Senator John Kerry's health care plan would expand coverage butwould fall short in transforming health insurance markets andmaking patients the key decision makers in the system. In effect,it would reinforce the status quo, with (according to one estimate)nine of every 10 dollars spent going to employers, insurancecompanies, and state governments, not to individuals.
Whatever merits one may ascribe to the recently enacted Medicarelaw, it has aggravated, not controlled, rapidly rising Medicarecosts. Its major feature is a massive entitlement expansion, but italso embodies some bad health care policy: There is no need for thefederal government to displace existing drug coverage, pre-empt newprivate-sector options, or accelerate the loss of employer-baseddrug coverage.
The best Medicaid policy would mainstream as many individuals andfamilies as possible into private coverage and encourageself-direction for those the Medicaid safety net was intended. Whenconsidering changes in the Medicaid program, federal and statepolicymakers should ensure fiscal control and improve the way thatlow-income individuals and families receive care.
President Bush's health care agenda would increase public andprivate coverage for millions of Americans. The outlined healthpolicy agenda introduces key changes in the conventional financingand delivery of health care. Chief among the proposals are healthcare tax credits for lower-income individuals and families and newmarket-based insurance reforms to enable Americans to purchaseprivate health coverage.