Wednesday, September 19, 2007

Market reforms - Health Reform Simplified and Explained

What follows are three soucces explaining the current state of health reform.

1) Washington Post, September 18. 2007

Health-Care Scorecard

Clinton Edwards Obama Guliani Romney

Seeks to insure Yes Yes Yes No no Americans

Requires all Yes Yes No No No
individuals to
buy insurance

Requires small No Yes No No No
bsinesses to
isure employees
o pay tax

Requires large No No No Yes Yes
bsineses to
insure employees or
pay tax

Provides tax No No No Yes Yes incentives for
HSAs
.


2) New York Times, September 18, “Hillary Clinton, from Revolution to Evolution, ” Bt David Brooks

David Brooks, moderate columnist for NYT, says Hillarycare is a huge step forward from 1993 – simpler, reassuring in that nothing about radical change, in touch with Americans’ values of choice and individual freedom, retains private care as heart and soul of system, offers take credits so people can afford care, and is evolutionary rather than revolutionary

It is, says Brooks, a “communitarian” approach – getting individuals, the federal government, insurers, doctors, and patients – go together around a big table to reach a consensus.

But, adds Brooks, communitarianism, has weaknesses. One, state governments. She limits the role of state governments, the usual source of legislative innovation, thus centralizing power.

Two, health plans, her bete noir. She commands health plans to cover everyone, no matter how sick. Health plans will surely find ways around her commandments.

Three, patients. If costs, say for MRIs, are lowered, patients will simply demand more MRIs, or anything test or procedure.

Four, posterity. What Hillary wants, says Brooks, will create a tidal wave of debt, something our children will have to absorb.

Brook concludes: “There are still complexities in the health system that no loya jirga, no matter how smart, can fully anticipate and control.” ( loya jirga is a large gathering or grand council held in Alfghanistan, Uzbekistan, Turkenstan, and Mongolia, held among competing tribal leaders, to reach consensus on difficult issues. There are not time limits on a loya jirga, and tribal leaders may deadlock and not reach consensus for years.)

4) Wall Street Journal, “Republicans Can Win on Health Care,” By Karl Rove

In his Op-Ed piece, Karl Rove claims Americans will be unable to trade freedom in selecting doctors and hospitals for government security, which, he says, leads inevitably to poor quality, inefficiency, rising taxes, and rationing.

Here’s Rove’s formula for a market-driven, consumer-oriented health system

• Level the tax paying field – Let all people, employees of large corporations and small businesses, and self-employed individuals, get deductions for health care.

• Give tax-free savings for health care, to be carried over year to year, i.e health savings accounts.


• Make health premiums portable from job to job, and state to state.

• Arm and empower consumers by letting doctors, hospitals, and health plans compete for their business.


• Pool risks of individuals, small business group in order to lower costs.

• Aim for price and quality transparency for patients.


• Stop junk lawsuits.

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