The essential problem in our health care system is that consumers are divorced from the cost of the services they consume. We have become so dependent on third-party payment that patients pay directly for only about 15 percent of total health care services, down from 56 percent in 1960.
Eighty-eight percent of Americans with private health insurance coverage get it through employers, and the employment-based health insurance system has served millions of Americans for more than 50 years.
Unprecedented numbers of individuals have moved from welfare to employment since enactment of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), making it the most successful welfare reform ever.
World leaders are making critical decisions based upon predictions of General Circulation Models or Global Climate Models (GCMs) that humans are causing global climate change or global warming.
A recent taping of William F. Buckley's Firing Line Debate, recorded in Dallas earlier this month hosted by the National Center for Policy Analysis and sponsored by the Hatton W. Sumners Foundation, will be aired at 8 p.m., Sunday, December 20, on KDTN Television/Channel 2and again at 2 p.m., Sunday, December 27, on KERA Television/Channel 13.
H. Sterling Burnett, an environmental policy and gun law analyst with the Dallas-based National Center for Policy Analysis will visit Washington to discuss possible changes to state and federal public forest management with congressional offices and targeted revisions of the Endangered Species Act with the Endangered Species Coalition.
Senators Orrin Hatch and Ted Kennedy have joined forces to establish a new government program to finance children's health insurance. They propose to fund the program by increasing federal cigarette taxes from 24 cents to 67 cents per pack – an increase of 43 cents. The Hatch-Kennedy tax promises to raise $30 billion over five years, with $20 billion to go for children's insurance and $10 billion for deficit reduction.
Rather than legislating in haste and ignorance and repenting at leisure, our government should maintain rational policies, based on science and adaptable to future discoveries.
There is a bipartisan consensus in Washington that youth crime, particularly violent youth crime, is a real problem that threatens to grow over the next decade. This consensus makes it highly likely that President Clinton will sign some version of a new federal juvenile crime bill this year – unusual only because Congress traditionally has passed crime legislation in even-numbered (read: election) years. Congress expects to do at the federal level what many states have already done: toughen the treatment of young criminals, who have regarded the juvenile justice system as a joke for at least the last decade.
More than half a million American children are in government-run foster care today. The federal government dictates — and funds — much of foster care policy, but states carry it out. Originally intended to provide safe, temporary homes for abused children, the $12 billion foster care system frequently keeps children in care for years — long after they are legally free to be adopted.
Last year Congress made tax-free Medical Savings Accounts (MSAs) available to 750,000 American workers and their families. Under a provision of the Kassebaum-Kennedy health insurance reform bill, small employers (50 or fewer employees) and the self-employed can purchase less expensive high-deductible health insurance policies and make tax-free deposits to an MSA. They can use their MSA money to pay small and routine health care expenses, reserving insurance to pay large, catastrophic expenses. Money that remains in the account at year's end earns tax-free interest.
Most people follow the conventional wisdom: If it ain't broke, don't fix it.
Washington follows its own wisdom: If it ain't broke, break it.
America has nearly 10 million children without health insurance, and many in the policy community propose a broad new entitlement program to insure them. But few have asked the important questions we must answer in order to design an effective policy response. For example, how many uninsured children are there? What are their demographics? How long do they remain uninsured? And is a new health insurance program the most cost-effective way to assure they get health care?
A few months ago, many on Capitol Hill were pronouncing the Clinton plan "dead." It was commonly assumed that mandatory alliances and other features of "managed competition" were also dead. But as we learn more details about the four versions of the Clinton plan that have emerged in congressional committee bills, it is clear that the reports of the demise of managed competition were premature.
Managed competition is the central idea behind the Clinton administration's plan to reform the nation's health care system. It is also the main idea behind the four versions of the Clinton plan reflected in four different congressional committee bills. [See the NCPA Brief Analysis, "Managed Competition Is Back."]
Four congressional committees have now produced versions of the Clinton administration's health care plan. Three of the bills would force all Americans and their employers to purchase a health insurance package that has become increasingly bloated with costly, special-interest benefits.
Medical Savings Accounts, also called Medical IRAs and Medisave Accounts, have more support in Congress than any other proposal to control health care costs.
Under "community rating" health insurers are required to charge the same premium to every policyholder, regardless of their expected health care costs. Under "modified" community rating, premiums may be adjusted by age and sex. Both types of regulation allow people who are already sick to purchase health insurance for the same price as those who are healthy.
Senator Bob Dole (R-KS) has just proposed a health care reform plan. The Dole plan builds on key reform ideas developed by the National Center for Policy Analysis. However, some benefits of the reforms would be diluted by unnecessary insurance regulations that should be dropped from the proposal.
One problem with our health care system is that many sick people who lose their health insurance find it impossible to purchase new coverage. Insurers may classify them as uninsurable, offer them a policy that excludes payment for medical services for their preexisting conditions or set their risk-rated premium so high they cannot afford it.
Relatively simple reforms would go a long way toward solving our most pressing health care problems without creating new ones. Unfortunately, the underlying debate is not about how to solve our health care problems. It's about how our health care system should be organized.
Are employer mandates the best way to pay for health care reform? Virtually all studies of mandates conclude that they kill jobs. Even the Clinton administration agrees.
The new crime bill is now in the hands of a congressional conference committee, which is resolving differences in the House and Senate versions. Despite some beneficial provisions, many are convinced we would be better off without any bill.
A common assumption in the current health care debate is that universal health insurance coverage requires an employer or individual mandate. Either directly or indirectly, these mandates would require individuals to obtain health insurance, whether they want to or not.
In his 1994 State of the Union message, President Clinton said the goal of his health care reform proposal is "to give every … American the same health care security they have already given to … federal employees." The Federal Employee Health Benefits Program (FEHBP) also has been held up as a prototype for reform by Stanford professor Alain Enthoven, father of managed competition. Liberal Senator Edward Kennedy has advocated allowing individuals and small business employees to join the FEHBP. And the program has been praised by a number of conservative Republicans.