Our Health Policy Matters

Should the Affordable Care Act be repealed so that over a million people making more than $123,000 per year can avoid paying $3,000 in taxes beginning in 2016?  And should they be allowed to pass on the cost of their health care to everyone else? This week, a local newspaper quoted a lifelong Florida Democrat as saying she might vote for Mitt Romney because she believed ACA offered “a costly giveaway to freeloaders.” The irony is that the law actually does just the opposite – and Mitt Romney knows this better than most.  It requires nearly all health care “freeloaders” either to get insurance or pay a tax penalty. Eighty percent of those affected will get insurance.  But the Congressional Budget Office reported last week that it expects 6 million people to owe the tax penalty beginning in 2014.  The $8 billion the penalty will eventually raise will help defray the cost of uncompensated care. Six million people make up less than 2% of our total p...

Should the Affordable Care Act be repealed so that over a million people making more than $123,000 per year can avoid paying $3,000 in taxes beginning in 2016?  And should they be allowed to pass on the cost of their health care to everyone else? This week, a local newspaper quoted a lifelong Florida Democrat as saying she might vote for Mitt Romney because she believed ACA offered “a costly giveaway to freeloaders.” The irony is that the law actually does just the opposite – and Mitt Romney knows this better than most.  It requires nearly all health care “freeloaders” either to get insurance or pay a tax penalty. Eighty percent of those affected will get insurance.  But the Congressional Budget Office reported last week that it expects 6 million people to owe the tax penalty beginning in 2014.  The $8 billion the penalty will eventually raise will help defray the cost of uncompensated care. Six million people make up less than 2% of our total p...

A Medicare exchange in which private plans compete with a public option?  A Medicaid program unshackled by federally determined program requirements and eligibility criteria? Now that Governor Romney has chosen Rep. Paul Ryan as his running mate, these new visions of Medicare and Medicaid will become part of the health policy debate in every state. They are both part of Vice-Presidential candidate Ryan’s now-famous Path to Prosperity proposal  published earlier this year. In his vision, Ryan attacks an “open-ended, blank-check” Medicare subsidy that in practical terms means a government that will pay providers what it costs to treat diseases even for the most expensive seniors.  In his own words:  “Medicare subsidizes coverage for seniors to ensure that coverage is affordable.  Affordability is a critical goal, but the subsidy structure of Medicare is fundamentally broken and drives costs in the wrong direction.  The open-ended, blank-c...

A Medicare exchange in which private plans compete with a public option?  A Medicaid program unshackled by federally determined program requirements and eligibility criteria? Now that Governor Romney has chosen Rep. Paul Ryan as his running mate, these new visions of Medicare and Medicaid will become part of the health policy debate in every state. They are both part of Vice-Presidential candidate Ryan’s now-famous Path to Prosperity proposal  published earlier this year. In his vision, Ryan attacks an “open-ended, blank-check” Medicare subsidy that in practical terms means a government that will pay providers what it costs to treat diseases even for the most expensive seniors.  In his own words:  “Medicare subsidizes coverage for seniors to ensure that coverage is affordable.  Affordability is a critical goal, but the subsidy structure of Medicare is fundamentally broken and drives costs in the wrong direction.  The open-ended, blank-c...

President Reagan gave his first speech on the AIDS epidemic almost twenty-five years ago on May 31, 1987.  This was after 36,058 Americans had been diagnosed with AIDS, 20,849 had died, and over a quarter of a million had been infected with HIV. For years, he had been criticized for ignoring and underfunding the worst public health crisis of the late 20 th century.   So he began his speech with a joke: “A charity committee approaches the wealthiest man in town for a contribution.  ‘Our book shows that you haven’t contributed any money this year,’ they tell him.  ‘Does your book also show that I have an infirm mother and a disabled brother?’ he replies.  ‘Why no,’ they say, ‘we didn’t know that.’ ‘Well, I don’t give them any money.  Why should I give any to you?’” The bad joke was an inadvertent punctuation mark on a presidency too fondly remembered by both republicans and democrats today. On matters of health, Reagan took us ...

President Reagan gave his first speech on the AIDS epidemic almost twenty-five years ago on May 31, 1987.  This was after 36,058 Americans had been diagnosed with AIDS, 20,849 had died, and over a quarter of a million had been infected with HIV. For years, he had been criticized for ignoring and underfunding the worst public health crisis of the late 20 th century.   So he began his speech with a joke: “A charity committee approaches the wealthiest man in town for a contribution.  ‘Our book shows that you haven’t contributed any money this year,’ they tell him.  ‘Does your book also show that I have an infirm mother and a disabled brother?’ he replies.  ‘Why no,’ they say, ‘we didn’t know that.’ ‘Well, I don’t give them any money.  Why should I give any to you?’” The bad joke was an inadvertent punctuation mark on a presidency too fondly remembered by both republicans and democrats today. On matters of health, Reagan took us ...

“States and private markets, not the federal government, hold the key to improving our health care system.” Those are the words of Presidential candidate Mitt Romney, as he articulates his health reform vision on his campaign web site . U.S. health care costs are around $2.5 trillion. This money buys a lot of care, and pays a lot of salaries.  One out of every six workers in America relies on the health care industry for a paycheck.  Romney thinks that’s too big a cost for care. “At its core of this debate,” he writes (jarringly inarticulately for an official campaign web site), “is the question of what creates better patient outcomes and more efficiency: free enterprise and consumer-driven markets, or government management and regulation?” I realize that he wants us to answer “free enterprise and consumer-driven markets.” But in this case, that doesn’t happen to be true. The reasons why we have even a semblance of an affordable health care s...

“States and private markets, not the federal government, hold the key to improving our health care system.” Those are the words of Presidential candidate Mitt Romney, as he articulates his health reform vision on his campaign web site . U.S. health care costs are around $2.5 trillion. This money buys a lot of care, and pays a lot of salaries.  One out of every six workers in America relies on the health care industry for a paycheck.  Romney thinks that’s too big a cost for care. “At its core of this debate,” he writes (jarringly inarticulately for an official campaign web site), “is the question of what creates better patient outcomes and more efficiency: free enterprise and consumer-driven markets, or government management and regulation?” I realize that he wants us to answer “free enterprise and consumer-driven markets.” But in this case, that doesn’t happen to be true. The reasons why we have even a semblance of an affordable health care s...