Ssrsh Kliff analyzes the long-awaited Republican alternative to the Affordable Care Act.
Sam Baker writes that the plan is for people to pay more for their own care.
Abstract: Following the Supreme Court’s decision in 2012, state officials are now deciding whether to expand their Medicaid programs under the Affordable Care Act. While the states’ costs of participating in the Medicaid expansion have been at the forefront of this discussion, the expansion has much larger implications for the flow of federal funds going to the states. This issue brief examines how participating in the Medicaid expansion will affect the movement of federal funds to each state. States that choose to participate in the expansion will experience a more positive net flow of federal funds than will states that choose not to participate. In addition to providing valuable health insurance benefits to low-income state residents, and steady sources of financing to state health care providers, the Medicaid expansion will be an important source of new federal funds for states.
Complete report here.
From Paul Ryan's original health care proposal, which established him in some eyes as tough-minded health policy intellectual with bold and innovative solutions. Such as these:
Provides a refundable tax credit – $2,300 for individuals and $5,700 for families – to purchase coverage in any State, and keep it with them if they move or change jobs.
Provides transparency in health care price and quality data, making this critical information readily available before someone needs health services.
Creates state-based health care exchanges, so individuals and families have a one-stop marketplace to purchase affordable health insurance without being discriminated against based on pre-existing conditions.
Equips states with tools like auto-enrollment programs and high-risk pools, so affordable health coverage can be accessed by all.
Addresses health care’s growing strain on small businesses, by allowing them to pool together nationally to offer coverage to their employees.
Encourages the adoption of health information technology and assists states in establishing solutions to medical malpractice litigation.
Seems like I've heard a lot of this before...
The American health policy trap: a costly and complicated system that has left a growing minority of Americans without financial protection in sickness but has nonetheless satsfied enough people to make it difficult to change. The key elements of the trap are a system of employer-provided insurance that conceals its true costs from those who benefit from it; targeted government programs that protect groups such as the elderly and veterans, who are well organized and enjoy wide public sympathy and believe that, unlike other claimants, they have earned their benefits; and a financing system that has expanded and enriched the health care industry, creating powerful interests averse to change.Paul Starr, Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform
"[There is] no difference between men, in intelligence or race, so profound as the difference between the sick and the well."
F. Scott Fitzgerald, The Great Gatsby
"Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick."
Susan Sontag, Illmess as MetaphorAdvocates of consumer-driven health care contend that patients are consumers of health care and that choice of insurance plan forms the basis of a successful health care model. In their seminal book Redefining Health Care, Porter and Teisberg argue that CDHC champions err by focusing on consumer choice rather than value-driven care as the primary economic driver of competition in health care.