Broder on A Market Makeover For Health Insurance

David Broder had a thought-provoking health care reform piece in the Washington Post this past Sunday.  Here are some highlights:

[T]his week the Committee for Economic Development (CED), a high-powered business group, will give a strong push to the idea with a report saying in blunt terms that business can no longer afford to pay the rising costs and lacks the clout to curb the forces that are driving health-care inflation . . . .

Instead, [the CED report] outlines a two-step solution, aimed at producing a competitive marketplace with broad individual choices.

First, the federal government would establish independent regional "exchanges" through which individuals would purchase one of many competing private insurance plans. The exchanges would set standards for the insurers and each year conduct an "open season" when purchasers could change insurers. The exchanges would manage risk adjustments for insurers, but no one could be denied coverage because of age or prior illness.

Second, every family would receive a fixed-dollar credit, sufficient to pay the premium on the basic, low-cost plan in its region, so it could be insured without cost to the family budget. Any higher-cost policy would be paid by individuals with after-tax dollars.

The current tax credit for employer-financed health care would end (along with the company obligation to insure its workers), and that saving, plus some form of broad-based tax either on payrolls or income or on purchases, would finance the universal insurance payments.

I am completely in favor of doing away with employer-provided health insurance and I like the idea of fostering a competitive marketplace for insurance to gain the efficiency that comes with that.  The current health care system in the U.S. is an on-going catastrophe, with no end in sight. A paradigm shift is necessary and this is a start. 

And as far as how to pay it, I am all for higher "sin" taxes on tobacco, alcohol, gambling, guns, etc. (all purchases that directly correlate with higher health care costs).  A more progressive income tax (that actually requires one to pay taxes) on the wealthiest 1% of Americans and multi-billion dollar corporations would also do the trick.

PS