Rep. Dave Camp and other House Republicans today released an outline of an alternative health care bill. It’s true that a Republican plan isn’t going anywhere, and anything coming out of the House as opposed to the Senate matters even less. But when the minority party presents an alternative, it’s at least an opportunity to highlight a different vision for reform. Unfortunately, this effort by Republicans fails miserably short by offering more government while doing nothing to foster a free market for health care in this country. In fact, it doesn’t even use the word “market” once.
For starters, the Republican proposal aims to reinforce the employer-based insurance model by maintaining the tax exclusion and simply creating a new one for individuals. While this is fairer than the current system, it would still preserve the system in which most people get their insurance through their employer, limiting their choice, hindering their ability to take insurance with them from job to job, and driving up costs because people have the notion that somebody else is paying all the bills.
The proposal also creates a raft of new subsidies, including: “immediate substantial financial assistance, through new refundable and advanceable tax credits, to low- and modest-income Americans”; “To help those aged 55 to 64, the plan increases support for pre- and early-retirees with low- and modest-incomes”; “Gives financial help to caregivers who provide in-home care for a loved one.”
Any truly free market reform would find some way around the thousands of benefit mandates states put on health coverage, which according to the Council of Affordable Health Insurance, help drive up the cost of policies by 20 percent to 50 percent. But instead of taking aim at this problem (many free market reforms involve allowing people to purchase insurance across state lines), the plan creates a new federal mandate allowing parents to keep children on their policies until they are 25. These so-called “slacker mandates,” which already exist in some states, sound benign actually drive up the cost of insurance.
And that isn’t even the only form of regulation in the GOP proposal It also, “Encourages states to create a Universal Access Program by establishing and/or reforming existing programs to guarantee all Americans, regardless of pre-existing conditions or past illnesses, have access to affordable coverage.” The problem with “guaranteed issue” laws is that they’ve led to a mass exodus of insurers in states that have adopted them, because when government says insurers have to take on riskier patients, they have to jack up prices on everybody else to recoup their costs. This means that healthier people tend to stop buying insurance, and insurers run for the hills. Once go down the road of “guaranteed issue,” the only way around this problem is to either adopt an individual mandate forcing people to buy health coverage — which creates other problems — or just increasing government subsidies.
The outline also offers some of the same vague promises as the Obama administration, such as cutting down on “waste, fraud and abuse” and “improv[ing] Americans’ lives through effective prevention, wellness, and disease
management programs, while developing new treatments and cures for life- threatening diseases.”
There is some more positive language in the bill, such as a mention of medical liability reform, health savings accounts, and allowing Medicaid and SCHIP beneficiaries to obtain insurance outside of a government plan. But there aren’t any more details, so its hard to say what that would mean.
The outline does not provide any numbers, either cost estimates or any mention of the value of the various subsidies and tax credits offered.
Perhaps I’m making a mistake by evaluating the plan based on how market-friendly it is, given that it isn’t being sold that way. In fact, the word “market” doesn’t appear once in the outline or press release.