Avoid having to check back and subscribe to Roll Away the Dew by email. It will take a whole pail of water just to cool you down!

Thursday, May 21, 2009

Republicans reveal their Healthcare Reform Ideas

I had previously decried the Republican party's health care reform ideas as the equivalent of a "I know you are but what am I" childish response. However, in the last few days, they put together a very reasonable incremental approach. It's not reform by any means but a viable proposal. I am pleased that they are at least now participating in health care discussions. However, on an unrelated topic, this pleasure with our political system was blunted by the fact that a credit card reform bill now allows me to pack a concealed weapon in a national park. That deer at the campground better show me some respect in the future!

Back to the Republican's proposal (should be clear that this is the proposal of the conservative arm of the party) which includes the following:
  • Employer-based health insurance is taxed in order to provide a tax credit of $2,200 for individuals and $5,700 for families to pay for coverage. An average individual health plan in my state is $2,400/year for an individual and $6,000 for a family so this will cover health insurance for the most part. That is cover it for those who can get accepted for an individual plan and won't have to pay twice as much for a state plan. There is concern that would this would reduce the incentives for employers to offer health insurance but I think that this is overrated. Health insurance is still a valuable incentive since you can a better group plan on the open market for the same price. Our focus groups have shown that employers do care about their employees and want to offer health insurance. For employers who don't care, they maydrop it anyway.
  • There would be a state run health exchange. This basically means that the state would issue a buyers guide or website for comparing plans. This does provide some objective comparison but there are websites out there, such as http://www.ehealthinsurance.com/ that already do this. Additionally, the government is not very good at explaining things in simple terms. The exchanges are vehemently opposed by insurance brokers since this takes away business from them. Insurance brokers are another middle man in the process but they are actually very good at explaining health insurance to people. Exchanges have had mixed results in the past.
  • States can shift people out of Medicaid into private plans. States can drop Medicaid eligibility already so I am curious what this provision entails. Allowing states to easily revoke the insurance of its most vulnerable citizens could have really bad consequences
  • There would be additional money for preventive services, wellness, improving health care IT, and giving kids ice cream on hot days. In one version of the article there was the obligatory fund for vaccines and other no brainers that everyone agrees on.
Senator Max Baucus pointed out that this was basically aspects of the Democrat's proposal with the employer tax. Here are my thoughts:
  • The shift of people with insurance helping pay for those who don't have insurance was part of McCain's plan and research showed that it would have incremental benefits, covering perhaps 5 million of the 48 million uninsured. This doesn't dramatically change anything about how health care is delivered, paid for, or address costs. It's an incremental step using the tax code. While I don't think that it will destroy the employer insurance model, it will probably reduce employer-based insurance by 5%-10%.
  • I am surprised that the Republicans would support the state exchanges of health care information because it puts a previously private function under state control. Health plans explain their plans through marketing and insurance brokers sell a lot of insurance.
  • My biggest surprise is that the Republicans split with their proposals as this is the conservative Republican's plans. The moderate Republicans will release their plan later. The famed Republican unity looks shaky. The bigger impact will be a possible coalition with conservative Democrats who are not excited about the large price tag of the Obama administration plan.
Overall, this does not feel like a Republican plan since there is some wealth redistribution via the tax code and state involvement in a previously private business function of the health care exchange. However, this plan does offer incremental improvement in health care coverage (it's not really reform) which is good to see. Obama's public plan option is causing everyone to propose ideas in order to avoid that option. If the intent of the public plan was to really just create serious proposals than that may turn out to be a very shrewd maneuver.

No comments:

Related Posts with Thumbnails