[NV Greens] Fwd: [usgp-dx] Bush is quietly dismantling employer-provided health insurance (LA Times)

Fri Feb 4 00:03:54 PST 2005

>
>
>Healthcare Overhaul Is Quietly Underway 
>by Ricardo Alonso-Zaldivar
>
>The Los Angeles Times, January 31, 2005
>http://www.commondreams.org/headlines05/0131-06.htm
>
>
>WASHINGTON ó Emboldened by their success at the
>polls, the Bush administration and Republican
>leaders in Congress believe they have a new
>opportunity to move the nation away from the
>system of employer-provided health insurance that
>has covered most working Americans for the last
>half-century.
>
>In its place, they want to erect a system in
>which workers ó instead of looking to employers
>for health insurance ó would take personal
>responsibility for protecting themselves and
>their families: They would buy high-deductible
>"catastrophic" insurance policies to cover major
>medical needs, then pay routine costs with money
>set aside in tax-sheltered health savings
>accounts.
>
>Elements of that approach have been on the
>conservative agenda for years, but what has
>suddenly put it on the fast track is GOP
>confidence that the political balance of power
>has changed.
>
>With Democratic strength reduced, President Bush,
>Senate Majority Leader Bill Frist (R-Tenn.) and
>House Ways and Means Committee Chairman Bill
>Thomas (R-Bakersfield) are pushing for action.
>
>Supporters of the new approach, who see it as
>part of Bush's "ownership society," say workers
>and their families would become more careful
>users of healthcare if they had to pay the bills.
>Also, they say, the lower premiums on
>high-deductible plans would make coverage
>affordable for the uninsured and for small
>businesses.
>
>"My view is that this is absolutely the next big
>thing," said former House Speaker Newt Gingrich,
>whose consulting firm focuses on healthcare. "You
>are going to see a continued move to trying to
>get people involved in the process by owning
>their own health accounts."
>
>Critics say the Republican approach is really an
>attempt to shift the risks, massive costs and
>knotty problems of healthcare from employers to
>individuals. And they say the GOP is moving
>forward with far less public attention or debate
>than have surrounded Bush's plans to overhaul
>Social Security.
>
>Indeed, Bush's health insurance agenda is far
>more developed than his Social Security plans and
>is advancing at a rapid clip through a
>combination of actions by government, insurers,
>employers and individuals.
>
>Health savings accounts, known as HSAs, have
>already been approved. They were created as a
>little-noticed appendage to the 2003 Medicare
>prescription drug bill.
>
>HSAs have had a strong start in the marketplace.
>Although regulations spelling out how they would
>work were not issued until mid-2004, as of Sept.
>30, about 440,000 people had signed up. And more
>than one-quarter of employers say they are likely
>to offer them as an option.
>
>The accounts are available only to people who buy
>high-deductible health insurance, either through
>an employer or individually. Consumers can set
>aside tax-free an amount equal to their
>deductible. Employers can contribute to workers'
>HSAs but do not have to. Unused balances can be
>rolled over from year to year, and employees take
>their HSAs with them when they switch jobs.
>
>The idea that losing one's job would not
>automatically mean losing protection for medical
>costs has bipartisan appeal. "Portability" was a
>key feature of President Clinton's ill-fated
>healthcare reform plan. But the GOP approach is
>significantly different: Whereas Clinton would
>have required all employers to chip in for
>universal health insurance, Bush wants to leave
>responsibility primarily to individuals.
>
>"This is certainly getting a lot of attention
>from employers," said Jack Rodgers, a healthcare
>analyst for PricewaterhouseCoopers LLP.
>
>One reason is potential cost savings to
>employers.
>
>A typical catastrophic health insurance plan
>carries an annual deductible of about $1,600 for
>an individual when purchased through a large
>employer. That means the worker pays the first
>$1,600 of healthcare expenses each year. By
>contrast, under the more comprehensive,
>employer-provided health insurance programs
>common today, the company begins to pay after
>about $300 in expenses have been incurred.
>Deductibles for families are considerably higher
>under both types of plans.
>
>"There's an issue about whether these things will
>work," Rodgers said. "[But] we could end up
>coming back 10 years from now and everybody will
>have high-deductible plans and [health savings
>accounts]."
>
>Sen. Ron Wyden (D-Ore.), who agrees with Bush
>that individuals should take more responsibility
>for controlling health costs, is nonetheless
>skeptical that HSAs, coupled with high-deductible
>insurance, will prove workable as a substitute
>for the present system.
>
>"I think the American people are going to want
>more of a safety net than the administration has
>been willing to commit to this far," Wyden said.
>
>Still, catastrophic health insurance is gaining
>credibility as a policy option.
>
>The California Medical Assn. supports a plan that
>would require all residents of the most populous
>state to carry at least high-deductible coverage
>ó just as automobile liability insurance is often
>mandatory. White House spokesman Trent Duffy said
>Bush was not contemplating such a requirement at
>the federal level.
>
>But the existence of health savings accounts may
>make it easier to enact state mandates such as
>the California proposal.
>
>Despite the record federal budget deficit, Bush
>on Wednesday proposed additional tax breaks and
