Alternatives to Obamacare

So it is easy to sit here and mock Obama's health care plan, because it is crap. But it is more difficult to provide alternatives to universal health care, and the so called "public option." I am not an expert in the workings of insurance, medical billing, health care, etc. Health care is a very complex issue, with heated opinions on both sides. But, I have done a little research, and found some alternatives that other's have come up with.

From Real Clear Politics:

Puts affordable coverage and choice within reach of all Americans. We do this by first ending the discrimination in the tax code that rewards corporations and employers for offering insurance yet offers no benefit to the unemployed and is unfair to the self-employed. Our current tax laws are a relic of the 1940's when Americans stayed in the same job far longer than they do today. It's time for a reboot.

Specifically, we would shift health care tax benefits to individuals and families in the form of a "Medi-Choice" tax rebate worth about $2,200 for individuals and $5,700 for families. Under our plan, if you like the health care you have, you can keep it - but you'll have more money in your pocket because you will still receive a tax rebate.

The Patients' Choice Act lowers health care costs and insurance premiums by more sensibly caring for those with chronic illnesses and those deemed "uninsurable." In addition to innovative prevention initiatives, our plan utilizes risk adjustment mechanisms and other options at the State level - such as reinsurance and risk pools - to extend coverage to those with chronic medical conditions. These steps will empower these individuals with greater choice, greater financial security, and a higher quality of life.

Prevents cherry picking by guaranteeing access to coverage. Even though we're confident that less government interference and more individual choice will control costs and improve quality and access, we recognize that markets can't solve all problems. That's why our bill prevents cherry picking - when insurance companies choose to cover only healthy patients - by equalizing risk across insurance companies and reversing the perverse incentives that leave those most vulnerable with the fewest options.

Our bill creates voluntary state-based solutions - state health exchanges - that will offer health insurance benefits using the same standard used for Members of Congress. Every American would have guaranteed access to coverage and care under this plan, regardless of patient age or health history. And to ensure that states get to design the solutions their patients need, states would have the freedom to form voluntary pooling arrangements with other state exchanges to diversify risk pools, ease administrative burdens and cover costs for insurance. We also provide simple new opportunities for automatic enrollment to help people who need coverage.

Strengthens the health care safety net. Currently, about 40 percent of doctors and hospitals do not accept Medicaid patients because payments are so low. This means that needy moms and kids may have health coverage, but poor access to health care. We remove the stigma from Medicaid recipients and give them the ability to purchase the health coverage and care they need from any provider. We preserve Medicaid for the blind, aged, and disabled and we eliminate widespread fraud in the programs. We do all this and still save states and the federal government about $1.3 trillion over the next 10 years.

Finally, our bill accomplishes these goals without spending any new federal money, or raising taxes. If this sounds too good to be true, we would note that the problem in health care is not that we don't spend enough, but that Americans aren't getting enough value for their dollars. On a per capita basis, America spends nearly twice what other industrialized nations spend on health care yet we are hardly twice as healthy.
From the National Review:

Among other things, the Burr-Coburn bill would establish an advanceable, refundable tax credit for health insurance, worth nearly $2,300 for individuals and just over $5,700 for families. This would make coverage more affordable for the self-employed, the unemployed, and those whose employers don’t provide health benefits — all of whom lose out under the current employer-based system. It would also help workers who are between jobs or are dissatisfied with their employer-provided insurance.

Meanwhile, the legislation would make Health Savings Accounts (HSAs) more attractive by removing the tax penalty on health-insurance premium payments made with HSA money, and by raising the ceiling on annual HSA contributions. In addition, the bill would let High Deductible Health Plans — which are paired with HSAs — cover preventative services.

HSAs were first introduced as part of the 2003 Medicare Modernization Act. In January, Diamond Management & Technology Consultants reported that, while the recent expansion of the HSA market had been “slower than expected,” HSAs “have become an integral element of the consumer-directed health-care trend.” According to Diamond, HSAs grew at an average annual rate of almost 70 percent between 2005 and 2008. Diamond reckons that the number of HSA accounts will swell to at least 11 million and perhaps as high as 13 million by 2012, at which point those accounts will have $35 billion–$45 billion in total assets.

Burr and Coburn also want to create State Health Insurance Exchanges that would function as marketplaces for consumers. These exchanges would have safeguards to protect patients with preexisting conditions. States would also have the opportunity to form new health-insurance pools.

The bill does not shy away from entitlement reform. It would subsidize the transfer
of certain low-income families from Medicaid to private insurance plans, an important step in ensuring that these Americans have ready access to health care. It would also restructure how federal and state governments share the burdens of Medicaid and Medicare; revamp the Medicare Advantage program; establish Medicare Accountable Care Organizations; and force wealthy Medicare recipients to pay more for the services they receive under Medicare Part B.

Nancy Pelosi has declared that the goal of health-care reform is to achieve “quality, affordable, accessible health care for all Americans.” The Burr-Coburn legislation would not guarantee “universal” insurance coverage, but it would make quality health insurance and care more affordable and accessible. Conservative policy wonks will doubtless find nits to pick in the bill, and it’s unclear how many Republicans will embrace the Burr-Coburn approach. In recent years, says former GOP whip Rep. Roy Blunt, “no more than two dozen” Republican House members have been deeply engaged in the health-care issue. That is now changing, thanks in large part to the challenge of defeating Obamacare.
From the Health Care Reform Coalition:

We believe any health care reform proposal must follow these principles:

Free Choice of Doctors, Hospitals, and Health Plans Any health care reform proposal must allow all Americans to choose their own doctor, hospital, and health plan. Furthermore, no reform proposal should coerce any American into buying a health plan designed by the government or be required to join a government-created, government-funded, or government-run purchasing pool or connector where the government selects health benefits and plans from which to choose.

