State Health Care Reform: Key Questions and Answers
Table of Contents
- Executive Summary
- Do We Need Individual Mandates?
- Should Government Decide How Medicine Should Be Practiced?
- Does Universal Coverage Lower Health Care Costs?
- What Is the Best Use of Government’s Health Care Dollars?
- Should We Encourage Consumer-Directed Health Reforms?
- Are Electronic Medical Records The Answer?
- Are Guaranteed Issue and Community Rating the Answer?
- Is a Massachusetts-Style Connector Part of the Answer?
- Does Modeling by the Lewin Group Bias State Choices?
- Appendix A
- Appendix B
- Appendix C
- About the Authors
What Is the Best Use of Government’s Health Care Dollars?
Historically, tax-supported health care programs have focused on two areas: public health programs to limit environmental health hazards and the spread of infectious and communicable diseases, and public programs providing individual care for people unable to provide it for themselves — primarily children, the frail and impoverished elderly, people with grievous injuries or diseases, and people with severe birth defects or developmental disabilities.
There is a finite amount of tax money available to subsidize health care. The Colorado proposal would divert substantial resources to areas in which state government has little prior experience and, in some cases, a poor record of success. These include extensive recordkeeping on large numbers of complex transactions for every individual in the state, developing and deploying effective information technology architectures that are new and untested, developing new regulations for every area of medical practice, developing and promoting wellness initiatives of dubious merit, vastly expanding means-testing for subsidies, enforcing the health insurance mandate, and extensively researching systems design.
Tax money spent on these initiatives is tax money not available for projects to ameliorate the conditions of those with serious disease or disability. This is of particular concern in view of the fact that many of the people who testified before the Commission were concerned about inadequate care under existing public subsidy systems.