Top-Down Health Care Reform
By Arnold Kling
One key improvement, for example, is eliminating the Nebraska FMAP provision and providing significant additional Federal financing to all States for the expansion of Medicaid. For America’s seniors, the proposal completely closes the Medicare prescription drug “donut hole” coverage gap. It strengthens the Senate bill’s provisions that make insurance affordable for individuals and families, while also strengthening the provisions to fight fraud, waste, and abuse in Medicare and Medicaid to save taxpayer dollars. The threshold for the excise tax on the most expensive health plans will be raised from $23,000 for a family plan to $27,500 and will start in 2018 for all such plans. And another important idea included is improving insurance protections for consumers and creating a new Health Insurance Rate Authority to review and rein in unreasonable rate increases and other unfair practices of insurance plans.
So, the main thing is to heavily regulate the insurance industry from Washington. No sign that the President is reaching out to those of us who disagree with top-down regulation and centralized power.
The New York Times reports on a controversy about the Dartmouth research which showed that high health care spending was wasteful. New research differs. The critic is quoted:
“We are about to embark on a huge transformation of our health care system,” Dr. Bach said. “If we start with a bunch of flawed measures, it will be as devastating as putting in the wrong coordinates before a moon shot.”
Top-down health care reform is like a moon shot. You have one chance to get it right. Instead, trial-and-error market evolution is less risky. If people make their own decisions about medical procedures, then the mistakes they make will not be so heavily dependent on the Dartmouth researchers and their opponents.
Once again, here is my bottom line for the health summit.]