GOP UNVEILS HEALTH INSURANCE PLAN
Reading through the excellent summary by Peter Ferrara at The American Spectator, I don’t see much new or revolutionary in the GOP alternative. Much of it was offered by John McCin during the campaign. And it appears that the authors of the bill - Senators Tom Coburn (R-OK) and Richard Burr (R-NC), and House members Reps. Paul Ryan (R-WI) and Devin Nunes (R-CA) - borrowed heavily from Heritage Foundation and American Enterprise Institute ideas put forward over the years. I suppose what’s different is that the plan is pretty comprehensive and, from my viewpoint, has a chance to work if the goal is to cover those who are uninsured, allow people to keep the coverage they have, provide more choices of affordable health insurance, and reduce health costs.
I won’t attempt to summarize the entire plan here but, according to Ferrara, “The bill would assure essential health coverage and health care to every U.S. citizen, without increased federal spending and taxes, and without the federal government taking over your health care.”
Much of the heavy lifting will be left to the states as they would set up insurance “exchanges” that will be like insurance bazarrs where consumers can shop for the best plan at the best price. States would also have to set up uninsurable risk pools to spread out the costs of covering people with pre-existing conditions.
But they don’t call it the “Patients Choice Act” for nothing. Health care consumers would be in the driver’s seat:
The key to the bill is that it shifts the tax benefits for employer provided health insurance from corporations to all workers. As a result, every citizen not retired on Medicare will get a refundable tax credit of $2,300 per year for individual health insurance or $5,700 per year for family coverage. For workers who don’t have insurance now or who pay for their own insurance, that is thousands of dollars a year they don’t have today to help pay for health insurance. Workers with employer-provided coverage can keep that or use these credits to purchase their own preferred insurance instead.
This immediately shifts health care power to workers and patients, who would be the ones making health insurance choices rather than employers. All consumers would be free to choose from the full range of coverage alternatives available in the marketplace, from Health Savings Accounts (HSAs) to Health Maintenance Organizations (HMOs) to standard fee-for-service coverage with different health provider network arrangements. The consumer could choose coverage options with maximum choice of doctors and hospitals and alternative treatments and care, like HSAs, or could choose coverage where the insurer takes responsibility for managing health care in return for lower premiums, like HMOs. Workers can take the health insurance they choose with them when they change jobs, as this new system makes such insurance fully portable.
The Wall Street Journal has a bare bones summary:
Four Republicans in Congress — Sens. Tom Coburn (Oklahoma) and Richard Burr (North Carolina) and Reps. Paul Ryan (Wisconsin) and Devin Nunes (California) — will today introduce a bill that moves away from federal centralization. Aptly called the Patients’ Choice Act, it provides a path to universal coverage by redirecting current subsidies for health insurance to individuals. It also provides a new safety net that guarantees access to insurance for those with pre-existing conditions.
The nexus of their plan is redirecting the $300 billion annual tax subsidy for employment-based health insurance to individuals in the form of refundable, advanceable tax credits. Families would get $5,700 a year and individuals $2,300 to buy insurance and invest in Health Savings Accounts.
Low-income Americans would get a supplemental debit card of up to $5,000 to help them purchase insurance and pay out-of-pocket costs. They would have an incentive to spend wisely since up to one-fourth of any unspent money in the accounts could be rolled over to the next year. The combination of the refundable tax credit and debit card gives lower-income Americans a way out of the Medicaid ghetto so they can have the dignity of private insurance.
The great majority of Americans with job-based health insurance would see little more than a bookkeeping change with the Patients’ Choice plan. But implicit in the policy is the acknowledgment that our system of tying health insurance to the workplace is not working for upwards of 45 million uninsured Americans.
That’s a pivotal point in the fight over reform: Will the next health-reform bill lock in a system of job-based health insurance or allow more individual choice and portability to fit a 21st century work force?
