Quick Thoughts on The Patients’ Choice Act

Some Republican members of congress released a new health care plan today, the Patients’ Choice Act, that has at its core the same idea as John McCain’s health care plan — eliminating the tax subsidy for employer-provided health insurance and replacing it with a different tax subsidy for individual purchase of health insurance. And while the new tax subsidy would be roughly as generous on average as the current one, it would grow less generous over time.

I’ll post some further thoughts on this document when I get to canvass some more expert reactions. But a few points:

— This plan seems to try to grapple with the problems involved in the individual insurance market, and in that sense is a big step forward from McCainCare, but it’s not clear that it successfully grapples with them.

— One clear step forward from McCainCare is that it broadens the scope of consideration and does various things in the prevention and wellness space.


— On the other hand, near the end they appear to be trying to gut Medicare and replace it with a more-expensive but less-generous system of subsidies to private insurance firms.

— Relatedly, very brief discussions of the VA health system and the health care system for Native Americans point toward privatization and subsidies of private firms.

Last, this is a somewhat mysterious idea:

Government health programs should adhere to the Hippocratic Oath to “First, do no harm.” This means federal programs should not promote or support unhealthy behaviors and taxpayers should not be expected to support programs that do not show positive results. This act would require reviews of existing programs and the consolidation of overlapping programs and the elimination of ineffective programs. Additionally, “junk food” that does not meet nutrition standards would be prohibited for purchase under the federal Food Stamp Program.

I have no idea what the scope of this would be. Does it rule out federal corn subsidies? Mandate a sweeping overhaul of federal transportation financing? I doubt that’s what they mean. But what do they mean?