President Bush’s Healthcare Proposal: Far Too Little to Have Impact On Healthcare Cost

Stanley Feld M.D.,FACP,MACE

A few days before President Bush’s state of the Union address David Philips wrote in the Minneapolis-St Paul Star Tribune

Minnesota hospitals: Rising red ink

“The sudden, steep rise in the number of patients who can’t pay their bills is causing budgeting nightmares for hospitals.

It’s led to staff layoffs in some cases, slower hiring in others and scrimping on low-tech supplies, hospital administrators say. What’s more, insurers get charged more to make up for the losses, leading to higher premiums for everyone else.”

It is bad for the hospitals’ bottom line to care for the uninsured and not get paid. The salaries of 1 million plus annually must be paid to hospital administrators.

Thirty million of the 46.7 million uninsured could buy insurance if the price was reasonable. However, they are buying for health insurance with after tax dollars. Their premiums are also high because the uninsured as an individual does not have the negotiating power of big corporate buyers of health insurance. They also do not have other advantages of group insurance. Insurance companies must accept all members of a group even if they have a preexisting illness. Presently, a 50 year old individual male with hypertension and hypercholesterolemia would not be qualified to buy health insurance.

President Bush proposed to level the tax playing field for the uninsured and self employed.. The pre-tax health insurance premiums are essential for any significant reform. However, his proposal is misguided. He has ignored other essential aspects of the disadvantaged uninsured. He has created a monetary advantage to hospitals and the insurance industry. More people will be insured and more money will be made. He has not dealt with fixing the runaway price structure of DRGs for hospitals, price transparency, community rated insurance premiums, or indiviual negotiating power. The consumer is only minimally empowered by his proposal. I am disappointed in the President. I know he knows better.

“The President’s plan would give a $7,500 tax break to individuals and a $15,000 tax break to families who either buy their own health insurance or receive it through their employer.”

Grace-Marie Turner a leading authority on Consumer Driven Health Care has fought hard for this tax reform proposal. It is vital to provide the uninsured and self employed uninsured with the same advantages as the corporate group insurance plans recieve. She was very pleased with President Bush’s proposal. However, I feel the attempt is only one required regulation in a healthcare system that requires all encompassing structural reforms for the advantage of the primary stakeholders.

Grace-Marie Turner: “And isn’t moderating the escalation of health costs the goal? This would help even more.

As I explained in a talk to the American Benefits Council in 2005:
• There would be some relief in sight for employers, giving them and their employees an incentive to bargain for better value.
• Employers would be more likely to stay in the game if the open-ended tax preferences were limited and they could gain a new tool to control costs.
• And the uninsured would benefit from new revenue for tax credits to help them purchase coverage.

We think this is important enough that we actually produced a book about it called Empowering Health Care Consumers through Tax Reform.
A tax cap would be the right thing to do.

Most of the politicians running for office have jumped in with an opinion. It is clear to me we need some thoughtful leadership right now. None of the politicians sound as if they understand the healthcare problem. They seem to be searching for sound bites. It sounds like they simply want to get elected or reelected. The situation is a smart entrepreneurs’ opportunity of a lifetime.