The basic idea is a health care voucher (like food stamps) as opposed to a health insurance mandate. This is a logical approach, one which every health care policy wonk can appreciate and support. However, it does not give government the kind of hands-on, top-down control over the health care system that the Democrats want, and hence it is a political non-starter.
He’s right, of course. The Democrats will treat this with the same contempt they gave the GOP budget alternative. This is really a shame because the last we heard, it appears that there will indeed be some kind of mandate in the Democrat’s final version that will force every American to buy into their scheme.
We are told that this is no big deal, that Americans already are forced to buy auto insurance so what’s a few hundred extra dollars out of the consumer’s pockets in order to to get everyone covered - an absolute must, experts say, if health care costs are to come down and make national health insurance work?
The problem from a conservative standpoint is twofold. First, just because one bad idea - mandated auto insurance - is accepted by the voter doesn’t mean that a second mistake should be made by mandating health insurance. Secondly the auto-insurance analogy should frighten anyone who thinks that mandating insurance for anything is a good idea:
In some respects, requiring auto insurance coverage is a poor analogy. In others, it points out challenges that a mandatory individual health insurance plan would find it hard to overcome.
There is still no guarantee that the uninsured will join the insurance pool. Despite auto liability insurance being mandatory in almost all states, large numbers of uninsured drivers take to the roads anyway. In New Jersey, the highest-cost state for auto insurance, about 12 percent of drivers are uninsured, contributing to higher rates for others.
Penalties for non-compliance for lacking health insurance would be harder to assess. The uninsured driver can be fined or have his license revoked. Most Americans would find it draconian, on the other hand, to refuse medical care altogether to the uninsured. Assessing financial penalties on the uninsured who have sought health care would be similarly counterproductive.
“Counterproductive” is an understatement. From yesterday’s Politico:
Under the Senate proposals, taxpayers would be required to obtain insurance by 2013 and report their coverage on federal tax returns. Those who do not purchase coverage would pay an excise tax, which could be as high as 75 percent of the premium for the lowest-cost health plan in the individual’s area. “This ‘individual mandate’ has been embraced by an array of stakeholders, but we do not know whether or not it enjoys broad appeal across partisan and sociodemographic groups,” three health policy and political experts wrote last month in Health Affairs, a leading health care journal.
Empowering the IRS to police the health insurance mandate will have predictable results with our bureaucratic overlords being able to assess thousands of dollars in penalties. Of course, they will never make a mistake. And the Congressional Budget Office has figured that millions will still refuse to get health insurance even if it is made affordable. This sets up a nightmare enforcement operation for the IRS where the more important job of going after income tax cheats will probably suffer - unless the agency is expanded considerably in order to handle the additional responsibilities.
The conservative alternative offered by Republicans would use the tax system as an incentive not the threat of having the IRS on your tail. Which plan has a better chance of succeeding in insuring most Americans? I think the GOP plan would work to bring more of the most resistant groups to health insurance into the game such as the poor and those who are single, young adults. There would be additional subsidies to low income folk and the basic coverage a healthy, young single adult would want to carry would almost be completely covered by the tax credit (Here in Illinois, a good major medical plan costs a single healthy adult around $300 a month). It is not too much of a stretch to imagine a better outcome with the Patients Choice Act.
Predictably, the left is looking at the plan as warmed over McCaincare, although Mathew Yglesias makes some good points on the differences:
— This plan seems to try to grapple with the problems involved in the individual insurance market, and in that sense is a big step forward from McCainCare, but it’s not clear that it successfully grapples with them.
— One clear step forward from McCainCare is that it broadens the scope of consideration and does various things in the prevention and wellness space.
— On the other hand, near the end they appear to be trying to gut Medicare and replace it with a more-expensive but less-generous system of subsidies to private insurance firms.
— Relatedly, very brief discussions of the VA health system and the health care system for Native Americans point toward privatization and subsidies of private firms.
