Health Care
Every American should have freedom of choice in health care. Learn More... Statement of Purpose The United States spends $2.1 trillion on health care, roughly 16 percent of the gross domestic product. Additionally, government is responsible for approximately 50 cents out of every dollar spent on heath care because of the huge and rapidly growing government health care programs: Medicare, Medicaid, SCHIP, and state and public health care programs. The result of so much government control is that health care is one of the most highly regulated sectors of the American economy. Government financing means government control, and government control means less personal freedom.

In order to protect individuals and families, we must change laws and regulations at the federal and state level to enable individuals and families to own and control their own health care policies and to take them from job to job without tax or regulatory penalties. Currently, only nine percent of Americans directly purchase their own health insurance. Individuals and families should be able to buy the health care plans they want at the price they wish to pay. Health plans and providers should be forced to compete on a level playing field in a free and open market where government will not be in the business of picking winners and losers. Finally, individuals and families should be free to choose health plans that accommodate their own ethics and morals. This means we must also transform Medicare, Medicaid, and SCHIP so that those providers are directly accountable to patients for their quality of care.

Featured Research

A Principled Path to Rational Health Care Reform

Congress will soon unveil legislation to reform the health care system. The policies outlined by President Obama during his campaign and those being discussed in Congress would centralize control over the health care system in Washington.

Ensuring Access to Affordable Health Insurance: A Memo to President-elect Obama

President-elect Obama, during the campaign you pledged to build a health care system in which Americans can be assured of access to affordable health insurance. You guaranteed Americans who already have insurance that nothing would change except that their coverage would be less expensive. You pointed to the health system that Members of Congress have as your model for expanding coverage. And you agreed that choice of doctor and care is a basic principle. These laudable themes struck a chord with Americans.

The Obama Health Care Plan: More Power to Washington

Senator Barack Obama's health care plan is laden with new regulations and government authority that would leave Americans with even less control of their health care dollars than they exercise today. A better course would be to transfer control of health care dollars to individuals and families, both to empower individuals to make informed choices and to enable the marketplace to respond rapidly to their needs and wants.

The Obama Health Care Plan: A Closer Look at Cost and Coverage

Barack Obama's health care plan would reduce the number of insured, but it would not control costs in any significant way. In fact, it would require considerable increases in federal expenditures.

Latest Research

How the Medicare "Doc Fix" Would Add to the Long-Term Medicare Debt

November 13, 2009

The House will soon take up legislation to "fix" the Medicare physician payment update formula. The likely result: huge new costs on taxpayers.

Government-Run Health Care Even Without the Public Option

November 9, 2009

The reforms under consideration in Congress would impose such rigid control on private health plans that it amounts to a government-run health care system.

A Closer Look at the House Democrats' Health Care Bill

November 6, 2009

A Closer Look at the House Democrats' Health Care Bill

Other Publications

Overcoming Health Care Disparities

It is obvious that not all Americans enjoy equal access to affordable and high-quality health care. The problem is particularly acute for ethnic and racial minorities. Portability of health insurance policies-enabling individuals to keep their coverage when they change jobs or maintain coverage throughout life changes-would be key to stabilizing health insurance markets and dramatically reducing the numbers of the uninsured, especially among blacks and Hispanics.

The FEHBP As A Model For a New Medicare Program

The deficiencies of the Medicare program are rooted in its defined-benefit structure and in its use of price controls. Medicare should be transformed into a defined cash contribution made to beneficiaries’ private plans or to the traditional Medicare program. The Federal Employees Health Benefits Program (FEHBP) is essentially such a system and is a good model for Medicare reform. The FEHBP has been highly successful at holding down costs while offering a wide range of benefits and types of plans. Its features for consumer information and plan standards also would be useful in a reformed Medicare program.

Choice and Consequences: Transparent Alternatives to the Individual Insurance Mandate

The proposal for an individual mandate requiring individuals to buy health insurance has emerged as the most controversial health policy issue in America’s Presidential candidates’ debate, reflecting similar divisions among a broad spectrum of health policy analysts.

