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Old 10-18-2004, 07:44 PM  
RINGLEADER RINGLEADER is offline
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Kerry Health Plan Would Fail - Recycles Clinton Care That Favors Healthy, Avoids Sick

Kerry health plan would fail, say critics
Recycled Clinton concept favors healthy, avoids sick
By Laura Gilcrest, CBS MarketWatch

WASHINGTON (CBS.MW) -- Critics of Sen. John Kerry's health care plan say that one aspect of the scheme, the Congressional Health Plan, is simply a reincarnation of an old Clinton administration idea that is doomed to fail.

The plan would open up to the entire country the health insurance scheme that federal employees have had for years under the Federal Employees Health Benefits Plan.

Depending on where he or she lives, a worker enrolled in the federal health plan can choose from between 10 and 20 different health insurance plans, ranging from HMOs to fee-for-service schemes.

Kerry's proposal would allow small businesses -- those with 50 or fewer employees -- to buy into the federal health plan via purchasing pools. Larger companies could also access the program by sponsoring the health benefits at their work sites.

Champions of the Kerry plan claim it would allow U.S. employees to choose a health plan tailored to their own medical needs, cutting costs in the process. But opponents of the program say that it actually creates "perverse incentives" that will shift most health insurance dollars to healthy enrollees, while the costly, chronically ill will be left in the lurch.

The Congressional Health Plan is actually the failed "managed competition" scheme that then-First Lady Hillary Clinton floated a decade ago, said John Goodman, president of the Dallas-based National Center for Policy Analysis and architect of the health savings account concept.

That aspect of Kerry's health care proposal "will morph into the Clinton plan very quickly because it's got all of the same problems," he said.

Among the biggest of these problems is that a field of 12 or 15 health plans all competing for enrollees will go after the profitable, healthy people who only cost the plans a few hundred dollars a year, luring them with "wellness" programs and even spa memberships, Goodman said.

On the other hand, Congressional Health Plan insurers would avoid enrollees with serious diseases like cancer and AIDS, who would be a costly drag on the plan's bottom line, Goodman said. "If a health plan wants to make a profit, it attracts the healthy and avoids the sick," he said.

"If you look at the [health plan] ads in publications that federal employees read, that's what these plans do. The ads show healthy families and healthy children and talk about wellness. You never see an ad [that says] 'if you've got cancer, come to us,'" he noted.

"You don't see that because health plans are running away from [patients with serious diseases]," Goodman said.

Under the federal health plan, each plan has to give the same premium to all employees. So the plans have extreme incentives to avoid sick people, Goodman said.

"If one plan gets the reputation as the best place for cancer treatment, it'll go bankrupt," he said. As a result, Goodman argued, "healthy people will get more health coverage and sick people will get less."

This imbalance is already present in the federal health plan, he claimed, but is still contained to some degree since the federal plan is part of a much larger market to which the practice of medicine is beholden, he said.

"But if that larger market were not there and if all we had was a system where these were the only incentives, then the quality of care would decline very rapidly for people who need [critical] care," Goodman contended.

"If you open FEHP to the whole country [the U.S. health care system] will become very unstable very quickly," he said.

"If this health plan system were properly designed, the plans would compete as vigorously for sick people as for healthy people," he said. Kerry's concept might work better if it were "risk-rated" similar to the Medicare program, with premium cost varying and employers paying more for high-cost enrollees. But such risk-rating would be no easy task under the Congressional Health Plan proposal, Goodman added, because "who would be willing to pay for the higher premiums?"

However, Ken Thorpe, an Emory University professor and a chief architect of the Kerry health plan dismissed Goodman's claims as "nonsense."

"I get frustrated with the misinformation and caricaturization of the Kerry plan," Thorpe said. The health plans' rush to insure healthy enrollees predicted by Goodman "doesn't happen" in the federal plan, he said.

"If that happened, we wouldn't have any plans left," Thorpe said. He said that federal health plans are equally distributed among the sick and the healthy and that the plans compete on a broad range of risk.

"The FEHP is the largest employment-based plan in the country. No other employment-based system has that kind of choice," Thorpe noted.

"It includes consumer-driven plans at the one extreme, all the way to fee-for-service plans, and everything in-between," he said. "In terms of choice, it lets individuals sort out for themselves which plan best fits their needs," Thorpe said.

"If you look at plan satisfaction, people in this program are by far much more satisfied than people in other employment-based plans," he said.

What's more, Thorpe said, the federal health plan is "highly competitive and has kept growth in premiums down without any risk sorting. There's not selection, there's not risk segmentation in the market."

Given that track record, the federal health plan is a successful model whose time has come for nationwide expansion, Thorpe added. "It provides choice and it's been up and running for years and years," he said.

Despite their sharp difference on Kerry's health plan, Goodman and Thorpe agree on one point: that health care is the biggest domestic policy issue in this election.

http://cbs.marketwatch.com/news/stor...le&dist=google
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Old 10-18-2004, 07:47 PM   #2
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Old 10-18-2004, 07:57 PM   #3
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I am pretty sure Kerry knows there is no chance for national health care. If he doesn't, he is delusional.
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Old 10-18-2004, 08:28 PM   #4
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What I want to know is who's going to pay for all these uninsured families. Actually I know we will be the ones to foot the bill.

Here is an example of one of the plans costs. Los Angeles and San Diego area from this web site. I chose Aetna HMO. It appears to me that they are all HMO's

http://www.opm.gov/insure/04/brochures/pdf/73-806.pdf

Monthly premium:

Self only: Govt share-$175.94, Employee share-$58.65 for a total of $234.59

Family plan: Govt share-$428.99, Employee share-$142.99 for a total of $571.98

How is this any more affordable than any other plan?
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Old 10-18-2004, 10:56 PM   #5
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We have state-provided health care for the uninsured here in Tennessee. It is often held up as a model. In reality, the costs are so high that there is very little money for any other initiative in the state. Furthermore, our state expenses keep going up faster than revenue, so we are always a few years away from a new tax increase. To top it all off, in every way that I have been able to compare, the benefits that are given away free through the plan far exceed the benefits I get as an employee of the state - this irritates me to no end. No thanks to state-provided health care.
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Old 10-18-2004, 11:01 PM   #6
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Quote:
Originally Posted by Brock Landers
I am pretty sure Kerry knows there is no chance for national health care. If he doesn't, he is delusional.
he doesn't
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