Sen. Ron Wyden (D OR) has come up with a plan for health care that just might work. Wyden’s plan requires all Americans to purchase health insurance, prohibits medical underwriting, replaces Medicaid with private insurance, and funds the program by a combination of employer contributions, individual payments, and recaptured funds from the mishmash of programs that attempt to address cost-shifting and indigent care.
Those folks making less than the poverty level will not pay anything for their coverage, with graduated subsidies for those making from 1x the poverty level to 4x. There’s a lot more detail to the plan, which you can peruse at your leisure at Wyden’s site.
Before you blow this off as another politician’s pipe dream, consider this. Wyden has clearly done his homework. The plan maintains a large role for private insureds while wooing providers by increasing reimbursement for primary care. It does not include federal rate-setting or price-setting or budget caps. It delivers the same benefit plan enjoyed by our elected officials (which is way better than the one I have thru United’s Golden Rule…) And, it enables all Americans to choose among plans (sponsored by private insurers) that compete not on how best they can risk-select, but on how well they can deliver care.
The Senator was also brave enough to get on a teleconference with your reporter and a dozen other health bloggers.
Jeez, I know, sounds crazy. But Wyden’s plan has been reviewed carefully by John Shields et al at Lewin & Associates. The Lewin report indicates employers will actually save money over several years, thereby enabling them to use the funds to buy machinery, train employees, perhaps even give raises.
Oh, and the plan delivers $1.5 trillion savings over ten years, according to the Lewin report.
Admittedly, this is a first pass, and I haven’t read the entire 166 page bill. But so far, it’s looking pretty good.
Yeah, I agree. I’ve been very impressed by what I read. The best pieces for me are the boost it gives to primary care, the fact that it’s all adminstered through the IRS so there won’t be a lot of extra administrative expenses going to the income determinations, the sliding scale charged to businesses so small, low revenue businesses like restaurants don’t get screwed, keeping the major insurance companies as big players (though they’ll still probably lobby heavily against the bill until the writing on the wall shows that it’s going to happen, then it will be an internecine battle between big insurers and little insurers), and others.
It is interesting to note the battles this presents, though. Between specialists and PCPs, between large insurers and small insurers. The AMA recently came out in favor of universal care, but half of their members lose under this plan. Will they back it anyway?
Thanks, Joe, for your post. Good stuff.
As you know (but your readers might not), I’m the netroots organizer for this effort – including the Senator’s website, Stand Tall for America.
So, here’s my plug — c’mon down to the website, and join the campaign.
http://www.standtallforamerica.com
How many Americans will it take to create universal, affordable, portable, nondiscriminatory, health coverage with a generous benefit plan and a focus on prevention?
Sir: 1-3-09.
I do agree with the fact that medicaid is so out
of touch with those who are
low income and with disablites,it does’nt address their real health needs as many are trapped inside a burning house without a chnace to escape.