Actually, the plan doesn’t “gut” Medicare but rather mostly expands existing programs:
Medicare includes an option for retirees to choose private coverage, called Medicare Advantage. Almost 11 million retirees have chosen such private coverage, close to 25% of all Medicare enrollees. The Republican plan would expand this option by allowing private insurers to competitively bid down the Medicare payments they would receive for providing the specified benefits. The insurers would also be able to modify benefits to provide more of what seniors are telling them they want, and then compete in the marketplace to sell those benefits to seniors. This same competitive bidding system has been in use for Medicare prescription drug benefits and is estimated to have reduced costs by 26%, with premiums charged to seniors 37% lower than originally expected. This private option would enable seniors to avoid the increasing threat of rationing under Medicare.
The bill also provides new performance for pay incentives for Medicare services. Physicians, hospitals, pharmacists, nurses, and others could form Accountable Care Organizations (ACOs) and receive bonuses for documented improvements in quality and patient satisfaction while lowering health care costs.
Overall, I’d give the plan a B+. I think the family subsidy is probably too low and it is probably overly optimistic that insurance companies will suddenly develop a soul and compete fairly on these exchanges to be set up by the states. They are going to have to be watched like a hawk to prevent price fixing and other ways they will try and game the system. And there is the probability that these uninsurable pools will not perform as advertised which may require additional funding. Critics of these ideas over the years have pointed out that the biggest failing of market based solutions to health insurance is that it won’t solve the problem of rising medical costs.
Yglesias points to this curious measure in the bill that appears to be targeted toward preventative care but does so in a strange way:
Government health programs should adhere to the Hippocratic Oath to “First, do no harm.” This means federal programs should not promote or support unhealthy behaviors and taxpayers should not be expected to support programs that do not show positive results. This act would require reviews of existing programs and the consolidation of overlapping programs and the elimination of ineffective programs. Additionally, “junk food” that does not meet nutrition standards would be prohibited for purchase under the federal Food Stamp Program.
Taking poor people’s potato chips away won’t change the fact that people who receive food stamps are still largely ignorant of what constitutes a proper diet despite efforts for 40 years to pass on nutrition information by the government. A better, more comprehensive effort there might be better than simply denying people a snack.
But overall, a good stab at addressing a very complex and thorny problem. And who knows” A few years of Obamacare and America might beg for a change to a system that will give them adequate care at an affordable price without having to deal with rationing or tax increases.
Mix that with a public option and I think we have a winner and I say that as an Obama voter. I think if some Republicans could accept the public plan blended with this idea and some Dem’s could accept it as long as it had a public option we would begin to move forward on this in a bipartisan way that would do a great deal to repair the image of the Republican party outside of its base. Another compromise toward a public option could be the creation of many non-profit health insurance options. Expecting a corporation to provide a service in your best interests at the lowest price AND expecting them to have a steadily rising stock price is not really realistic as they will have to choose one or the other. Currently they as all other companies are forced to worry more about quarterly earnings which is healthy in many industries but what about those that are supposed to care if we live or die?
Comment by The Magical Sky Father — 5/20/2009 @ 11:18 am
One of the main problems with Employer based insurance is the fact that it stifles freedom and entrepreneurship. Health care is so incredibly expensive and undeniably necessary that the current system locks people into positions that effectively deny them further pursuit of happiness.
It makes the pitfalls of risk taking and entrepreneurship so incredibly unappealing that people are willing to forgo their dreams and ambition, in order to continue that family health insurance they need to bad.
This is a huge problem with health care insurance, as it is now, and it ultimately hurts the country in the long run. It stifles innovation and new business creation and is totally unamerican.
Insurance companies know this, and are happy to maintain their strangle hold on their customers as long as they possibly can. Workplace based insurance is a terrible way to do this, and is detrimental to the American Dream. Any move away from this employer based system is a good move, in my opinion.
Comment by Chuck Tucson — 5/20/2009 @ 11:44 am
“The bill would assure essential health coverage and health care to every U.S. citizen, without increased federal spending and taxes, and without the federal government taking over your health care.”
