Heritage Foundation Leadership for America

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.

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.

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.

Interview on the President-Elect Obama Health Care Plan