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A little bit more choice in a reformed healthcare system

Wyden Good news today from the backstage maneuverings on the Senate Democrats' healthcare reform bill. As The New Republic reported, Democratic leaders have agreed to give more flexibility to millions of Americans who get their health insurance today through their workplace.

First, a little background. My favorite healthcare reform proposal was the Healthy Americans Act by Sens. Ron Wyden (D-Ore.) and Robert Bennett (R-Utah). In addition to being a genuinely bipartisan approach to the issue, it was smart about bringing market forces to bear on the industry. But it also was the most radical departure from the current system, because it would have decoupled health insurance from employment. Instead of continuing to have employers cut deals with insurers and then pay part of the cost of coverage on their workers' behalf, it would have given employees the subsidies and tax benefits directly, grouped them into statewide risk pools and created new markets for them to shop for policies. In addition to giving workers far more choice of insurer and plan -- most employers have a take-it-or-leave-it approach to health benefits -- it would encourage them to spend their healthcare dollars more wisely. That's because, for the first time, they'd see the total cost of their insurance and all the options for managing it.

Wyden tried in vain add a variation of that plan to the Senate Finance Committee's healthcare bill -- his amendment would have let workers take vouchers from their employers in lieu of health benefits, then use those vouchers to help buy individual policies through new state insurance exchanges. Now, finally, he has persuaded Senate Democratic leaders to give his vision of employee choice a foot in the door. Wyden announced a deal this afternoon with Senate Majority Leader Harry Reid (D-Nev.) and Finance Committee Chairman Max Baucus (D-Mont.) to add a slimmed-down version of his plan to the healthcare reform bill the Senate may take up Saturday.

As with his earlier amendment, the proposal would give workers the option of converting the money their employer spends on health benefits into vouchers they could use to buy policies through the state exchanges. The main difference is that this capability would be available only to certain workers who would be exempt from the bill's requirement to obtain insurance. Specifically, it would apply only to those earning less than four times the federal poverty threshold (e.g., $88,200 for a family of four) whose employer-sponsored insurance premiums would consume 8% to 9.8% of their total income.

It's not much, but it's a start. Now let's see if Reid can get the 60 votes needed to start debate on the bill....

Photo: Sen. Ron Wyden. Credit: Alex Wong / Getty Images

-- Jon Healey


Comments () | Archives (9)

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In a way ,we have a voucher system today that isn't working. Let's take New York as an example. There are over 2.7 million uninsured however 1.3 million could be insured if they enrolled in a public program. Effectively,these people have a free voucher to sign up for coverage and they chose to remain uninsured. Now you want to add more people to the uninsured by allowing more people to chose on their own what coverage they should have..people will figure out that not having insurance and using the emergency room is much cheaper than paying a penalty..we have relied on choice and as a result hospitals are more writing off more charity balances and people chose the cheapest way out disregardless of the long term impact


Just because it wasn't the choice of the politicians with the power, there was no reason why newspapers couldn't have given the only real bi-partisan plan, one that was the product of many years of work, a fair hearing. That such a serious effort wasn't presented to the public for consideration is precisely what doomed it.

b yates

Are you an absolute idiot. Do you know what the ultimate costs of this government monster is going to be and the huge number of political hacks who will be making policy for something they have little understanding of. They are using phony numbers, wild projections, and laying huge costs on the bankrupt states to makeup for the short-falls in the federal budgeting process so they can hide the true costs. There aren't enough doctors to handle the new system so enjoy the waiting lines. Do your homework before telling your readers this fiction.

Gordon Potik

The Healthcare anger … I am mad as hell and won’t take it anymore.
1. While healthcare is generally ok, we don’t get the health care we always need.
2. Our doctors are the keepers of the key to other services based upon to whom the Group reports.
3. The HMO controls the care we can get and the treatment we might need.
4. The services provided by the labs are very slow.
5. The time with the doctor is limited.
6. The doctor is required to maintain volume patients per hour versus quality care.
7. Our hospitals are pressured to provide diminished care do to patient overload.
8. The current system is controlled by the Insurance companies that created the HMO or PPO service that one can select to get the Healthcare service THEY provide.
9. The Group assigned to the Insurance Company is totally controlled by the Insurance Company in terms of available services.
10. Our current Healthcare is controlled by the Lobbies of Independent insurance companies and Pharmaceutical companies.
11. The Healthcare Insurance companies are run by a Board of Directors and stock holders. This makes a service oriented industry to be heavily profit motivated and hence diminish service to the members of the established HMO or PPO or other Healthcare setup.
12. What would happen to the Health Insurance industry if a person wanted to purchase Health Insurance across state lines? The list of these available Health Insurance companies could be provided by the Federal Government. These companies could be regulated by the Federal Government as our other industries selling commerce across state lines.
13. The Healthcare legislation must strip health insurance companies of their longstanding exemption from federal antitrust laws.

