Republican Health Care Plan Unveiled

Republicans in Congress are slated to unveil their health care reform plan on Wednesday, a proposal that relies heavily on private mechanisms, contains no individual mandate, and offers tax incentives for families and individuals to help pay for coverage.

Titled "The Patients' Choice Act of 2009," the plan will be introduced by U.S. Senators Tom Coburn, (R-OK) and Richard Burr (R-NC) and U.S. Representatives Paul Ryan (R-WI) and Devin Nunes (R-CA) at 11 a.m. The focus of the proposal -- an advanced copy of which was obtained by the Huffington Post -- is to push for a "guaranteed choice of coverage" in the private market through federal-state partnerships know as State Health Insurance Exchanges.

Individuals, the authors write, will have a "one-stop marketplace" to choose plans in the exchange, including the option of keeping their employer coverage and/or existing insurer. "Participating insurers," meanwhile, would be required to "offer coverage to any individual -- regardless of patient age or health history" though there is no mandate for an individual to purchase that insurance.

Where the plan seems likely to run into strong opposition is in its efforts to drastically move the insurance market away from employer-based or publicly operated plans. As championed by John McCain during the presidential campaign, The Patients' Choice Act of 2009 effectively ends tax breaks for employers who provide health coverage to their workers, choosing instead to give a $5,710 tax cut to families and a $2,290 cut to individuals to help them pay for health insurance coverage. Critics insist that this system would end up costing both business and consumers more over the long term. And some objective analysts have agreed. After all, families are currently paying approximately $12,300 a year for health care today.

The notion that guaranteed choice can be achieved under the private market is also predicated on several debated notions. The first is that an effective enforcement mechanism can be put in place requiring private insurers to offer coverage. The authors call for the creation of a non-profit, independent board "to penalize companies that cherry-pick health patients." The second concern is that the market itself might consolidate. The latter is already promising to be a big problem, a Democratic critic of the plan notes, as studies show the HMO and Preferred Provider Organization industries to be "highly-concentrated, or anti-competitive, in 96% of metropolitan areas."

There are, finally, some budgetary concerns with the Republican proposal. The authors call for investing in chronic disease prevention for problematic, long-term illnesses -- including providing $50 million annually for increased vaccine availability. They pledge major administrative improvements in Medicaid and Medicare as well. And they promise to ensure compensation for injured patients by encouraging legal reforms. All of this will require spending, and eliminating the tax exclusions for employer coverage can only get them so far.

Below is the 14-Page Outline of The Patients' Choice Act of 2009. Take a look and tell us what you see.

PCASummary -

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Comments

[vippy]

Adopt this plan only if congress/senate is willing to give up theirs and adopt this proposal!

[kevman08]

Their stance of "choice" is getting really old. Has any Republican every read a healthplan manual? You have this crappy "choice" or that crappy "choice". In-network, out -of-network, non-covered items, and deductibles. These are NOT "choices" ALL private healthplans are nothing but an over-priced band-aid that has lived far beyond it's years. Obama needs to stop trying to be a centrist and give us our single payer plans NOW!!

[ProgressiveBum]

Great analysis! And very succinctly put!

[RumiSouth]

Their plan says we can save money by:

A) Punishing senior citizens for their "bad habits"

B) Giving out free flu shots (finally! A universal benefit -- Obama can keep that).

C) Quit letting poor people buy junk food!

The Republicans can't help it; they always have to blame the poor. But this time, the GOP has stumbled across their own success. For those who don't know, at the behest of the Bush regime food stamps have already been made electronic. We can actually automate enforcement of regulations like this one with the bar-code scanners at every cash register that sells food. Not to mention that...

...wait for it...

...there are already nutritional standards about what you can buy with EBT cards! Yes, we can keep po'folks from eatin' theyselves into dieyuh-betus, sho' nuff. Most of the urban legends about "food stamp abuse" were untrue to begin with, and now the last remaining real abuses are going the way of the Dodo.

[RumiSouth]

The Republican Party makes one glaring admission in their plan: "Washington and state bureaucracies already control more than 59.8 percent of health care spending."

This is a talking point primed to backfire. They mean to frighten Harry and Louise with the news that universal health care is THAT CLOSE ALREADY. Instead, they're basically admitting to Harry and Louise that their party is on the wrong side of history. What are the chances Harry and Louise will feel like they have been left out?

Moreover, I'd say the 59.8 percent figure is out of date -- and the percentage is still climbing. Remember all that talk about the evils of union health care plans, and how they were bringing down General Motors? Well, GM has been shoving retirees out of the plan and onto Medicare for months. My source for this information? I was in the call center as the angry old people called us...to register, to check prices, and to complain. You have no idea how many times I heard Obama's name. He has become their last, best hope for better.

In contrast, the GOP has more or less recycled McCain's plan. End waste! Stop the welfare state! Just don't mess with the insurance industry!

Didn't we already have an election about this stuff?

[ramal]

Let's see I currently pay a health insurance premium to my employer of around $800.00 a year for single coverage. If I were even able to find an insurer on my own being 55 years old and having chronic health problems my premium would probably rise to around $7,200.00 a year. Would any Repug please explain how their plan would be a good thing for me or anyone else for that matter? These people don't live in the real world.

