More on the N.C. Justice Center's health-insurance proposal
My analysis of the N.C. Justice Center's proposed universal health-insurance coverage plan for North Carolina is here. (The plan is here.)
I got a couple of responses yesterday after my deadline that I'm posting here.
One was from David Ward, a spokesman for U.S. Sen. Richard Burr, R-N.C.:
As health care costs continue to rise, it is important we look for solutions that can make health insurance more affordable for people and their families. I am pleased to see North Carolinians engaging in discussion and work to improve access to affordable and high quality health care in North Carolina.When it comes to health insurance, Americans need choice, ownership, and control. By giving individuals choice and control over their plans, they will become smarter about their health care options. Our health system is the best in the world. It's time to ensure that American families have access to it.
The other is from Terrie Reeves, an associate professor in the department of business administration at UNCG's Bryan School of Business and Economics. She writes:
In general, the NC Justice Center’s Health Access Coalition proposal for Guaranteed Affordable Choice of health coverage for all North Carolinians appears to be a good attempt at a solution for a very difficult problem. The major impediments to implementing such a plan would appear to be how to marshal the political will, as the proposal says, and how to guarantee that the federal government can and will provide the help that is “required in order to implement many of the proposed steps. . . “The proposal suggests that we can have universal access without lowering choice or service quality. However, marshaling the political will means confronting, instead of skirting-around-the- edge of the trade-off decision. Do we North Carolinians want everyone to have access to affordable health insurance and/or affordable health care (and how do we define ‘affordable’), or do we want to contain the cost of health insurance and/or health care, or do we want the greatest choice of how health care is provided and by whom, or do we want health services of the highest quality? If, as the proposal argues, we want everyone to have access to affordable health insurance, then we must be prepared to accept either greater costs, or fewer health care services choices, or lower health care quality, or perhaps all three.
The proposal suggests that costs to the individual will not be increased because of system cost savings under a universal access program with emphasis on prevention, because of additional revenue from increased taxes on cigarettes, and because the federal government will make up for any differential. There is not (yet) a consensus that prevention decreases overall health services costs. Federal government help may also be an overly optimistic idea. Some recent projections suggest that the Centers for Medicare and Medicaid Services will most likely run out of funds to pay Medicare expenses sooner than anticipated. Under such a scenario, will there actually be funds for existing state programs, such as an expanded SCHIP program, let alone additional funding for universal insurance coverage?
The proposal’s ideas about increasing cigarette taxes, initiating research on health care cost increase drivers, providing more public health education, and consolidating the insurance markets are not new, but they may be areas upon which political consensus could be most easily reached. Requiring that insurance companies charge only so much or that they sell prescribed plans may mean that some companies quit the NC market, thus lowering choice. In short, it seems as though the NC Justice Center’s Health Access Coalition must be very politically savvy to enact such a proposal in North Carolina.
