I’ve been a bit too busy lately to keep up with this blog. This blog is a good update of the continuing saga of health care/insurance reform in this country.
Ron Wyden, a senator from Oregon, initiated Senate bill 334 in 2007 and added several amendments in March 2008. The Congressional Budget Office’s analysis of the proposal found that it was revenue neutral within two years.
Likes: Basic plan is the standard basic Blue Cross/Blue Shield plan offered to federal government employees. State administered private insurance pools to spread the risk to insurers. Individual mandates to purchase insurance. People with low incomes are partly subsidized. Automatic enrollment if an individual makes no choice and no penalty to an individual who fails to make a choice. Ability to buy a more expensive policy if one can afford it. Leaves alone existing insurance policies negotiated as part of a collective bargaining agreement – the unions will like that. The basic plan is indexed to growth in GDP, not medical costs.
Dislikes: The basic plan is indexed to growth in GDP which is sure to grow less than medical costs. Private insurers will surely increase deductibles or reduce coverage for some services to offset the actuarial difference. The plan still involves employers who will pay a sliding scale tax (deductible) on the number of employees they have. However, with medical premiums increasing by 7 – 12% every year, I suppose that a sliding scale tax will at least be a known cost. It also evens up the playing field between larger companies, who pay more than smaller companies.
Of all the proposals I have read, I like this one the best for its fiscal soundness and it’s realistic approach to the competing interests of all.
Of course — we are not talking about health care reform. We are talking about reforming how people obtain health insurance. One of the questions we have to ask is whether a give insurance reform plan will lead to better or worse care. One thing that sunk the Clinton plan was that Clinton(s) foresaw the move to managed care which was seen as a “bad thing” by opponents. Yet today we have managed care. Better or worse? I'm pretty happy with Kaiser although I think the premiums are outrageous. But maybe I would think differently if I weren't healthy and used the services more than once or twice a year. L
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