Employers are tired of the rising costs of providing healthcare
Employees are tired of having to pay out of pocket for shrinking coverage
Federal and State governments are tired of seeing their own health bills go up as costs seem to be spiraling out of control
There are too many people that fall through the cracks due to
Lack of health insurance
Inadequate health insurance
Limited access to healthcare
3 Health Care for All?
There is a national consensus that healthcare reform is needed, but one major hindrance has been finding a middle ground that both the left and the right could agree upon
4 The State of the Union for Health Care
A conversation with Senators Bob Bennett (R-Utah) and Ron Wyden (D-Oregon)
Panel 1 Innovation of the Future of Health Care (CEO of Johns Hopkins, Chief Medical Officer for Philips Healthcare, Former Commissioner USFDA)
Panel 2 What Should Reform Look Like? (President of The Joint Commission, Executive VP of Social Impact, AARP, Chief of Medical Affairs, United Health Group)
Remarks by Representative Frank Pallone
5 Healthy Americans Act
Originally introduced by Senator Rob Wyden (D-Oregon) as a step toward healthcare legislation
It has since attracted bipartisan attention and is currently being spearheaded by a group of senators, most notably the aforementioned Senator Ron Wyden and Senator Bob Bennett (R-Utah)
Its most prominent objective is provide affordable, high quality health coverage for all Americans
6 Crossing party lines
In addition to Senators Wyden and Robert F. Bennett, the Act is sponsored by Senators
Lamar Alexander (R-Tenn.)
Maria Cantwell (D-Wash.)
Thomas R. Carper (D-Del.)
Norm Coleman (R-Minn.)
Bob Corker (R-Tenn.)
Mike Crapo (R-Idaho)
Judd Gregg (R-N.H.)
Daniel Inouye (D-Hawaii)
Mary Landrieu (D-La.)
Joe Lieberman (I-Conn.)
Bill Nelson (D-Fla.)
Arlen Specter (R-Pa.)
Debbie Stabenow (D-Mich.).
7 Letter to President-Elect Obama
The group sent a letter to Obama recommending seven goals for health care legislation
Ensure that all Americans have health care coverage
Make sure health care coverage is affordable and portable
Implement strong private insurance market reforms
Modernize federal tax rules for health coverage
Promote improved disease prevention and wellness activities, as well as better management of chronic illnesses
Make health care prices and choices more transparent so that consumers and providers can make the best choices for their health and health care dollars and
Improve the quality and value of health care services.
8 Healthy Americans Act Objectives
guarantee private health care coverage for all Americans and allow them to choose the health insurance that is right for them
provide health benefits equal to those that Members of Congress now enjoy
modernize the employer-employee relationship regarding health care benefits making health care portable from job to job and even allow Americans to keep it between jobs
provide incentives for individuals and insurers to focus on prevention, wellness and disease management rewarding Americans for maintaining healthy lifestyles
establish tough cost containment measures that save 1.48 trillion over 10 years
9 Basic Structure
Reform by building on what works and improving what doesn't
Individuals and families will continue to have private insurance policies that they can purchase from either their employer or one of their state's approved insurers.
If you currently receive health coverage from your employer, you will still be able to do so, but your employer will no longer be in control of your health care decisions and if you lose your job, under the Healthy Americans Act, you won't lose your health insurance.
The way it works, is that your employer will give you a raise equal to the amount he/she is currently paying for your health care coverage and the federal government will give you the tax deduction that your employer currently gets for providing you coverage.
You will then have the option of choosing to either stay with your current employer-provided plan or selecting a different plan that makes better sense for you and your family.
Insurance companies will be required to charge subscribers a standard rate and will no longer be allowed to deny coverage based on prior illnesses or anything else.
In the end, the Healthy Americans Act will require that insurance companies to compete to keep you healthy and if you aren't satisfied with what your insurance company is providing, you will have the option of taking your business elsewhere.
10 What if your company doesnt offer health insurance?
Employers who don't currently offer health benefits would have to make phased-in "Employer Shared Responsibility Payments," which would be used to provide financial assistance to individuals and families of modest income. After two years, all employers would make "Employer Shared Responsibility Payments." These payments would reflect the relative ability of small and large employers and low- and high-wage industries to make such payments, and would have no direct impact ON the coverage that is available to their employees.
11 Affordable Quality Healthcare
Those people earning between 100 percent and 400 percent of the federal poverty line (10,400 annually per person) would also receive subsidies on a sliding scale to help pay their premiums. The bill also creates a generous standard deduction to help Americans pay for health coverage regardless of whether they get coverage on their own or through their employers.
12 Reform the Private Insurance market
The Healthy Americans Act stipulates that insurance companies be required to cover every individual who chooses to enroll and that they be prohibited from raising prices or denying coverage if individuals are sick or are at risk of becoming sick.
Previous and existing health problems, occupation, genetic information, gender and age could no longer be used to determine eligibility or the price paid for insurance.
13 Focus on Preventative Care
The Healthy Americans Act focuses on preventive care and provides insurance companies with an incentive to keep their subscribers healthy.
Individuals would not be charged co-pays for preventive services or chronic disease management.
Insurers would be able to offer discounts and other incentives based on participation in wellness programs, like nutrition counseling, tobacco cessation and exercise.
Doctors will be reimbursed under the Healthy Americans Act for investing time in chronic disease management and prevention
14 Safety Net
The government, for its part, would make sure that every American has, and can afford, health insurance. Every time an individual interacts with local, state or federal government, they could be required to verify their enrollment in a private health insurance plan.
15 State Based Health Help Agencies
Agencies instituted to help guide individuals through the enrollment process so they my choose from a variety of private plans offered by their state
These agencies would also provide consumers with unbiased information about competing private health plans and determine premium reductions that will ensure every American can afford their health plan.
HHAs would ultimately lower administrative costs by coordinating payments from employers, individuals and the government.
16 How is it funded?
The plan would pay for itself once the act is up and running by eliminating administrative costs and changing the outdated tax code that gives businesses write-offs for even the most lavish designer health plans
It would return surpluses to the government after the first two years of implementation.
17 Financial Analysis
The CBO which analyzed the bill with the Congressional Joint Committee on Taxation. showed that, under the Healthy Americans Act, it will be possible to not only to cover all Americans for the same amount of money the nation is currently spending on health care but to reduce the increase in health care costs over time.
18 The Basic Principles of the Healthy Americans Act
CHOICE - Gives Americans choice in what type of coverage best suits their individual and family's needs and a choice in where they receive health care services.
PORTABILITY - Because the individual will now own their health policy, insurance becomes portable from job to job and individuals will no longer feel tied to their job because of health benefits.
TAX REFORM - Breaks the link between employment and insurance, giving employees instead of employers the tax benefit, which will strengthen incentives to shop for lower cost plans, as well as improve health care quality.
HEALTHY BEHAVIOR - Promotes personal responsibility and preventative medicine by creating incentives for individuals to engage in healthy behavior.
MARKET FORCES - Provides for patient-driven health care through market forces by allowing more transparency and competition, thereby forcing insurance companies to compete on price, benefits, and quality.
19 Recent News
Article in the Wall Street Journal on April 10th, 2009 A Health-Care Plan that could Bridge the Divide by Gerald Seib
Describes the public option obstacle
The State of the Union for Health Care, sponsored by the Atlantic A Conversation with Senators Bob Bennett and Ron Wyden