NCPA - National Center for Policy Analysis


March 22, 2010

President Obama and Democrats in Congress say that starting over on health care reform is akin to stonewalling.  They are wrong, says Don Brunell, president of the Association of Washington Business.

Reforming health care is not about social engineering or jamming an unpopular and expensive experiment down our throats.  It is about building upon what is working and fixing what is not.  But the competing plans in Congress amount to a complicated and untested trillion-dollar gamble.  What would their plans mean for America, asks Brunell.

The first clue is what is happening in Massachusetts, says Brunell:

  • That state's universal health plan is the basis for the Democrats' health care reform in Congress, yet, average insurance premiums there are the highest in the nation, and the state is poised to impose cost controls in an effort to stop the financial hemorrhage.
  • Since it was enacted in 2006, premiums in Massachusetts have climbed at an annual rate of 30 percent in the individual market.
  • Small business costs have increased by 5.8 percent and per capita health spending in Massachusetts is now 27 percent higher than the national average.

In other words, it is not the model for America's health care system, says Brunell.

Yes, health care is too expensive, but there are safer ways to bring down costs.  It all starts by giving consumers a choice and allowing market-based innovations to flourish, says Brunell:

  • For example, Indiana has implemented consumer-driven health care for state workers using Health Saving Accounts (HSAs).
  • The state pays the premium for the plan and deposits $2,750 per year in an account controlled by the employee.
  • Employees use the money to pay their medical bills and get to keep any unused funds.
  • The intent is that participants will become more cost-conscious and careful about overpayment or overutilization.

To date:

  • Indiana employees have pocketed some $30 million, or about $2,000 per employee, in unused HSA funds.
  • For the 6 percent of employees who use up their entire account, the state shares additional health costs up to an out-of-pocket maximum of $8,000, after which the employee is completely protected.
  • More than 70 percent of Indiana's 30,000 state workers chose the HSA option this year, by far the highest in America's public sector.

Source: Don C. Brunell, "'Start Over' is Not Code for Stonewalling Health Care Reform," Association of Washington Businesses, March 5, 2010. 

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