The Massachusetts Approach: A New Way To Restructure State Health Insurance Markets

 

A Federalist Approach To Health Reform: The Worst Way, Except For All The Others

Support for state action should be part of any strategy to expand health insurance coverage. Decades-long political deadlock in Washington has frustrated national efforts to expand coverage. Some states have already undertaken to do this; others show a determination to do so. Regulatory and legislative flexibility would trigger widespread state action. Whether one thinks that ensuring coverage requires a unified national approach or that diverse conditions require different methods in different states, the likelihood of progress will be advanced if states test out various ways to expand coverage.

How Federalism Could Spur Bipartisan Action On The Uninsured

A way to end the political impasse and make progress on covering uninsured Americans.

Evolving Beyond Traditional Employer-Sponsored Health Insurance

For most working-age families, health insurance coverage is directly connected to the workplace. But because of structural weaknesses in this traditional form of coverage, it is steadily eroding, especially for workers in the small business sector. The health insurance system needs to evolve along a different path if it is to adapt to the goals and needs of today’s workforce. Unfortunately, existing laws and insurance arrangements obstruct that evolution. Three key steps are needed to achieve a gradual transformation without disrupting the successful parts of the system.

Building Public Support for Slowing the Growth of Health Care Spending

The task of moving from policy proposal to successful legislation means navigating the waters of public opinion that influences practical politics. This is true of all areas of policy, of course, but health care waters are especially turbulent. Health care is intensely personal and costly for families, and even small policy changes have potentially huge financial implications for them as well as other stakeholders. If successful ways of addressing the health spending challenge are to be devised, it is critical to reflect on the underlying values and moral choices associated with any policy approach.

Perspectives on an Individual Mandate

An individual mandate is a legal requirement that every person have health insurance coverage. In 2008, debate over individual mandates has figured prominently in presidential and congressional politics. In contrast to many of today’s left/right, red/blue divides, supporters and opponents of individual mandates cut across partisan and ideological lines.

Latest Commentary

With Pelosicare DOA, Can Reid Rescue Obamacare in Senate?

November 13, 2009

With the House passing Speaker Pelosi's version of Obamacare by a 220-215 vote on Saturday night, the next arena for battle on an attempted government takeover of health care is the United States Senate. Sen. Lindsey Graham (R.-S.C.) correctly stated on "Face the Nation" this past Sunday that "the House bill is dead on arrival in the Senate."

Doubling Down on Defeat

November 10, 2009

The 2009 elections in Virginia, New Jersey and New York sent a strong message to elected officials. Yet many politicians may be willing to risk their future by continuing to promote unpopular ideas.

Congressional Spenders Ignore Deepening Government Waste

November 9, 2009

To get a handle on how out of control federal spending has become, consider this: It surged to $30,000 per household in 2009. That's up from $21,000 (adjusted for inflation) in the 1980s and '90s. Yet rather than cut back, Congress plans to spend even more.

A Healthy Reaction: Voters Say No to Big Government

November 6, 2009

"Contain the scope of the debate": This has been a key element of the Democratic strategy to enact Big Government health reform. As long as voters perceive the issue as a nice, neat, four-cornered proposal to expand health coverage, the liberals who control Congress will win.

Barack Obama: Media Sweetheart and Golf Addict

November 3, 2009

Barack Obama enjoys wide support from his liberal friends in the media. That allows them to ignore the growing discontent average Americans hold toward a leader who promised so much and has delivered so little.

Campaign Stops Blog

Stuart M. Butler - NYTimes.com

Health Care Experts Blog

Stuart M. Butler - National Journal Online

The Massachusetts Approach: A New Way To Restructure State Health Insurance Markets And Public Programs

In April 2006, Massachusetts enacted legislation to reorganize both its health insurance markets and a large portion of its health care subsidy system. In this paper we consider how the Massachusetts approach differs from most previous state health reform efforts, while also noting its antecedents. We examine the policy implications of the legislation’s key elements and discuss how other states might consider altering the scope and specifics of those components. We conclude that both parts of the Massachusetts reform strategy merit consideration by other states and together hold promise for expanding coverage, particularly by addressing the problem of coverage discontinuity.

Why Believe New Promise When Congress Breaks Old Promise?

11/13/2009

Congress wants America to believe its new promises to control spending even as it reneges on its old promises and spends more than ever. The “new” promise within health care reform bills is to reduce Medicare spending by hundreds of billions of dollars. Yet simultaneously, Congress is reversing 1997 legislation that claimed it would reduce   Read More...

