NCPA - National Center for Policy Analysis

Choice Is Key To Affordable Health Care

July 14, 1999

Every American should have access to affordable health insurance, says Daniel H. Johnson, Jr., former president of the American Medical Association; but due to the failure to control the cost of insurance, the number of uninsured is growing.

However, a substantial, broad-spectrum consensus seems to be developing around the following three policy objectives: expanding the choices, establishing individual selection and ownership of health insurance, and establishing a defined contribution.

Federal and state policymakers will have to craft new policies to create a more effective medical marketplace, says Johnson, and should be guided by four principles:

  • End discrimination against personal choice;
  • Expand personal choice and allow patients to change their minds;
  • Establish a defined contribution as a principle in both public and private health care financing;
  • And end IRS discrimination against the personal purchase of insurance and allow patients to purchase plans through cooperatives if they wish to do so.

Two significant problems exist in trying to achieve these policy objectives, according to Johnson, tax inequity and the systemic disadvantage to the individual in purchasing health insurance under current conditions.

Source: Daniel H. Johnson, Jr. (former president, American Medical Association), "How to Expand Health Care Choice and Improve Access for Working Families," Heritage Lecture No. 640, July 12, 1999, Heritage Foundation, 214 Massachusetts Avenue, N.E., Washington, D.C. 20002, (202) 546-4400.


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