Ron Wyden’s interesting universal health care proposal, which is essentially a variant of managed competition with an individual mandate that decouples employment from insurance is getting some support. And notably it has a major Republican, Bob Bennett from Utah, signing on. (Following is an email Wyden’s office sent out)
U.S. Senators Ron Wyden (D-OR) and Bob Bennett (R-UT) are scheduled to join some of the nation’s top CEOs at a news conference this Monday, May 7, to announce new business support for efforts to reform the nation’s ailing health care system. Wyden and Bennett are the chief Senate sponsors of the Healthy Americans Act (HAA), the first bipartisan, comprehensive health care reform bill in more than a decade to guarantee health coverage for all Americans.
CEOs and business leaders scheduled to attend the news conference with Wyden, Bennett and U.S. Reps. Brian Baird (D-WA) and Jo Ann Emerson (R-MO) include Steve Burd, CEO, Safeway Inc.; Art Collins, CEO, Medtronic, Inc.; H. Edward Hanway, CEO, CIGNA; Nancy McFadden, Senior Vice President, PG&E Corporation; Steve Sanger, CEO, General Mills; and Ronald A. Williams, CEO, Aetna Inc. Baird and Emerson announced earlier this week that they will introduce the Healthy Americans Act in the House.
Realistically this isn’t going to pass any time soon, and if it did Bush would veto it. But it does set the groundwork for a universal insurance system compromise sometime in the future and at least Aetna and Cigna think that they’ll be better off taking that compromise than the alternative!
Don’t look for any Republican plan to consider patient cost and access an issue. Their issue is feeding their corporate contributors. These so called managed competion plans are just a stop gap profit preserver. Why would providers be in favor of reduced utilization any more then oil and coal companies are in favor of alternative fuels.
I wonder about several things with the Wyden approach.
First, how efficient will it be to, in effect, sell health insurance one policy at a time as opposed to thousands at a time (through a large employer)? The main problems with employer provided health care, in my opinion, are lack of choices and lack of access to affordable coverage if one loses or leaves a job or retires before becoming eligible for Medicare. An employer mandate, at least for all but the smallest employers, coupled with lots of choices similar to the Federal Employees Health Benefits Plan might be a more workable approach.
Second, the Massachusetts experience is instructive on several levels. First, Massachusetts has the highest per capita healthcare costs in the country (over $9.000), a below average percentage of the population that is uninsured, and a market that is overwhelming dominated by non-profit insurers and hospitals. Supposedly greedy for profit insurers and hospitals are simply not much of a factor in Massachusetts.
Within the last couple of days the Massachusetts health connector website went live. People can key in their zip code, date of birth, number of people to be covered, etc. and get rate quotes from four or five different plans for each of four coverage levels – Bronze (both with and without RX), Silver and Gold. Type in a Massachusetts zip code and try it out. The website is: http://www.mahealthconnector.org.
Third, with respect to the Wyden plan to cash out employer coverage and let individuals buy their own insurance, what happens in the future if both healthcare and health insurance continue to increase faster than both general inflation and wages? The affordability issue, which is already a significant problem, especially for those whose income is only moderately above the level likely to receive subsidies, will be exacerbated.
As I’ve said numerous times before, access and affordability are important issues, but a big part of the solution is finding ways to safely and appropriately reduce healthcare utilization. I would urge Senator Wyden et. al. to give that aspect of the issue the attention and emphasis that it deserves and needs.