Health Care: Mandates or Vouchers
Grace-Marie Turner and Joseph R. Antos write about a Republican health care proposal,
The nexus of their plan is redirecting the $300 billion annual tax subsidy for employment-based health insurance to individuals in the form of refundable, advanceable tax credits. Families would get $5,700 a year and individuals $2,300 to buy insurance and invest in Health Savings Accounts.
Low-income Americans would get a supplemental debit card of up to $5,000 to help them purchase insurance and pay out-of-pocket costs. They would have an incentive to spend wisely since up to one-fourth of any unspent money in the accounts could be rolled over to the next year. The combination of the refundable tax credit and debit card gives lower-income Americans a way out of the Medicaid ghetto so they can have the dignity of private insurance.
The basic idea is a health care voucher (like food stamps) as opposed to a health insurance mandate. This is a logical approach, one which every health care policy wonk can appreciate and support. However, it does not give government the kind of hands-on, top-down control over the health care system that the Democrats want, and hence it is a political non-starter.