Reaction: Thank you Doctor Coburn. Viz the Kling quote - so good, it will HAVE to be D.O.A. in the Pelosi Congress. They are allergic to good ideas.
But if they are, it’s a huge gaping political opening for the GOP - “Aptly called the Patients’ Choice Act, it provides a path to universal coverage by redirecting current subsidies for health insurance to individuals.” - that opening is a ‘CHOICE’ agenda. we see the same dichotomy across a wide variety of political issues - healthcare, retirement, education, energy, business and property ownership, guns, etc. Republicans are for more choice and individual decision-making, Democrats for less choice.
oh, and great factoid on New Jersey liability insurance - 12% of NJ drivers are uninsured, even though that’s against the law!?! Mandates? fuggedaboutit!
Comment by Freedoms Truth — 5/20/2009 @ 12:41 pm
#1: “Expecting a corporation to provide a service in your best interests at the lowest price AND expecting them to have a steadily rising stock price is not really realistic as they will have to choose one or the other.”
WTF?!? Walmart, McDonalds, IBM, Merck, Intel … 40 years of doing all of the above that you say is impossible. Walmart served customers better and was rewarded with becoming the largest retailer in the world. It’s very unrealistic to imagine that the laws of economics get repealed when talking about a different industry.
“Currently they as all other companies are forced to worry more about quarterly earnings which is healthy in many industries but what about those that are supposed to care if we live or die?”
You pay them to care, or rather pay them to provide a service. Substandard service providers in a competitive market lose customers and go out of business. Apparently, Liberals dont understand or appreciate how consumer choice and market competition really works.
it’s a complete illusion that you can squeeze more ‘caring’ out of govt-provided plans … without competition, you get cost escalations and less innovations, which means in an environment of limited resources, you’ll get to … rationing. As noted of the GOP plan: “This private option would enable seniors to avoid the increasing threat of rationing under Medicare. “
Comment by Freedoms Truth — 5/20/2009 @ 12:55 pm
Fairness? Not on either side from what I can tell. Mandating the purchase of insurance, like auto insurance, is bad. Only being able to choose from a bazar of bad policies is bad too.
The thing is, the markets aren’t fair. Where does my premium money go anyway? It goes to pay for other peoples health care, duh? So, health care, and any insurance really, is socialistic by nature. I only get to choose what group I want to socialize with. I don’t get why more people don’t wake up to this.
If we were talking individuality here, like the GOP/Libritarians always go on about, I would only pay for myself. Then if I didn’t get sick, I shouldn’t have to pay anything. I should be refunded my premiums or have them roll over.
But when I do get sick, health care costs are outrageous. Same as when I get in an auto accident. Why? Because there are too many people between me and the person who I should be paying to do me a service and there is no transparancy of what part of my fees go to who. And almost no choice, the problem is systemic. So, we need to ditch the system completely.
If we accept that insurance, by its very nature, is a kind of socialism, then nobody should be put off by talking about socialized medicine. The only difference would be …do we want small group socializm, where the groups compete for members? Or do we want large group socialism, where everyone is a member?
The conservatives don’t like the “everyone” option because it gives them no choice and they believe, rightly so, that government will get fatter and everything will be less efficient. Like with the USPS, there will be no incentive to improve, no competition.
But with the small group socialism, unless there are a whole lot of groups competing and a lot of transparancy, there still will be little incentive to improve and compete (vis a vis car insurance, gas stations, grocery stores, etc.) Savings based on choice become marginal and the headache to make the right choice is agonizing. Also, small groups may not be able to cover all the members fairly considering that just a small portion of the group could bankrupt the insurer due to very high cost of actually paying for care.
So, what does one do? Well, if socialism is a problem, then we should stop thinking of how to tweak how insurance works and find another solution.
Consider the military. How do they make their money? From the tax payer. We pay, the do military stuff. Most folks don’t have a problem with the military and don’t consider it a socialist thing.
Couple that with the two real problem we are facing: higher insurance premiums and the uninsured. The problem is the same, no choice.
