Friday, June 19, 2009


With the Washington insiders at reporting this weekend that health care reform appears to be in “real jeopardy,” and the Senate Finance Committee so uneasy that they have decided to delay reform bill markup until after the July Fourth recess, it’s increasingly clear that an approach of layering more and more fixes onto the present system isn’t going to work.

In a previous post, I suggested that reform should be guided by seven principles:

1. Affordable basic benefits
2. Fairness of tax treatment
3. Price competition without “cherry picking”
4. Individual choice, individual payment responsibility
5. Restrictions on monopolies
6. Realistic funding
7. Freedom from politics

With these as a starting point, this may be a good time to look again at Senators Wyden and Bennett’s Healthy Americans’ Act.

The Wyden-Bennett bill is unique in two respects: it is co-sponsored by Democrats and Republicans, and it doesn’t assume that major changes can’t be made to our present way of financing health care.

The bill doesn’t completely match the seven principles, but it does some critical things:

1. It establishes community rated basic benefits, with a ban on medical underwriting.

2. It levels the playing field for all Americans by eliminating the tax exemption for employer-paid insurance.

3. It moves the responsibility for choosing—and paying for—coverage to those who will use the care, but provides subsidies for the lower-income, as well as tax deductions to offset premium costs

4. It provides real competition among insurance plans, including plans offered by employers, and specifically bans insurer “cherry picking” of the best risks.

5. It mandates universal coverage, while limiting taxpayers’ liability.

6. It changes Medicaid into a wrap-around program accessing the same insurers as other individuals, potentially reducing some of the financial burden on states, and eliminating the “Medicaid program stigma.”

The bill is not beyond criticism, but anyone reading Senator Wyden’s speech on the Senate floor this past week on the challenges of health care reform, will be struck with how much closer he seems to be to addressing the key issues than the proposals that have been emerging from various congressional committees over the past month.

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