Pro vs Con

Capping jury awards would have almost no impact on health costs, according to the Congressional Budget Office. But it would help conservatives protect insurance company profits, instead of patients victimized by fraud or negligence.

Medicare has worked for 40 years. But the price pressures driving up costs in the private health care system affect Medicare as well.

Medicare actually has lower overhead than private health insurance. And if we design a comprehensive program to cover all Americans, we can save $1 trillion over the next 10 years. That will get health care costs under control and stabilize Medicare.

With 47 million without health insurance, and millions more underinsured, we’re tragically rationing care right now. When we guarantee quality health care for all, people will no longer be denied health care because they can’t afford it, lose their jobs or have pre-existing medical conditions.

Conservatives opposed great reforms like Social Security and Medicare by screaming socialism. They were wrong then, and they’re wrong now.

Guaranteed affordable health insurance would not make doctors and other health care professionals work for the government. The progressive plan is about making sure you have good health insurance you can afford and the ability to go to the doctors you want.

Guaranteeing affordable health care choices for all will require some tax revenues—$50 to 100 billion per year depending on the plan—plus modest contributions from companies and individuals. But it will save us $1 trillion in health care spending.

We’ll be able to slash administrative costs, emphasize preventative care, reduce emergency room visits and cut down on unnecessary procedures with electronic medical records.

With guaranteed affordable choice, if you have insurance you like, you keep it. Or, you can choose between quality private and public plans. The health care guarantee assures health plans that make sure you can pick your doctor. And it ensures that you have an insurance policy you can afford.

There is little evidence that health savings accounts are closing the health care affordability gap between working-class individuals and individuals with six-figure salaries and greater. The Government Accountability Office reports that "tax filers who reported [health savings account] activity in 2005 had higher incomes on average than other tax filers. Among tax filers between the ages of 19 and 64, the average [annual gross income] for filers reporting HSA activity was about $139,000 compared with about $57,000 for all other filers. The income differences existed across all age groups." In addition, there is evidence in the GAO report that because of the way health savings accounts are structured, they are serving as convenient tax shelters for the well-heeled. At the same time, lower-income people find that not only are they unable to afford to make a significant contribution to their accounts, they also are finding that many employers will not contribute to their accounts, as many employers contribute to health insurance premiums. Health savings accounts are not a substitute for a true plan to make health care available to all.

Cuts in payments to doctors and hospitals will only worsen the underfunding of our medical infrastructure and increase disincentives for doctors to care for Medicare and Medicaid patients. What's really needed is reform: Our country's current health care system wastes hundreds of billions of dollars in administrative and advertising expenses, and in efforts to shift or deny payment. Medicare's administrative costs are up to four times less than those of the private insurance companies subsidized by Medicare Advantage. Congress should resist the Bush administration's cost-cutting proposals and instead set the stage for real reform of our health care system.

The government's administrative expense to run the Medicare program accounts for only 3% of Medicare spending. By contrast, the amount of every premium dollar retained by private insurance companies for marketing, administration and profit is 14%. The CBO has projected that the marketing and the profits of the insurance industry would add $38 billion in costs in the first seven years of the program compared to a benefit that was administered through Medicare.

Question to ask: "Why was Part D designed to hit seniors and taxpayers with such high and unnecessary administrative costs?

The 1,300 drugs on the Veterans Administration formulary account for the vast majority of prescriptions that are filled by people on Medicare - and Veterans can still get the drugs not on the VA formulary. They just need to have their doctor explain why they need the drug in question.

Additionally, no plans in the Medicare program cover all 4,300 FDA approved drugs. These plans have preferred drugs as well, which is why the typical beneficiary had to spend 8 hours last year sifting through the various options, according to a study done for the Medicare Payments Advisory Commission. Seniors with many drug needs presumably spent even more time.

Question to ask: Why has the VA received significantly higher marks than private health care in independent surveys of customer satisfaction for the past 7 years?