David Leonhardt reports in today’s New York Times:
You might think, then, that a central goal of health reform would be to offer people more choice. But it isn’t.
Real choice is not part of the bills moving through the Democratic-led Congress; even if the much-debated government-run insurance plan was created, it would not be available to most people who already have coverage. Republicans, meanwhile, have shown no interest in making insurance choice part of a compromise they could accept. Both parties are protecting the insurers.
This is only half right. It is true that the versions of health reform already marked up by Democratic majorities in the House and Senate would decrease, not increase, Americans’ health care choices. But it is 100% untrue that conservatives have not proposed health care alternatives that would increase consumer choice. In fact, virtually all of the conservative health plans on Congress are centered on the insight that increased consumer choice is the key to higher health care quality and lower health care costs:
- Sens. Tom Coburn (R-OK) and Richard Burr (R-NC) along with Reps. Devin Nunes (R-CA) and Paul Ryan (R-WI) have all sponsored the Patients’ Choice Act which provides a path to universal coverage by redirecting current subsidies for health insurance to individuals and establishes new safety net that guarantees access to insurance for those with pre-existing conditions.
- Rep. John Shadegg (R-AZ) has sponsored the Health Care for All Americans Act which offer tax relief for those who don’t have employer-sponsored insurance or don’t like their current work place coverage, establish new pooling arrangements for individuals, and facilitate mechanisms for the state to address high cost individuals.
- Sen. Mike Enzi (R-WY) has introduced the Ten Steps to Transform Health Care in America Act which eliminates unfair tax treatment of health insurance for all Americans, thereby expanding choices, coverage, and control over your health care and increases affordable options for working families to purchase health insurance through a standard tax deduction.
For our part, Heritage has long been an advocate for consumer driven, patient-centered health reform. Here are six key principles Heritage fellow Ed Haislmaier outlined just last year:
- Individuals are the key decision makers in the health care system. This would be a major departure from conventional third-party payment arrangements that dominate today’s health care financing in both the public and the private sectors. In a normal market based on personal choice and free-market competition, consumers drive the system.
- Individuals buy and own their own health insurance coverage. In a normal market, when individuals exchange money for a good or service, they acquire a property right in that good or service, but in today’s system, individuals and families rarely have property rights in their health insurance coverage. The policy is owned and controlled by a third party, either their employers or government officials. In a reformed system, individuals would own their health insurance, just as they own virtually every other type of insurance in virtually every other sector of the economy.
- Individuals choose their own health insurance coverage. Individuals, not employers or government officials, would choose the health care coverage and level of coverage that they think best. In a normal market, the primacy of consumer choice is the rule, not the exception.
- Individuals have a wide range of coverage choices. Suppliers of medical goods and services, including health plans, could freely enter and exit the health care market.
- Prices are transparent. As in a normal market, individuals as consumers would actually know the prices of the health insurance plan or the medical goods and services that they are buying. This would help them to compare the value that they receive for their money.
- Individuals have the periodic opportunity to change health coverage. In a consumer-driven health insurance market, individuals would have the ability to pick a new health plan on predictable terms. They would not be locked into past decisions and deprived of the opportunity to make future choices.