage and instead pay a payroll tax equivalent to
what they currently were spending on health coverage. But how tempting that offer would be depends
on how generous the Medicare Extra plan turns out to be, a crucial detail which
hasn’t been specified yet. What has been
specified is that every new born would
automatically be enrolled in the new plan, so that ultimately the resulting
healthcare plan would look a lot like the single-payer plans being
sponsored in Congress.
Plans 1, 2,
and 3 are designed to bring healthcare coverage to everyone. Not so the rest
of them.
Plan 4, The Urban
Institute’s Healthy America Plan aims to disrupt the employer market as little
as possible. Recognizing that most people with employer plans are reasonably
happy with them, they would set up new insurance marketplaces for those whose
insurance isn’t very good anyway – mainly the Obamacare and Medicaid populations.
The cost of their insurance would be
covered partially by tax increases, and partially by the premiums they'd pay into the
system.
Plans 5
through 8 are buy-in programs – paid for in no way by higher taxes, but by the
subscribers only. As such they would exclude all those unable to afford it. For that reason I'm against them.
But I’m
against buy-in programs also for another reason, and for that, let me refer to an
email I just received which quotes Wendell Potter, whose every word here is worth
reading and taking to heart:
“I spent 20 years as a health
insurance executive before leaving my job as a vice president at Cigna. I can
tell you firsthand that by focusing on a half-baked measure like a Medicare
buy-in, Democrats would hand a huge gift to the private insurance industry
while doing less than the bare minimum to help struggling businesses, workers,
families and patients.... It’s time for Democrats to stop
proposing health care reform that relies on insurance companies to play fair.
After two decades in the for-profit health insurance industry, I can assure you
they never will. They have no interest in doing anything that might in any way
jeopardize profits. Their only interest is delivering profits to their
shareholders. From that perspective, the status quo is very profitable. For
everyone else, not so much.
Champion dramatic reforms, not
half-measures!
Business owners are struggling to
provide health insurance to their employees, workers' take-home pay is
shrinking as their premiums go up, patients are literally begging for their
lives on fundraising platforms like GoFundMe, doctors and hospitals are drowning
in paperwork dealing with insurance claims departments, and more than 80
million people lack adequate health insurance. That number is increasing every
year. Reform is desperately needed.
Democrats have the chance to be
the champions of that reform if they don’t waste their energy on half-measures.
Instead of thinking about how they can make small tweaks to the health care
system, they should start thinking about how to enact dramatic reforms that
will assure universal coverage while reducing costs and encouraging economic
growth. Voters and taxpayers are asking for Medicare for All. It’s time to
listen.”
For all these
reasons, I’ve left Vox’s description of the four “buy-in” plans for you to read
in the original document (see the link). You can make up your own minds.
Dio
PS: If you’d
like to leave a comment (and I hope you will) simply click on the number of comments area. In the comment
box that appears, you can share your thoughts.