So, lets create a choice and fill the gap at the same time by creating a national health care branch of the military for the uninsured. An American Medical Corps.
I don’t need insurance for the Army to fight for me. So, I don’t need insurance for a Medical Corps to treat me.
This will allow all the folks that are happy with their insurance to keep it, it won’t grow government (unless you consider the Army government, and I don’t), and the people who pay for their own health care can feel good about getting perhaps some privileged treatment w/out health care itself being a privilege.
It’s a win/win situation here. Will it cost? Sure. But we just take it out of the current military budget which is too high anyway and redirect/restrict a bit our “world policing” at the same time. That should make both liberals and conservative (real conservatives I mean) pretty happy as we won’t have to spend any more than we already do, insurance companies can keep doing their thing, we can reduce our entanglement in foreign affairs, we can provide health care for everyone, we can create jobs (just enlist in the Medical Corps). Win/Win.
Comment by PFarthing — 5/20/2009 @ 1:34 pm
#4 First off I put the free market cures all ills arguments in the same category as I put religions, fantasy. The free market was never to be treated as a religion but as the best of all bad options. If a better option exists it should be used or you are getting stuck in a cult like mentality unable to react when the facts on the ground change.
From the viewpoint of many Americans the facts on the ground changed in the early 00’s when prices were supposed to be going down stayed flat while wages for average workers took a nose dive.
Also Wal Mart grew huge under the Clinton administration and Hillary just so happened to be an ex-board member think Haliburton if you are wondering why I fail to be impressed with their prime growth years. IBM was built on the back of government funded innovation and contracts and Merck manufactures drugs that it charges more to US customers to help subsidize low costs in poorer nations (they are not alone this is done by all of the US drug companies that I know of)and is benefiting from that shiny new prescription drug bill. I agree that McD’s has a good history but could you please avoid bringing up successful examples of the non-free market in your defense of the wonders of the free market it makes yuou sound insane.
Second calling me a liberal actually helps you in no way, it is merely meant as an insult that I am not insulted by which is one of the many reasons that the Republican party is getting its ass handed to it. It worked with Baby Boomers and a little with Gen X’s but they have already made their political affiliation choices meanwhile the group this kind of insult repels or amuses is the exact demographic you are losing, those under 35 and the college educated.
Either way many approaches can be taken for health care reform that would allow the republican party to turn a corner but screaming “Free Market” will do nothing but cause laughter and possibly some mocking with anyone but the republican base. Accepting that maybe health care is something that for profit corporations may not be all that good at would be a lightning bolt that would make a large stir in the nation if it came from republicans. This is also true if they offered to meet half way and put a public plan in with the purposed legislation, in fact that could easily muddy the Democrats attempts to own the issue though if Obama signed the bill he would walk away a winner in the publics eyes as well. In short to someone that used to vote Republican and that would eventually like to again offering only “free market” solutions with nothing outside of the Republican comfort zone means that the Republicans deserve to stay exactly where they are as leadership and governance are about compromise and they do not understand the meaning of the word. The Democrats on the other hand are moderating and compromising between government and private industry options within there own party which does look pretty impressive.
Would you like to call me a commie as well??
Comment by The Magical Sky Father — 5/20/2009 @ 1:57 pm
@ Freedom’s Truth:
“Walmart served customers better and was rewarded with becoming the largest retailer in the world”
Wow. I gotta go see your Wal-Mart. Al the one’s I’ve been to have hands-down the worst customer service I’ve ever seen from any buisness. Ever. The only reason to go is for the cheap prices DESPITE the customer service, not in addition to it.
Comment by busboy33 — 5/20/2009 @ 3:16 pm
busboy33 said:
LOL. Amen. Not to mention that once all the local businesses shut down because they couldn’t compete, it was literally the ONLY place to buy stuff. Either you buy stuff you need at Wal-Mart and like it, or, well, you buy stuff you need at Wal-Mart and don’t like it.
