Daily Sentinel: Incremental steps better than monster health bill
December 16, 2009
Among the most recent dust-ups regarding the massive health care reform bill awaiting action in the Senate was a demand late last week by labor leaders that Democrats eliminate the tax on so-called "Cadillac" health insurance plans.
The tax wouldn't affect only corporate fat cats, the labor leaders rightly proclaimed, but would tag many middle-class Americans who traded higher wages in favor of better health plans through their employers.
That issue followed a variety of disputes — from abortion to expanded Medicare coverage to pay caps for insurance executives to the multiple permutations of the public option — that have dogged health care bills.
At more than 2,000 pages and growing, the bill has become too large not to fail. The legislation has so many moving parts that it's impossible to keep track of all of them or know with any certainty what their consequences will be. When it affects 16 percent of our national economy and likely will increase our rapidly mounting national debt, the consequences for all of us could be unimaginable.
Frankly, we believe it's time for Congress to drop this Rube Goldberg approach to health care reform — in which new sections are continually being added to the battered legislative contraption while members hope they can still make it function.
A better approach is to attack health care reform incrementally, focusing first on cost containment. Keep costs from continuing on their skyrocketing trajectory and you will prevent families and businesses from dropping health insurance. You also will make it more feasible to provide coverage to those who now are uninsured.
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We don't claim to have a simple idea to accomplish cost containment. But there are measures that have been suggested that can help.
One such measure, discussed by many people but absent from the House and Senate versions of the health care bill, is to abolish the ban on buying insurance across state lines. The ban was created because individual states wanted to regulate insurance within their boundaries. But it has proved costly and inefficient, while in today's world offering no great protection to consumers.
Especially in states where very few insurers operate, eliminating the ban would spark competition and help stabilize, if not reduce, insurance prices.
Additionally, we think the government should expand the availability of HSAs — health savings accounts — that allow individuals to set aside a portion of their pre-tax pay into a savings account they can use to pay health care bills and purchase insurance. Any money left over at the end of the year can be rolled into the following year and eventually put toward retirement.
HSAs provide incentives for individuals to spend their health care dollars carefully and to shop for the best insurance deals. They make sense for many people and will help contain costs, especially if they're linked to high-deductible, catastrophic health insurance plans.
There are no doubt many other ideas being developed to curb costs by people with substantial expertise in health care. Those that have merit should muster enough votes in Congress to be implemented.
The notion that we have to fix health care with one massive, many-faceted bill — which will have thousands of unforeseen consequences and whose impact on our national economy is far from predictable — should be as obsolete as a 1940s x-ray machine.