NCPA - National Center for Policy Analysis


November 15, 2006

Health insurance in the United States should be personal and portable, says John C. Goodman, president of the National Center for Policy Analysis (NCPA). In the Nov./Dec. edition of Health Affairs, Goodman calls for a switch from employer-based health insurance to a system of personal and portable insurance, based on the individual.

"Most of us have a plan chosen not by us, but by our employers," said Goodman.  "Even if we like our health plan, we could easily lose coverage because of the loss of a job, a change in employment, or a decision by our employer."

Goodman considers three reform models for moving toward personal, portable coverage:

  • The NCPA-Texas Blue Cross Blue Shield proposal calls for employers to purchase a group insurance health plan that would then stay with their individual employees.
  • The Massachusetts health care plan integrates spending subsidies and tax subsidies by using free-care money to subsidize the purchase of private health insurance, and using the extra taxes paid by people who are uninsured to provide the safety-net care they may obtain.
  • The health reimbursement arrangement (HRA) approach is based on notional accounts created by specific employers; the account itself is not portable, although insurance purchased with the account can be.

Each model builds on the current system of health care, says Goodman.  The three models assume that the current tax regime remains in place, making entry into the system through an employer attractive to workers.  They also allow employers and employees to benefit from the economies of group purchasing in the transition.  Administrative costs to employers will be further lowered if their role becomes purely financial.

"Personal and portable health insurance is an idea whose time has come," said Goodman. "There are benefits to both employees and employers."

Source: "Health Insurance Should Be Personal And Portable; NCPA President Calls For Action With Analysis Of Reform Models," National Center for Policy Analysis, November 14, 2006; based upon: John C. Goodman, "Employer-Sponsored, Personal, And Portable Health Insurance," Health Affairs, Vol. 25, No. 6, November/December 2006.

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