Comment by Chuck Tucson — 5/20/2009 @ 3:55 pm
Hey Rick, I saw your link on Facebook and thought I’d comment since this has always been a real world issue for my family…This plan would offer some assistance and financial respite to the millions upon millions of underinsured Americans. Yet the benefit to the uninsured is way way too low for a family–$5700 buys about 4-5 months of high deductible, high co-pay insurance. I’m not sure why Americans are convinced that some type of government insurance limits choice and violates one of the inalienable rights of being an American. Since moving to Canada I’ve experienced unparalleled choice, access, and quality in medical and behavioral health care. Much better choice and access than we ever had in the US even with our Teamster insurance. The emphasis on preventative medicine is also much greater here. It wasn’t until we moved here that your nephew finally received appropriate diagnosis and treatment for his asthma. We don’t worry about the cost of a nighttime trip to the emergency room during an asthma attack. It’s far from a perfect system, but ask even the most right-wing Canadian (that’s kind of like a McCain Republican I think) and they wouldn’t want to revert to a private system.
The problem here is one of scale, I think. Canada has fewer residents than California. A similar point could be made of European countries (who seem to have bigger problems than Canada in maintaining an adequate national health care system) whose populations are from 3 to 10 times smaller than the US.
A better template to examine would be Russia. Their state run system is so bad that people barter with doctors for examinations and treatments.
I’m very glad you like your health care system in Canada and that it is performing as advertised. I’m just not sure Obamacare would do the same here. You might note that I say the family stipend offered in the GOP plan is too low and that the temptation for insurance companies to game the system at the state level exchanges means that there would have to be close federal oversight to prevent price fixing and other dodges. The market won’t cure all that is wrong with the health care crisis in America. But some of the solutions offered by the GOP are a damn sight better than the top down mandated solutions offered by Obama.
ed.
Comment by Your Canadian sister — 5/20/2009 @ 8:17 pm
This plan might go a long way in solving one of the problems with health care in America today; the cost problem. To give a personal example, I was recently laid off by my firm and was offered the option of COBRA coverage. The cost of my plan is normally $375, but a provision in the Obama stimulus offers a 65% price reduction for the first 9 months of COBRA coverage, bringing my bill down to $131 and change. With only $405 dollars per week being offered by New York State, and with the chances of finding work in my field of Architecture being slim to none while the recession lasts, this is truly a godsend! If the this proposed plan could offer a similar savings to the average american family and employer, it could really change the fortunes of the GOP.
Unfortunately, it does nothing to fix the other big problems in American health care, one of which is the sanity sapping act of dealing with the health insurance companies to actually pay for ones medical treatment. Frankly, if the members of congress had to deal with Oxford and Blue Cross et al. rather than their “no questions asked” government issued insurance, there would have been a successful bi-partisan creation of a single-payer system years ago!
Comment by Surabaya Stew — 5/20/2009 @ 10:46 pm
This plan might go a long way in solving one of the problems with health care in America today; the cost problem. To give a personal example, I was recently laid off by my firm and was offered the option of COBRA coverage. The cost of my plan is normally $375, but a provision in the Obama stimulus offers a 65% price reduction for the first 9 months of COBRA coverage, bringing my bill down to $131 and change. With only $405 dollars per week being offered by New York State, and with the chances of finding work in my field of Architecture being slim to none while the recession lasts, this is truly a godsend! If the this proposed plan could offer a similar savings to the average american family and employer, it could really change the fortunes of the GOP.
Unfortunately, it does nothing to fix the other big problems in American health care, one of which is the sanity sapping act of dealing with the health insurance companies to actually pay for ones medical treatment. Frankly, if the members of congress had to deal with Oxford and Blue Cross et al. rather than their “no questions asked” government issued insurance, there would have been a successful bi-partisan creation of a single-payer system years ago!
Oops…forgot to say great post! Looking forward to your next one.