Video: Pelosi Says Jail “Very Fair” Punishment For Not Buying Health Insurance

11/13/2009

According to the non-partisan Joint Committee on Taxation (JCT), the House health care bill passed last Friday empowers the federal government to imprison people for up to five years if they willfully refuse to buy federally regulated and approved health insurance. Shomari Stone of Komo 4 News in Seattle pressed the Speaker on this point yesterday.   Read More...

The Logic of Obamacare

11/13/2009

The Washington Post’s Ezra Klein asks: “One of my frustrations with the cost-control discussion is that people set this up like a choice between this bill and a bill with more cost control. In reality, it seems more like a choice between this bill and nothing. And this bill does a lot more cost control   Read More...

In the Green Room: Utah’s Gov. Herbert on DC ‘Freezing Out the States’ Over Health Reform

11/12/2009

It’s simple: “Our approach in Utah is to give consumers more choice,” said Governor Herbert during a Heritage Foundation visit earlier this week. “If we can put them in the control position where they’re spending dollars that are their own, they’re going to make better choices.” Similarly, the Governor believes that States, not the federal government   Read More...

Is there a Constitutional Basis for Mandatory Health Insurance?

11/12/2009

Does the Constitution allow the federal government to force individual citizens to buy health insurance? Sen. Tom Coburn (R-OK) and Rep. John Shadegg (R-AZ) have been waging a war to force Members of Congress to include a concise explanation of the constitutional authority empowering Congress to enact legislation as part of every bill.   Read More...

Health Care Plan 'Crowds Out' Family Coverage

October 03, 2007
Health care plan 'crowds out' family coverage
  • Health Care Plan 'Crowds Out' Family Coverage
  • Percentage of Children with Private Health Insurance
  • SCHIP Distribution of Children by Income Level
  • SCHIP Eligibility Above 200 Percent of Federal Poverty Level
  • SCHIP: No Child Left Off Welfare
  • State Children's Health Insurance Program Plan Activity as of January 18, 2007
  • States Exceeding 50 Percent Medicaid Threshold
  • States that Cover Adults Under SCHIP
  • The 'SCHIP Plus' Alternative: An 8-to-1 Win for Kids
  • U.S. on collision course to 'socialized medicine'

Health CareFix Health Care Policy
President Obama and members of Congress want to solve America's health care problems by centralizing decisions in Washington. A better approach would make individuals and families the key decision makers in their health care.

Read more on FixHealthCarePolicy.com

Another Round in the National Debate on Health Care Reform


While Americans are eagerly awaiting the details of President-Elect Barack Obama's health care reform proposal, it is well to recall the last national debate on health care reform: the debate over the 1993 Clinton Health Plan. While many of the issues are strikingly similar- rising costs, large numbers of Americans without health insurance and gaps in coverage- today the circumstances are different. One thing that has not changed is that popular support for broad goals- a slowing of health care costs and an expansion of health insurance coverage- does not automatically translate into popular support for specific health policy measures, particularly when the trade-offs embodied in those health policy measures are made transparent to the millions of Americans who would be affected by them. It is not "bumper sticker" slogans, but crucial details, that matter. Check out the Heritage Foundation's analysis of the 1993 Clinton Health Plan and its leading alternative, The Consumer Choice Health Security Act, based on major changes in the tax code, the insurance markets and principles of personal choice and competition.



Recent Heritage Testimony

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Heritage Experts on Health Care

Media Information Line: (202) 675-1761

Robert

Robert A. Book Ph.D.

Senior Research Fellow in Health Economics , Center for Data Analysis

Stuart

Stuart M. Butler Ph.D.

Vice President, Domestic and Economic Policy Studies , Domestic Policy

Greg

Greg D'Angelo

Policy Analyst , Center for Health Policy Studies

Edmund

Edmund F. Haislmaier

Senior Research Fellow in Health Policy Studies , Domestic Policy

Robert

Robert E. Moffit Ph.D.

Director , Center for Health Policy Studies

Nina

Nina Owcharenko

Deputy Director , Center for Health Policy Studies

Dennis

Dennis G. Smith

Senior Fellow in Health Care Reform , Center for Health Policy Studies