1. What are the Options for Health Insurance Reform?
Principles for Reform
Tax Incentives and Individual Insurance Markets
Mixed Private-Public Group Insurance with Shared Responsibility for Financing
Single Payer/Public Insurance
Covers Everyone +
Minimum Standard Benefit Floor –
Premium/Deductible/ Out-of-Pocket Costs Affordable Relative to Income
Easy, Seamless Enrollment ++
Choice
Pool Health Care Risks Broadly
Minimize Dislocation, Ability to Keep Current Coverage
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Administratively Simple
Work to Improve Health Care Quality and Efficiency
Governors, congressional leaders, and presidential candidates have proposed strategies to reform the health system : and we are going to hear from three states who have recently implemented or proposed universal coverage. The approaches currently being discussed at federal and/or state level can be broadly characterized as those that would
provide tax incentives for coverage on the individual market,
those that would build on existing private and public group insurance with employer and individual mandates with new group insurance options often referred to as connectors or exchanges with premium subsidies for low income families
and a third approach are those that would cover everyone through public insurance like Medicare.
Measured against the key principles in our report, both the mixed private/public approaches and the public insurance approaches would have the greatest potential for broad system improvement. Massachusetts has recently implemented a mixed private public approach , Gov. Arnold Schwarzenegger has proposed a similar approach and CA is in the heat of debate over reform, and Gov. Rendell of PA has also put forth a private-public proposal… States have taken the lead on health care reform and we are eager to hear updates from three leading states today on their experience so far.
[The mixed private/public approach might be less disruptive because the 160 million or so people in employer based plans could keep it if desired, easing the transition to universal coverage at the outset.]
Absent policy change: Costs expected to go to 20% of GDP and uninsured to move up the economic ladder
Aiming higher: Why not the best?
U.S. has the resources and technology; facing facts can help build consensus
Facing facts can help build consensus
0 = Minimal or no change from current system; – = Worse than current system; + = Better than current system; = Much better than current system
Source: S.R. Collins, et al., A Roadmap to Health Insurance for All: Principles for Reform, Commission on a High Performance Health System, The Commonwealth Fund, October 2007.