A Health Reform Whose Time Has Come

Posted on by John C. Goodman

The basic idea: take all the spending and tax subsidies we now provide to private health insurance and use that money to give every American not on a government health plan a refundable tax credit. This money could be used to purchase health insurance and make deposits to Health Savings Accounts, from which people could purchase health services directly. Rep. Pete Sessions has a bill that would do just that.

Read the original article on the Washington Examiner website.

2 thoughts on “A Health Reform Whose Time Has Come”

  1. Let’s keep the IRS out of healthcare. How about a voucher system? Or a plan where the government pays consumer chosen insurance companies directly to cover the premium for basic coverage (allowing consumers to pay more for premium coverage). See comingtogether.info .

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  2. Thanks for sending these links. I have just had time to look at the articles linked directly. I hope to look at the internal links later. I have several reactions to a cursory reading both articles. The article on “The World’s Greatest HealthPlan” has several outdated counterpoints. My reaction when I first read about that bill that failed thanks to McCain, was that the title was more than pretentious, it was over-the-top top-down grandiosity.

    My first reaction is that they are trying to do too much at once. It would be hard to sell. I like the basic concepts. The basic thrust of a tax credit was first introduced in 1998 by the AMA, which they seem to have abandoned under the influence and funding by vested interests to keep the present open money faucet to insurance companies and managed care companies open.

    I would call them rebates. I believe that they should be the principle of fairness: “All families should get the same help from the government when they obtain health insurance, regardless of income.” But I view government’s money as our money. When it is redistributed, it should be called a rebate.

    I also like the concept of the Roth HSA. A Roth HSA is money that is not taxed coming out. Usually, that means that it is post tax money. The novelty here is that this is not post-tax money, but pre-tax but treated as though it is post tax.

    My belief is that medical care needs to be built up from the bottom up. That means starting with strengthening primary care, the greatest weakness of our medical care system but the component that clearly makes the biggest difference in people’s health outcomes. So, I would start reforming medical care in the U.S. by strengthening primary care.

    In my book that Dave Racer and I just released, I go into depth in Chapter 2 why primary care delivers the most cost-effective improvement in people’s health outcomes.

    My proposal is to give rebates directly to people to build direct relationships with primary care providers. This would be into what I call “Empower-Patient Accounts”, which empowers people to directly pay for primary care instead of doing it through third-party payers. It also would take the burden of paying for primary care off the backs of employers.

    I am most recently interested in finding a way to ensure that money in these accounts is used appropriately for medical care. My thought is that states would set up and approve private entities into which these monies could be deposited. People would then be given “smart credit cards.” The ones my wife and I use give us an itemized listing of what we used the credit cards for under which categories. It seems to me that the entities that hold these credit cards could be charged with the responsibility of assuring that they are used appropriately and that the cards cannot be forged. People would then either lose the use of the cards and/or get penalties if they used them inappropriately.

    There are many things wrong with health care in the U.S. I recently jotted down fifty-six of them. See the attached – medical concerns addressed in EPAEP (Empower-Patient Accounts Empower Patients!). Many of the changes involve mindset changes, which I devote the last chapter to. I argue that we should start with Empower-Patient Accounts, and once we get people to accept the idea that we should not use third-party payers for all medical care, we can then move on to Roth HSAs, and then family Roth HSAs as Beecher/Racer suggested in their book “Passion for Patients.” This could be a much simpler idea to fund through block grants to states beyond what states might be able to fund on their own to their non-Medicare adults

    This may be presumptuous, but is there any way that I can communicate with Sessions and Cassidy? As a retired family practitioner in rural Minnesota, I am far away from the wheels of power in this country.

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