>subsidies for HSAs, particularly for low-income
>families. He also called for a tax credit to help
>small businesses offer the plans to their
>employees. The low-income aid would be worth a
>maximum of $3,000 per family.
>
>"Health savings accounts all aim at empowering
>people to make decisions for themselves, owning
>their own healthcare plan," the president said.
>Consumer-driven decision-making is more likely to
>control costs than having bills paid by a third
>party, such as an employer, he added.
>
>"If a third party makes that payment, [the
>consumer] never gets to ask the question [about
>cost]," Bush said. "He just accepts the decision.
>And all of a sudden, when you have consumers
>starting to ask questions about cost, it is a
>governor on cost, at the very minimum."
>
>During his confirmation hearings, incoming Health
>and Human Services Secretary Michael Leavitt
>called for renewing the national debate over the
>future of the healthcare system and spoke of "the
>transformational need of detaching healthcare and
>employment."
>
>Critics say that Bush's vision represents wishful
>thinking at best, and at worst, a perilous new
>direction in national health policy.
>
>"One danger with this is that people will not get
>needed care because they want to save a few
>thousand bucks," said Rep. Pete Stark
>(D-Hayward), a leading lawmaker on healthcare.
>
>"Healthcare isn't like buying a Chevrolet," Stark
>added, disputing Bush's assertion that individual
>patients can be empowered to control costs. "You
>can go to Consumer Reports and read about the new
>Malibu, but if I asked you to describe a regimen
>of chemotherapy for someone who has colon cancer,
>you'd be out of gas.
>
>"We are talking about highly technical services
>that 99% of the public doesn't even know how to
>spell the names of," he said. "Secondly, there is
>no uniformity within the medical community as to
>what services ought to be used. It's a 'by guess
>and by gosh' sort of practice."
>
>The combination of HSAs and catastrophic
>insurance is too new for any definitive data on
>how consumers are faring.
>
>A study released Thursday by the Commonwealth
>Fund, a private foundation that supports research
>on healthcare policy, found that people with
>high-deductible policies were more likely to have
>trouble paying medical bills than those in
>traditional insurance plans. They were also more
>likely to skip care because of cost.
>
>The study did not look at the combination of
>high-deductible plans with HSAs, but the report
>cautioned that the savings accounts might not
>solve all the problems.
>
>Many experts believe HSAs could quickly become
>one of the main ways to obtain health insurance
>for people working in small companies or buying
>coverage on their own.
>
>Workers at large companies with standard health
>plans may be less likely to experiment with HSAs,
>although many large employers are already
>requiring their workers to shoulder a bigger
>share of health insurance costs. The existence of
>a government-sanctioned alternative to the
>traditional system might accelerate that trend.
>
>"We are not trying to do one big change for the
>whole country, all at once ó like what sunk
>Hillary-care," said Grace-Marie Turner, president
>of the Galen Institute, a research organization
>that promotes conservative, market-based health
>reform.
>
>We want to let people choose this if it meets
>their needs, and not rip out the underpinnings of
>the current system."
>
>But even the most ardent backers of HSAs concede
>that the country is not fully ready for them.
>They say critics such as Stark are correct to
>point out that there is little information
>available to consumers for comparing the costs of
>various medical options.
>
>In a recent article in the New England Journal of
>Medicine, Frist called for what would amount to a
>healthcare information revolution. Within the
>next decade, he said, patients should be able to
>gain online access to performance rankings and
>prices for doctors and hospitals.
>
>"Increased access to more accurate information
>about care and pricing will make possible Ö the
>transformation of the healthcare system," Frist
>wrote. "Whether selecting their physician,
>hospital or health plan, consumers must be able
>to choose what best meets their needs."
>
>A comprehensive system of healthcare information
>would be costly to create, and perhaps
>challenging for patients to navigate. On
>Thursday, Bush proposed some initial steps, such
>as computerized medical records and standardized
>information technology for medical offices.
>
>His vision of an empowered patient calling the
>shots may stand little chance without a new
>information infrastructure.
>
>Gingrich acknowledged: "You can't have an
>informed marketplace in a setting where you don't
>have any information."
>
>
>Copyright 2005 Los Angeles Times
>
>###
>
>
>
>
>
>__________________________________
>Do you Yahoo!?
>Yahoo! Mail - Helps protect you from nasty viruses.
>http://promotions.yahoo.com/new_mail
>_______________________________________________
>Natlcomaffairs mailing list
>To send a message to the list, write to:
>Natlcomaffairs at green.gpus.org
>To unsubscribe or change your list options, go to:
>http://six.pairlist.net/mailman/listinfo/natlcomaffairs
>
>You must know your password to do this.
>
>If you can't figure out how to
>unsubscribe, as a last resort only,
>send a message OFF LIST to
>steveh at wagreens.us
>
>If your state delegation changes, please see:
>http://gp.org/committees/cc/documents/delegate_change.html
>
>For other information about the Coordinating Committee, see:
>http://gp.org/committees/cc/


-- 
Paul Etxeberri

"Forests precede civilizations and deserts follow"   ---Chateaubriand