Use Competition to Make the System More Efficient
Expand the Current System to Cover More People
Create a National Health Care System
The main problem with the health care system is that costs keep going up. All the other problems in the health care system stem from this and won't be solved until we give everyone real choices and the ability to take responsibility for what they spend on care. That means reducing regulation and using free market competition to allow insurers to offer a wider range of plans. We should also embrace managed care, which watches expenses carefully and has already slowed down the rise in health care costs. By moving further in the direction of managed care and adopting medical savings accounts, which encourage individuals to save and shop around for health care, we’ll be able to bring down costs and cover more people.
We don’t need to rip up the existing health care system and start over. We already have the best, hightech medical centers in the world and insurance programs in place that cover 85 percent of Americans. We can just extend those proven programs, public and private, to cover more people. We can require employers and individuals to have health insurance and offer them financial incentives to make it affordable. The federal government already has effective health programs for the elderly (Medicare), the poor (Medicaid), low-income children (CHIP) and its own employees. If we expand the eligibility for those plans and require employers to offer coverage, we’ll be able to cover more uninsured people with the least disruption to those who already have insurance. Gradually expanding the current system is the most practical way to cover more people without breaking the budget.
Decent health care ought to be a basic right, not something that depends on the job you hold. Our patchwork health care system of private insurance and government programs simply isn’t working. It’s time to try what Canada and most European countries already have: a national, government- run health care system. The system would work much like Medicare, except that everyone would be entitled to coverage, regardless of age, income or job status. Like Medicare, you’d still pick your own doctor, but the government would get the bill. We’ve debated what to do about health care for years, but nothing else has solved the problem. This is the only way to solve the problem of the uninsured, once and for all.
Use Competition to Make the System More Efficient
Expand the Current System to Cover More People
Create a National Health Care System
What should be done?
Offer tax credits and tax-free medical savings accounts to make it easier for people to buy individual coverage.
Make your insurance “portable” so people can keep the same policy if they change jobs and not be totally dependent on what their employer provides
Encourage more employers to provide coverage through HMOs and other forms of managed care to ensure competition.
Encourage small businesses to join together in insurance pools to negotiate for better rates.
Encourage the use of lower-cost generic drugs and allow people to buy approved drugs from Canada and Europe. Charge patients more if they insist on brand-name drugs.
Allow private insurers to create basic policies that would cover the most common problems and make coverage affordable for small businesses and individuals.
Require employers to offer health coverage to all their workers, even low-wage or part-timers. Offer tax incentives to business to cover the cost.
Lower the Medicare eligibility age to 55.
Extend the Children’s Health Insurance Program cutoff age to 25.
Increase Medicaid funding and raise the income cutoff to cover the working poor.
Open up the federal employee health insurance program to allow individuals without insurance to buy coverage at favorable rates.
Create a Medicare-style "single payer" system, where the government provides health insurance for everyone.
Allow patients to get a standard list of covered health services from any doctor or hospital in the program.
Raise taxes or repeal existing tax cuts to fund the program.
Tie the new health insurance system into existing government programs to promote good nutrition, mental health awareness and exercise.
Arguments For This Approach
If the health care system becomes more efficient, we can provide more services for more
people, without spending more money.
The constant rise in health care costs hurts everybody – it burdens business and government and makes insurance too expensive for lowincome people.
The only way to control costs is for insurers, health care professionals and patients to make decisions about what they really want and need. That means empowering patients to set aside money tax-free for medical care and allowing them to seek out cheaper alternatives, like drugs from other countries.
HMOs and other forms of managed care control costs by relying on competition, rather than heavy-handed government programs.
By expanding existing programs and employer- provided insurance we can cover most of
the uninsured.
This is the least disruptive way of attacking the problem – it won’t require massive changes in how the health care system operates or how people get their insurance.
People will still be able to pick their own doctors and health plans and get the same quality of care.
Health care should be a right, not a privilege for those lucky enough to have a good job, or to be over a certain age. This approach is the only way to guarantee that everyone gets medical care.
ICountries with national health care systems often have good health care at a lower cost because the government can make bulk purchases of drugs and control costs.
This will actually reduce paperwork. Doctors and hospitals will only have to deal with one set of forms and one government agency, rather than dozens of private companies and government agencies, all with different rules.
Any new taxes will be offset by the savings earned when employers and workers no longer
have to pay insurance premiums.
Arguments Against This Approach
This approach will do little to expand health care to the millions of Americans who don’t have insurance.
This will mean patients will have to face a lot more red tape and may even be turned down for treatment an insurance company decides is too expensive.
Under managed care, decisions about treatment are often made based on what’s cheapest, not necessarily the best.
The real reason health care costs are going up is new, expensive treatments and the aging population.
This will be an expensive expansion at a time when the federal government already has a budget deficit, and we still may end up with some people uninsured.
The Medicare program is already at risk and will likely go broke as it deals with aging baby boomers. Adding more people to Medicare will just cause the program to collapse more quickly.
This will do nothing to control health care costs, which are rising at an outrageous rate.
Requiring employers to provide coverage will be expensive, and even if the government helps with the cost, we’ll still impose a huge paperwork burden on business.
Under this plan, a government bureaucracy tells you what health care you can have.
In Canada and other countries it’s common to wait months for elective treatments or surgery.
This will require steep tax increases. All the health care costs now paid by private industry
would be taken on by taxpayers.
The Canadian and European health care systems are expensive and those nations struggle to cover their costs without breaking the budget.
Health costs will still be a burden to businesses, which will trade a health insurance plan they can control for a health care tax they can’t.
Use Competition to Make the System More Efficient
Expand the Current System to Cover More People
Create a National Health Care System
The big plus is that people would have many more choices for the kinds of insurance
they want and competition among insurers for your business would make the policies more affordable.
The big risks are that insurers would take advantage of the situation and that most people really need help deciding which policies will be best.
The big plus is that this builds on our current system and keeps most of the healthcare system in the private sector – not in the hands of government.
The big risks is that this expands a system that is astronomically expensive and confusing – it does very little to squeeze the duplication and excess out of the system.
The big plus is that everyone would have insurance and the money now going to insurance companies and their profits could actually be spent on health care.
The big risk is that this would be monumentally expensive and give a big government agency the power to say what kind of care will be covered and what won’t.
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