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October 29, 2007

The New School presents competing congressional health care plans

This afternoon from 2:00 to 4:00 p.m., The New School will present a forum entitled "Reforming Healthcare: the latest solutions from the United States Congress."

The main participants are authors of four major pieces of healthcare legislation now making the rounds in Congress: the Healthy Americans Act, Bob Bennett, U.S. Senator, Utah (R) and Ron Wyden, U.S. Senator, Oregon (D); the Every American Insured Health Act, Richard Burr, U.S. Senator, North Carolina (R); the Universal Health Care Choice and Access Act, Tom Coburn, MD, U.S. Senator, Oklahoma (R); and the United States National Healthcare Insurance Act, John Conyers Jr., U.S. Representative, Michigan (D).

Bob Kerry, the former democratic senator from Nebraska and now president of The New School, will lead this discussion. He will also represent the National Commission for Quality Long-Term Care which he co-chairs with Newt Gingrich.

Essentially, these plans fall into 3 categories:

Free-market solution: tax breaks will make private health insurance plans purchased by individuals competitive with employer-based coverage which already benefits from tax relief. This also includes  making out-of-pocket healthcare expenses tax deductible. Reforming Health Saving Accounts regulations which mandate the user purchase a high deductible plan will make this plan more attractive.

Reversing regulations that prohibit buying health insurance in other states, will allow the consumer to shop for the best deal nationwide. It's interesting to note that for all the Republican presidential candidates, only John McCain supports this. Romney is against it, while Giuliani would only consider a plan that would phase in a nationwide health insurance market. McCain is also the only one to support the re-importation of prescription drugs.

Guaranteed, mandatory participation in a private plan: favored by the Democratic candidates, it gives each person more choices ("choice" is the new buzz word) requires that the government monitor and ensure participation by all individuals. These plans can also use tax incentives, as well as reversing the Bush tax cuts.

Single payer: this will embrace and extend the current entitlement programs, bringing them under one umbrella of one government agency which will provide payment to private providers.

Here's a little background on the initiatives to be presented at today's forum:

The Healthy Americans Act would:

  • guarantee private health care coverage for all Americans
  • establish cost containment measures to save $1.48 trillion over 10 years
  • be fully paid for with the $2.2 trillion currently spent on health care
  • mandate that insurance will no longer be tied to employment
  • stipulate a 2-year transition period where employers who provide healthcare benefits would be required to convert their workers' health care premiums into higher wages; those employers who don't offer healthcare benefits would have to make phased-in "Employer Shared Responsibility Payments; after 2 years all employers would be required to make these payments
  • require all employees to purchase private healthcare coverage
  • subsidize the premiums for those who live below the poverty line
  • subsidize the premiums on a sliding scale for those between the 100% and 400% poverty line
  • establish state-based Health Help Agencies (HHAs) which would guide individuals in enrolling in private plans in their state. It assumes that the "HHAs would ultimately lower administrative costs by coordinating payments from employers, individuals and the government."
  • stipulate that insurance companies be required to cover everyone regardless of health status such as a pre-existing condition, and would not allow coverage cancellation or raising the premiums
  • verify participation in a private insurance plan any time someone interacts with local, state or federal government
  • provide incentives to insurance companies to keep their subscribers healthy using, for example, wellness programs for nutrition counseling and tobacco cessation
  • reimburse private physicians for investing time in chronic disease management and prevention

The Every American Insured Health Act would:

  • use free market strategies to give Americans the resources and rights to purchase health care
  • end the tax code discrimination against those who cannot get insurance through their employer by using a flat tax break: $2,160 per individual, and $5,400 per family
  • encourage individuals to take an active role in managing their health and health care purchasing options

The Universal Health Care Choice and Access Act would:

  • strengthen federal disease prevention programs while demanding results and accountability. "Seventy-five percent of the total health expenditures are spent to treat these largely preventable chronic diseases [heart disease, cancer, stroke, COPD and diabetes]
  • provide MediChoice tax rebates to shift tax breaks from businesses to individuals; $2,000 for individuals, $5,000 for families
  • create a national market for health insurance, opposing the current regulations that mandate purchasing coverage in your own state
  • offer states the option to design their own Medicaid programs that would best serve their beneficiaries
  • provide more health care choices to veterans and American Indians
  • reform medical malpractice by solving disputes through mediation and impartial medical experts

The United States National Healthcare Insurance Act would:

  • establish a single payer healthcare system utilizing a national health insurance card and ID number
  • eliminate all co-pays or deductibles
  • "create a publicly financed, privately delivered health care program that uses the already existing Medicare program by expanding and improving it to all U.S. residents, and all residents living in U.S. territories"
  • reduce overall annual healthcare spending by over $50 billion in the first year
  • will save $150 billion on paperwork and $50 billion by using rational bulk purchasing of medications
  • mandate that all employers pay a 3.3% payroll tax per employee while eliminating their payments towards private health plans (currently employers pay on average 8.5% of payroll towards health coverage
  • prohibit private insurers from selling coverage that is similar to the benefits of this plan; additional benefits can be offered
  • annually set reimbursement rates for physicians, health care providers
  • negotiate prescription drug prices
  • allow this conversion to take place over a 15-year period,  will proposed funding of $1.86 trillion per year through the sale of US treasury bonds
  • repeal the Bush tax cut of 2001

The National Commission for Quality Long-Term Care co-chaired by Kerry and Gingrich presents very general guidelines such as "empowering individuals and families." I didn't see any specific initiatives for attempting to enact these goals on their Web site.


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