Letters to health-care Santa: Bring back the death panels!
Over the course of this week, I'll be asking some health-care experts what they'd like Santa to add to the bill during conference committee, and publishing their responses on the blog. This edition comes by way of Henry Aaron, a senior fellow of economic studies at the Brookings Institution. A noted health-care expert, Aaron focuses on the reform of health-care financing; public systems such as Medicare and Medicaid; Social Security; and tax and budget policy.
I have three items — the second and third would, I believe, facilitate passage. All are comparatively marginal, as I think that spending time on major changes is irrelevant and unproductive, given the already horrendously difficult task facing those who are going to try to fashion a bill that can pass both Houses of Congress.
First, I would like to see the end-of-life counseling provisions restored to the bill. From a policy standpoint, it is not a major item, as end-of-life counseling already exists in embryonic form — George Bush actually signed it into law in the Medicare Modernization Act. But allowing a thoroughly scummy libel to kill such a benign policy is deeply offensive. It would be refreshing if members of Congress would stick a thumb in the eye of those who lie.
Second, I would like to see Paul Starr’s idea of replacing the tax on those who refuse to buy insurance with a simple exclusion from coverage for a specified period of those who elect not to have coverage. I’ll leave it to Paul to flesh out his own idea.
Third, I would base the tax on high-cost plans not on each company’s actual cost, but on the cost of each company’s plan as applied to a population of standardized age distribution. Actuaries can do such calculations quite readily. Such a tax would get at what really should be taxed — unduly generous plans — not plans that are high cost only because they apply to a particularly old population.
Earlier in this series, Diane Archer called for Congress to create national exchanges rather than state exchanges, Alain Enthoven offered some ideas for how to fix the exchanges, David Cutler proposed a soda tax, Austin Frakt argued for competition in the Medicare Advantage program, Jacob Hacker broached letting the public sector help the private sector negotiate lower rates, and George Halvorson tried to expand the exchanges to include providers of actual care rather than just insurance coverage.
Posted by: DanielColascione | December 23, 2009 8:08 AM | Report abuse
Posted by: wisewon | December 23, 2009 9:39 AM | Report abuse
Posted by: ThomasEN | December 23, 2009 10:35 AM | Report abuse
Posted by: ab13 | December 23, 2009 10:36 AM | Report abuse
Posted by: staticvars | December 23, 2009 12:25 PM | Report abuse
Posted by: billkarwin | December 23, 2009 12:54 PM | Report abuse
The comments to this entry are closed.