Today, John Edwards released his plan to provide universal health care to all Americans. If you're too busy to read the 7 page summary you can check below for my summary and comments.
The full plan is available here.
Edwards divides the funding of his plan into four components based on the responsibility of four main actors: Businesses, Government, Insurance Companies, and Individuals.
1. Businesses. Businesses will either be required to either provide a comprehensive health plan for their employees or they will have to contribute to the cost of covering them through Health Markets (explained below). Edwards claims his plan will reduce business costs and actually make it easier for them to offer insurance because all Americans will be covered (increasing the pool size) and because if the cost of administering their own plan is too high, they can choose to put money into the Health Markets which takes the burden of administration off of them.
2. Government.
a. Medicaid and the state CHIP programs will be expanded to cover all adults under the poverty line and all children and parents under 250% of the poverty line.
b. Tax credits will be offered to subsidize individuals who are not eligible for employer-based health insurance or Medicaid/Medicare. These tax credits will be used for the purchase of insurance through Health Markets. The credit is on a sliding scale and can be used even if the family has no tax liability.
c. Mandate that insurers insure everyone regardless of preexisting conditions, age, etc. In addition insurance policies must offer preventive and chronic care treatment.
d. Continued support for public health infrastructure (An aside...Isn't Spitzer talking about cutting funding to public hospitals to balance the budget?)
3. Insurance Companies. Finally we get to Health Markets. Edwards describes these as "regional...non-profit purchasing pools that offer a choice of competing insurance plans." Now I was skeptical of this whole health care plan and this point in particular UNTIL, I read this sentence,
"At least one plan would be a public program based upon Medicare." And then this explanation,
"Health Markets will offer a choice between private insurers and a public insurance plan modeled after Medicare, but separate and apart from it. This American solution will reward the sector that offers the best care at the best price. Over time, the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan." (emphasis mine)
The final point about Health Markets is that administrative costs
will be borne by the Health Markets themselves (not sure how this works unfortunately). Therefore, businesses that opt in, will not have to worry about the costs of running a plan. They will only pay the taxes similar to paying the current payroll taxes. This is a good incentive. And while it may lead to more business dropping health coverage of their employees, at least they will have to put in money into these plans.
4. Individuals. Individuals will be required to obtain health insurance through one of the three options: Employer-based plans, Public Programs, or Health Markets. The Amish are exempt.
The entire program is expected to cost between 90 and 120 billion a year and would be at least partially paid for by increasing taxes on those making over 200,000 a year but also by collecting taxes that are not currently brought in by the IRS.
In addition there is much in this plan to reduce or contain costs in the health care system.
Briefly,
1. Help doctors deliver the best care.
a. Promote evidence-based medicine:
- Establish a public organization to dissemination information (without the taint of pharma companies).
- Support new technologies to disseminate information
b. Reward providers that give the best care with the best results (similar to rewarding good drivers) by providing higher reimbursements to them.
c. Prevent medical errors
2. Invest in preventative care.
a. Make preventative care cost little or nothing for patients.
b. Improve treatment of chronic diseases (i.e. pay for diet and nutrition counseling)
3. Allow patients to review a hospital or doctors performance.
4. Work for environmental and health justice by reducing pollution, especially in low-income/minority neighborhoods and support translation services.
5. Improve Productivity with Information Technology.
a. Electronic Medical Records
b. Support local infrastructure to make health care delivery more efficient.
6. Protect patients against dangerous medicines.
a. restrict direct-to-consumer advertising for new drugs.
b. strengthen the FDA's ability to monitor new drugs after they reach the market.
c. Ensure that researchers evaluating medical devices and drugs are truly independent.
That's it.
I think it's excellent. Ideally I'd just want to expand Medicare to all people, but I think this is very politically astute. It allows for a mechanism to transition to such a system in a way that is politically feasible. In addition, it does NOT set up a universal health care system that offers NO future mechanism for a single-payer system (like the MA plan or Wyden's plan).
I give it an A (A+ reserved for Medicare for all).
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