Health Savings Account Option for All Americans Health Savings Accounts (HSAs) are the only health plan that allows free choice of doctors and hospitals while providing incentives to reduce health care spending. Therefore, HSAs must be an option for all Americans, including those who are beneficiaries of government health care programs, such as Medicaid and Medicare. Any regulations or obstacles to making HSAs an option for Medicare and Medicaid beneficiaries must be removed to meet this goal.

Tax Fairness and Simplification for All Americans
The current tax break for health insurance is discriminatory, unfair, and, quite frankly, a mess. Employer-provided health insurance is tax free from income and payroll taxes. Self-employed individuals get to deduct the cost of their premiums from income. And, consumers who buy their own policy get no tax break. Workers who are displaced from a job due to a trade agreement get a 65 percent tax credit under the Health Care Tax Credit (HCTC). This mess cannot continue.

We believe the tax break for health insurance needs to be fair, nondiscriminatory, and apply to all Americans whether they get their health insurance from their employer or not.

Affordable Health Insurance for Small Business
Fewer and fewer small employers are providing health insurance because of the cost. The cost of health insurance is especially painful for tiny employers who employ fewer than 10 employees. Benefit mandates and regulatory mandates, such as HIPAA’s guaranteed issue mandate on small employers, apply to state-regulated, fully insured plans. Large employers who self-insure under ERISA escape all the benefit mandates at the state level and have more flexibility in designing a health care plan for their employees.

Small employers should be allowed to join together across state lines and have the same flexibility that large employers enjoy.

Buying Health Insurance Across State Lines
Individuals who buy their own health insurance plan and many small employers are limited in the type of health insurance that they can buy. Most are forced to buy insurance in their state that contains all the benefit mandates and benefit regulations imposed on them by state legislators. Families in Minnesota are forced to buy a health plan that contains 62 mandates, while families in Idaho can buy a plan with 13 mandates. In New Jersey, a family HMO costs $1,652 per month, while a family can buy a HMO plan in Pennsylvania for $707 per month!

The Constitution permits interstate commerce, so American families should be allowed to buy health insurance that meets their health care needs and should be allowed to buy insurance from other states. If a family in Idaho wants to buy a health care plan with all of Minnesota’s 63 mandates, they should have the choice to buy. If a family in Minnesota wants to buy a health care plan with Idaho’s 13 mandates, they should have that choice.

Health Care Price Disclosure
Since the creation of HSAs, more than 6 million Americans have chosen them for their health care needs. While more Americans will continue to choose HSAs, it is important for America’s families to know the cost of health care. Hospitals mark up their prices dramatically – some more than 500 percent – so it is important for an open health care system for shoppers to know the cost of the care that is being provided.

Hospitals and doctors should be encouraged as a condition of accepting Medicare and Medicaid reimbursement to publish their cost to provide the care. They should also publish the reimbursement schedule from various payers, including Medicare and insurance companies, so consumers will be better educated.

High Risk Pools for People who are Sick
Thirty-three states have high risk pools that provide health insurance to people who are sick and can’t get health insurance. This population represents a small portion of the country, but they should not be left out of America’s health care system because they are sick. Congress has historically provided federal dollars to encourage states to establish a high risk pool for people who are sick, and states have taken advantage of these federal dollars.

Congress should continue to provide incentives for states to establish high risk pools so people who are sick can have access to affordable health insurance.

Convert DSH payments into Health Insurance Block Grants/Vouchers
The federal government provides nearly $20 billion dollars a year in disproportionate payments (DSH) to hospitals that treat people who don’t have health insurance. Considerable evidence exists that hospitals actually collect and profit from uninsured patients. DSH payments should be sent to the states in the form of health care block grants. States would be required to use those DSH payments to provide vouchers for private health insurance for the uninsured.

Nonprofit Alternatives to Health Insurance
More than a hundred thousand Americans choose not to buy health insurance because they belong to nonprofit, faith-based organizations that share each other’s health care costs. These Americans should be allowed to continue this alternative way to access our nation’s health care system and should not be coerced into buying health insurance.

More Competition Between Facilities
Consolidation and mergers of hospitals has led to actual or near-monopoly conditions in many communities in the United States. Monopoly always leads to excessive prices, poor quality, and lack of innovation. The biggest obstacle to increasing innovation and competition are the Certificate of Need laws that are still in effect in most states. These laws are 1970s style regulations that allow existing facilities to block the establishment of new competitors. They should be repealed.

No Mandates
According to the Council for Affordable Health Insurance, state lawmakers have enacted more than 1,900 benefit mandates on consumers. The federal government has enacted three mandated benefits on consumers. In addition, states and the federal government have imposed guaranteed issue coverage mandates and price control mandates (community rating) on American workers and small employers.

We challenge Congress and state legislators to impose a five-year mandate free zone on Americans beginning in 2008 and running through 2013.

No Government Price Controls
The Federal government should not expand its practice of setting prices in our health care system. Price Controls distort the marketplace causing perverse incentives and cost shifting.

No Basic Benefit Packages or Actuarial Equivalent
Federal and state legislators should not impose a health insurance benefit package on Americans nor should they require consumers to buy a health insurance plan that is equivalent in value to an existing health insurance plan.

No Health Care GSEs
The federal or state government should not become or create government sponsored enterprises for health care that act as reinsurance programs. Private reinsurance companies provide insolvency protection and important health care services, such as chronic care management, to people who are sick.

Anyway, it is clear, to me at least, that there are plenty of alternatives out there. Obama's plan isn't our only choice to solving this problem, and don't let anyone tell you otherwise. Whenever a Democrat tells you that you have no other choice, reach for your wallet, before they do.


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