The main thrust of the Republican health care bill is an argument against greater government spending on health care. By completely repealing the employer-tax exclusion for health care benefits, they’re redistributing money already in the system and giving it to Americans in the form of refundable tax credits.
The argument is this: after the employer exclusion is repealed, employers will convert the money they spend on your health care benefits into higher wages and you’ll be able to use that increase and the ($2,290 per individual or $5,710 per family) refundable tax credit to purchase health care coverage in the new State Health Insurance Exchanges or the existing individual market.
Since everyone would have “universal access” to coverage, greater government involvement in health care would be counterproductive. Government rots the system, and Americans know this, they argue:
In solving our health care crisis, Americans already know that government will not work…Patients should be able to choose from a variety of private insurance plans. The Federal government would run a health care system — or a public plan option — with the compassion of the IRS, the efficiency of the post office, and the incompetence of Katrina.
Therefore, greater government involvement must not only be avoided, but existing government involvement should be phased out. Low-income families with dependent children should shift out of Medicaid and into “higher quality private plans through direct assistance that will be coupled with a tax credit.” Medicare Advantage — the program that contracts with private insurers — should be “reformed” and possibly expanded.
But today, the Commonwealth Fund released a new survey indicating that “elderly Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than people covered by employer-sponsored plans.” “The findings bolster the argument that offering a public insurance plan similar to Medicare to the under-65 population has the potential to improve access and reduce costs,” the organization concluded:
- Medicare beneficiaries report easier access to physicians. Ten percent of Medicare beneficiaries’ physicians did not accept their insurance, compared with 17 percent of respondents with employer-sponsored plans.
- Medicare beneficiaries are less likely to report not getting needed services. Twelve percent of elderly Medicare beneficiaries reported going without care, such as prescribed medications or recommended tests, because of cost restraints. Of individuals with employer-based plans, 26 percent reported experiencing these cost/access issues.
- Medicare beneficiaries are sicker and poorer but report fewer medical bill problems.
Medicare beneficiaries were less likely to report a medical bill problem than those covered by employer plans.
Within our hybrid public-private system of coverage, public plans compliment private insurers — providing services to vulnerable populations more efficiently. Today, talk of “government-takeover” conjures up images of health care rationing in Great Britain or Canada. If, however, Democrats are able to shift the frame of reference to an expansion and improvement of Medicare, then they may very well win this debate.