09/26/2012 02:22 pm ET

Best Healthcare Plan? Here's What Obama And Romney Aren't Talking About

By now you’ve heard the competing campaign slogans. Obama wants a government takeover of healthcare. Romney wants to turn it all over to big business. And while both claims are elephant-sized exaggerations, the best course might be something neither is talking about: nonprofit health care plan providers.

In a survey published this week in the November issue of Consumer Reports, all of the top 10 insurance plans in America were operated by nonprofit organizations (NPO), including several plans offered by Kaiser and Harvard Pilgrim.

In the political debate over who should provide healthcare for Americans, the theme of nonprofit health care gets less attention as campaign politicking has focused on two ends of the spectrum: government-run health care versus for-profit health insurance.

But take away the profit-motive and shareholders, and often nonprofit organizations can better focus on the mission to provide health care rather than drive revenue, some medical consumer experts say. Perhaps that's why NPO health insurance has proven so popular. At least 40 percent of Americans who have private insurance have a non-profit provider, according to the Alliance for Advancing Nonprofit Health Care, although many may not realize it.

For most Americans, health insurance comes from the government in the form of Medicare or Medicaid or from private insurance either from for profit companies or NPOs. Millions of Americans have no insurance at all, either because they don't qualify for government programs, cant afford private insurance or don't believe they need it.

Under the Affordable Care Act, which will start in 2014, consumers continue to have these choices, and the plan expands government-run programs. Millions of uninsured will also be able to access health insurance through health care exchanges, or online markets where consumers can shop for health insurance among competing plans offered by private companies as well as nonprofit organizations.

Republican nominee Mitt Romney's main thrust is to privatize more health care plans by shifting Medicare recipients to voucher programs; consumers would still likely have a choice between private and NPO-run healthcare.

Yet as the debate continues, perhaps the better question for the candidates is not the rhetoric over public vs. private, but what kind of organization is offering the best kind of care and how can that be scaled to provide affordable access for most Americans.

In the Consumer Reports survey, the top-scoring brand in the survey was Kaiser, a nonprofit, integrated health care provider available to consumers in at least nine states, including California and Colorado. The top-ranked plan in the country was the Harvard Pilgrim HMO, which is available to residents of Massachusetts, Maine and New Hampshire.

For-profit brands like Aetna, Humana and UnitedHealthcare did not fare as well in the rankings, which included more private plans in the bottom 100 than in the top 100, according to Consumer Reports.

However, nonprofit organizations are hardly a panacea for a health care system that many consider broken. This week, a report from two North Carolina newspapers showed that large nonprofit hospitals in the state have been marking up costly cancer drugs as they corner the market on cancer treatment in the state.

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