Comment by Surabaya Stew — 5/21/2009 @ 3:27 am
Heres a situation happening all over the country and now its hit me. A year ago I had open heart surgery. I was sent the bill to remind my insurance company to pay it… the amount was $247,000. Now, in one week my job will be outsourced to India’s incompetent engineers, and I’ll only have my insurance coverage for 3 months. With a pre-existing condition like I have, Bill Gates’ money couldn’t buy me insurance. Hell, even the devil himself, George Soros couldn’t get insurance. Whats the Heritage Foundation’s and American Enterprise Institute’s solution to that? (Don’t get sick?, or pray?) Lots of good a $2300 tax credit will do me!! THAT is the problem and tax credits don’t help those of us who can’t afford to buy insurance to begin with. Insurance IS socialism!!!
Nick - the GOP plan has a requirement for the states to set up “uninsurable pools” where people like you will be able to purchase insurance at the same price as everybody else because the risk will be spread out among all insurers doing business in your state. Not a perfect solution (my guess is that actuarials will be very busy figuring out just who might be “uninsurable”) but I think it will be better than Obama’s idea which will probably involve “Commissions” that will force insurance companies to take on people with pre-existing conditions and probably pay a larger subsidy for it. Either way you win but we all benefit if the costs of such insurance can be held down by spreading the risk.
ed.
Comment by Nick — 5/21/2009 @ 7:01 am
I hope you’re right Rick. I don’t care who gets the credit because thats not the issue but we HAVE TO get a handle on rising health/insurance costs as its killing our economy. Emergency room healthcare is NOT an option.
Comment by Nick — 5/21/2009 @ 8:32 am
Rick said:
I would think conservatives would decry this as socialism and would not support it.
Spreading risk is done on Wall Street all the time. Why do you think they call them “Hedge Funds?” Seriously, the whole idea of mutual funds is to spread the risk of loss by purchasing many stocks. Some will go up, some down but you hope more go up so that the MF earns money.
Or were you being sarcastic?
ed.
Comment by Chuck Tucson — 5/21/2009 @ 8:59 am
Heh, no, I wasn’t being sarcastic. Wall Street is a great deal more voluntary than this seems to be, which was my concern.
Comment by Chuck Tucson — 5/21/2009 @ 2:50 pm
As in moderately-to-left-leaning independent, I actually think there is a LOT of good in this proposal. I’d like to see some true debate about this proposal (and its nice to see something coming from GOP except “the wealthy need a tax cut” and budget-news conferences with no numbers). As with all proposals there would be enough debate to ‘vet’ the plan and find any flaws… for example
“This means federal programs should not promote or support unhealthy behaviors….”
Does this strike anyone here as far too vague? This could mean anything from smoking (bad, but legal) to not wearing a helmet when riding a motorcycle to having unprotected sex to doing drugs (illegal and completely right for tax payers to not support, of course) to ANYthing that “the Feds” decide is too unhealthy to ’support’.
And what does that mean, anyway? “Not support” how? Denying coverage if you take a spill while hang-gliding because it’s an unhealthy risk? Not covering your chemo if you have cancer if you’re a smoker?
I think we’d need to replace “unhealthy” with “illegal”. I mean, we’re talking about health insurance here - so I don’t understand what exactly they mean by “Federal programs should not support….”
I’d also demand that there be increases in the new “refundable credit” tied to future increases in inflation. And finally, I’m not sure what “refundable credit” means… if it means you purchase a plan now and get a tax break on April 12th, that won’t do a lot of good for working people who are living paycheck to paycheck as it is.
But still, this is a very promising idea and I’d like to see it explored more in depth by both sides (only by listening to the left and the right can you come to some sort of truth in the middle).
Comment by harsens-rob — 5/21/2009 @ 4:26 pm
@ Mr. M.:
“A better template to examine would be Russia. Their state run system is so bad that people barter with doctors for examinations and treatments.”
Why? Is the only correlation to the situation here the geographic and population size? Or does the fact it sucks (as our health care sucks) make the appropriate comparison?
Comment by busboy33 — 5/23/2009 @ 11:56 am