With the Washington insiders at politico.com
reporting this weekend that health care reform appears to be in “real
jeopardy,” and the Senate Finance Committee so uneasy that they have
decided to delay reform bill markup until after the July Fourth recess,
it’s increasingly clear that an approach of layering more and more
fixes onto the present system isn’t going to work.
In a previous post, I suggested that
reform should be guided by seven principles:
- Affordable basic benefits
- Fairness of tax treatment
- Price competition without
- Individual choice, individual
- Restrictions on monopolies
- Freedom from politics
With these as a starting point, this
may be a good time to look again at Senators Wyden and Bennett’s Healthy
The Wyden-Bennett bill is unique in
two respects: it is co-sponsored by Democrats and Republicans, and it
doesn’t assume that major changes can’t be made to our present way
of financing health care.
The bill doesn’t completely match
the seven principles, but it does some notable things:
- It establishes community
rated basic benefits, with a ban on medical underwriting.
- It levels the playing field
for all Americans by eliminating the tax exemption for employer-paid
- It moves the responsibility
for choosing—and paying for—coverage to those who will use the care,
but provides subsidies for the lower-income, as well as tax deductions
to offset premium costs
- It provides real competition
among insurance plans, including plans offered by employers, and specifically
bans insurer “cherry picking” of the best risks.
- It mandates universal coverage,
while limiting taxpayers’ liability.
- It changes Medicaid into
a wrap-around program accessing the same insurers as other individuals,
potentially reducing some of the financial burden on states, and eliminating
the “Medicaid program stigma.”
The bill is not beyond criticism, but
anyone reading Senator Wyden’s speech on the Senate floor this past
week [http://wyden.senate.gov/newsroom/record.cfm?id=314529], on the challenges of health care reform,
will be struck with how much closer he seems to be to addressing the
key issues than the proposals that have been emerging from various congressional
committees over the past month.
Roger Collier was formerly
CEO of a national health care consulting firm. His experience includes
the design and implementation of innovative health care programs for
HMOs, health insurers, and state and federal agencies.
He is editor of Health
Care REFORM UPDATE