[wikwox]

They should have named the plan " For Love of Vouchers". Or perhaps Tax cuts cure cancer!

[lcdbsez]

It's amusing to see the weepublicans trying to describe a mafia shakedown scheme (like this) as a healthcare option.

Sooooo, lemme get this straight . . . I pay an insurance company $4K-a-year . . . for . . . something I could walk into any doctor's office or clinic for, if I paid in cash . . . but, I have to fork it over to the insurance company first, b/c . . . they're the bullies guarding the door -- ????

Sorry, but I don't see what function the insurance mafia serves in this situation -- other than to generate money/profits for the CEOs. Oh, yeah, sure -- they employ thousands and thousands of low-skilled, low-wage paper-pushing slugs . . . and, oh my! what would happen if alllllll those pathetic jobs were eliminated -- with thinking like that, we'd still be driving around in horse-and-buggies and using kerosene lamps, too!

How about substituting real jobs, paying liveable wages, in industries that don't exist solely to rip-off people -- for a change????????

[Carolab]

Howard Dean touts Obama's health care plan in Kalamazoo speech:

http://www.mlive.com/news/kalamazoo/index.ssf/2009/05/howard_dean_touts_obama_health.html

[LA2000]

I really don't understand our American aversion to nationalized health care. Other, far wiser nations have solved this problem a long time ago. We should learn from them rather than attempt to reinvent the wheel. The solutions already exist. They've been tested and have succeeded. When will we be humble enough to accept that sometimes other countries can teach us something?

The Canadian system works. I am American. I got sick while on a job in Canada. The quality of care was superior, faster, and cheaper than my "free market" pricey US insurance. The myth that Canadian healthcare is some crazy Orwellian bureaucracy is exactly that: a myth.

And as for you Canadian complainers: try trotting down here and trying out the most expensive but lowest ranked healthcare system in the modern world. Nothing will make you sing the Canadian national anthem louder than a trip through our dysfunctional American medical establishment.

[Chip W]

I think a lot of it is the knee-jerk "Eek, eek, Socialism" reaction.
The question of what might work doesn't even get asked when there's a hint of the "S" word.

[vippy]

Same here. I am from Germany and I only can say good things about their healthcare there.
Far superior to what I am experiencing here.

[Actongue]

My Omi and Opi would fly back to Germany when they needed to go to the Doctor.

Here a pill there a pill everywhere a pill to treat the pill.

Like Chip said they equate anything even if it is far supierior to sicialism and that everything that is a social thing is bad.

[gypsysailor]

This looks like more republican smoke and mirrors to allow something that cries out for regulation to be turned over to the free marketplace. Remember free markets? Got us right where we are today.

[pmag88]

The bottom line is that people don't have the time or the tools to become experts at evaluating insurance companies and medical care in general. Thats why our government relies on a system of care which insures that they don't have to. They don't have to worry they made the wrong choice, or they were lied to, etc. They don't have to go through arbitration with some nebulous third party to resolve disputes. None of that exists in their world, but in our world it's catch as catch can. Personal responsibility for us, quality, taxpayer paid, government health care for them and their families.

[msgruntled]

Exactly right on the two castes in this country.
From: http://unrepentantcommunist.blogspot.com/2008/09/socialism-for-richor-how-roubini-was.html

"Gore Vidal writing in the 1980's made the observation that Reagonomics was nothing more than the expression in policy terms of the fact that "The US government prefers that public money go not to the people but to big business. The result is a unique society in which we have free enterprise for the poor and socialism for the rich."

[pmag88]

Actually, I must amend my original post. Not even the first paragraph is good. I have a friend who works for an insurance company and she tells me that due to additional, unexpected, costs associated with a recent surgery, she would have much preferred her old HMO and would go back in a second. The doctor performing Her operation was in network, the two anesthesiologists weren’t. And no rational explanation why this fairly routine surgery required two anesthesiologists. Just fork up the money.

[pmag88]

The first paragraph is on point. The rest is sheer madness.

[houseafire]

I heard today, I think it was on the Maddow show?, not sure, that the republicans are planning on reading the complete bill, in it's entirety, with all amendments, just to slow down the progress of the health care reform bill....

I gotta say, in my opinion, judging the results over the past couple of months, both the democratic and republican house and senate are FAR more interested in playing stupidass little political games and selling themselves to the highest bidding lobbyist than they are in even giving the actual we the people even a second worths of thought.

I'm disgusted and completely disappointed.....and, my future votes will reflect my strong feelings!

[vippy]

Yes, vote them all out of office, all incumbents! After 4 years vote them out again. Only then do we have a chance!

[myptofvu]

Single Payer or you're fired!!!

[blaising]

Since when are republics for "choice"?

Another republic Tourette moment?

[Tahut]

Go back and read the last sentence in the third paragraph ...

"And increasing the association between patient responsibility for payment and quality of outcomes would vastly improve accountability"

So it seems we the public are at fault for not paying our fair share of medical expenses and the hospitals for running up the bills - it's never the fault of business.