Gordon Potik

I have some questions about the Healthcare package being proposed.
First ... Where in the legislation does it indicate that the existing health programs must proceed as they are currently designed? This is not legislation to change Healthcare; it is legislation to Regulate the Insurance Healthcare system, a system that has a very powerful lobby. It is time to make some adjustments to the Healthcare Insurance system.
Second ... Where in the legislation does it indicate that there are no changes for programs currently operating? You know that there are changes because there are new regulations.
Third ... Where in the legislation does it indicate what I must do if I lose my job, have no money, and need insurance?
Fourth ... Where in the legislation does it indicate what must happen with those individuals that are not citizens of the United States? What about individuals that cannot identify who they are. What will happen with their services?
Fifth ... Is there any part of the legislation that pertains to tourists visiting this country? What services are they entitled to, who pays, and will travel insurance be mandatory for tourists coming to the United States?
Sixth … why does the legislation have to be so complicated??? Simplicity simplicity simplicity.
Seventh … why not a consortium or co-operative of insurance companies to cover the costs of the uninsured? What would happen if we permitted individuals to purchase Health Insurance policies across state lines?

Registry Cleaners

From the article: "As The New Republic reported, Democratic leaders have agreed to give more flexibility to millions of Americans who get their health insurance today through their workplace."

And how long will that flexibility last once all the private health care insurers are driven out of the market by the monopoly that the government intends to establish? This eventuality is never addressed by any of the Democratic proponents for health care reform.


Why is the federal government involved in the first place? What happened to the powers granted to the government were few and limited?


"At $300 Million per vote it's pretty expensive. Thank you so much, NOT, for being a pusher of the most immense tax increase big brother ever tried to foist on Americans. At some $300 millions per vote (check Louisiana's Senator) this is the most expensive steamroller ever bought. Socialist and Marxist Senators Feinstein, Boxer, Reid, and the rest are cooperating with "Our Glorious Leader" in destroying America - "Our Glorious Leader" praised the bowl movement in the Senate from Korea, home of another equally demented "Glorious Leader". The illegal aliens are rejoicing at this step toward yet another "amnesty".

robert diogenes

How to save MONEY on healthcare REFORM!

GET THE FACTS BEHIND THE NEWS! The Urban Institute estimated that a gov’t insurance plan would save $224 to $400 billion over a period of 10 years. The private insurance co’s simply will not offer the low cost full coverage insurance plans that would reduce the subsidy for the uninsured and underinsured. The gov’t plan would. The Congressional Budget Office has confirmed this by estimating that the cost of one of the proposed House plans would be reduced from $1.1 billion to only $800 billion, a saving of $300 billion over a 10 yr period with a gov’t plan.

There is another important step we can take to reduce cost by an estimated $40 billion annually or $400 billion over a 10 year period.

According to Drs. David Himmelstein and Steffie Woolhandler (PNHP) Physicians for a National Health Plan the public option misses at least 84 percent of the administrative savings available through a single payer, gov’t, healthcare plan.

The public plan option would not do anything to streamline the administrative tasks (and costs) of hospitals, physicians offices, and nursing homes. They would still contend with multiple payers, and hence still need the complex cost tracking and billing apparatus that drives administrative costs. These unnecessary provider administrative costs account for the vast majority of bureaucratic waste. The Physician group research in California showed that now 31% of every health care $ was paid for administrative costs. This compared to 3% of Medicare administrative costs.

So why not have a single payer healthcare plan with a gov't option for those that want their own healthcare plans?



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The Opinion L.A. blog is the work of Los Angeles Times Editorial Board membersNicholas Goldberg, Robert Greene, Carla Hall, Jon Healey, Sandra Hernandez, Karin Klein, Michael McGough, Jim Newton and Dan Turner. Columnists Patt Morrison and Doyle McManus also write for the blog, as do Letters editor Paul Thornton, copy chief Paul Whitefield and senior web producer Alexandra Le Tellier.

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