As the U.S. Chamber has spelled out, and the Congressional Budget Office (CBO) has also made clear, there are many ideas out there to get health care costs under control. As you can see in the House- and Senate-passed bills, many in Congress believe the best way to control costs is to raise taxes on health care products and insurance, slash payments to doctors and hospitals, create and expand government-run programs for health insurance and long-term care, and force individuals and businesses to purchase what they don’t want or can’t afford. At the Chamber of Commerce, we prefer proposals that will actually increase choice, competition, and consumerism.
Real choice doesn’t come from a new government program. In fact, the “public option,” which might end up as the only option, would be just one more plan, and would cost more than private insurance. Why not break down state barriers, allow consumers to choose from thousands of insurance plans, instead of forcing them to stay in consolidated markets with burdensome coverage mandates? The CBO said that this option alone would both cut health care costs by 5% and save the federal government at least $12 billion. Allowing small businesses to pool together and purchase plans outside of state bureaucrats’ control would save billions more by getting people off of Medicaid and into new, more affordable employer plans.
If we want real competition in health care, we should let people and plans see the costs and quality of providers and procedures. That’s a big project and it will take time, but it could be jump-started by releasing patient-protected CMS claims data to quality reporting organizations. Overnight, we could have massive amounts of data on thousands of hospitals and doctors, and could let people truly see the costs of care. This used to be called the “Clinton-Gregg-Obama” bill.
Once people see the real costs of health care, those costs need to matter – which means a purely third-party-payer system needs some change. For starters, we need many more high-deductible health plan (HDHP) options to give people skin in the game. People often expect their health insurance to cover everything, because it costs so much; HDHPs have lower premiums but do not immediately kick in to cover all costs. But the plans need work – the accounts they are paired with should be able to pay the plan premiums, should have much higher contribution limits (especially for those with chronic conditions or low incomes), and they need to be tweaked to work better with innovative health programs like Patient-Centered Medical Homes and accountable care organizations.
Enact these changes, and we have already cut health care costs, insured more Americans, and created real competition between health plans and providers – while helping people be better health care consumers and giving them the tools to be smart shoppers. And we saved money for the government, without taxes and without infringing on individual or employer autonomy. These few items would not be a comprehensive reform plan, but they would certainly be a good way to start – and they could all garner bipartisan support.
James Gelfand
Senior Manager of Health Policy
US Chamber of Commerce
Similar to the HDHP, I believe a significant piece of the reform should be the elimination of mandatory coverage items. Insurance companies should be forced to carry a given product (i.e. abortion, sterilization, even breast cancer treatment) by the consumer purchasing this policy. When government mandates minimum coverage, it has insisted that rates go up for all. Buying coverage options should be no different than buying a cell phone plan - get what you need and nothing more.
Posted by: Ron Hoofnagle | 02/20/2010 at 08:14 PM