Health Care Unity: The Top Ten List

One lesson learned over the last several decades of health policy battles is that bi-partisan action is key.

While health care never became a top-tier issue in the presidential campaign, exit polls showed that 70% of voters were ?very concerned? about health care costs and availability.

Several newly-elected legislators from both sides of the aisle, such as Democratic Senator-elect Barack Obama of Illinois and Republican Sen. Lisa Murkowski of Alaska, made health care a priority issue and are determined to push for action in the next Congress.

So where is the common ground?

During the campaign, both Sen. Kerry and President Bush proposed offering refundable tax credits for health insurance, both saw the need for new group purchasing pool options for individuals and businesses, and both encouraged greater adoption of information technologies in the health sector. These are good starting points for action.

The bottom line: To reduce the number of uninsured, consumers need direct subsidies to purchase coverage and more options in how they obtain health insurance.

In the private sector, the growing movement toward consumer-directed health care will certainly accelerate as companies and individuals investigate new options to engage patients as partners rather than adversaries in managing health care costs. And implementation of the new Medicare law will be a top priority and a big challenge in the coming year.

But based upon proposals offered during the campaign, here is our top ten list of likely legislative initiatives impacting health care:

1. Providing refundable, advanceable tax credits for the uninsured. (This includes allowing the credits to be used to create HSAs, if recipients choose this option.)

2. Creating an above-the-line deduction of premiums for HSA-qualified health insurance

3. Providing a $200/individual, $500/family rebate to small firms to set up HSA accounts for their workers

4. Providing a mechanism for new purchasing pools to be created for small businesses and individuals

5. Allowing cross-state purchasing of health insurance

6. Providing new funding to sign up those who are eligible but not enrolled in Medicaid and SCHIP ? and beginning to reform Medicaid in the process

7. Promoting health care deregulation, including removing the moratorium on specialty hospitals and lifting the ban on private contracting in Medicare

8. Enacting medical liability reform

9. Facilitating adoption of information technologies

10. Accelerating organized care management of patients with chronic diseases and major acute incidents and promotion of prevention programs for killers like diabetes and obesity

Health care clearly will be advanced by President Bush as part of the ?ownership society? he is cultivating to give consumers more tools to create a properly functioning market in the health sector that will increase choice and reduce costs.


In California, voters wisely repealed a law, enacted last year in the final days of the failed Gray Davis administration, which would have required employers to pay at least 80% of their workers’ health insurance costs or pay into a new state insurance fund that would cover them.

Gov. Schwarzenegger campaigned heavily against the measure, calling the pay-or-play employer mandate a jobs killer. A majority of California voters understood the threat to both jobs and to control over health coverage and voted to repeal the law 51% to 49%.

With our increasingly mobile workforce, the lock between health insurance and the workplace doesn?t work for millions of people. Employers, especially small firms, also find the costs and the administrative hassle of providing health insurance increasingly burdensome. Allowing more individual ownership of health insurance looks to the future of a mobile, flexible workforce and will facilitate competition to expand choices and lower costs.

Grace-Marie Turner

P.S. There was, understandably, a dearth of new papers on health policy over the last week. Our articles Round-Up will return next week. In the meantime, there are many conferences of interest. Here are the details.


Improving Health Care: A Dose of Competition

American Enterprise Institute Health Policy Discussion

Monday, November 8, 2004, 10:00 a.m. – 1:30 p.m.

Washington, D.C.

For additional details and RSVP information, go to:

A Post-Election Prescription for Health Care

Pacific Research Institute Event

Tuesday, November 9, 2004, 6:00 to 7:30 p.m.

The Huntington Hotel, San Francisco

For additional details and RSVP information, go to:

Private Health Insurance: Is The Managed Care Backlash Over?

Health Affairs/California HealthCare Foundation Briefing

Wednesday, Nov. 10, 2004 – 9 a.m. to noon

The National Press Club, Washington, DC

To RSVP for this event, please contact Eliza Brinkmeyer of Burness Communications, at, or at 301-652-1558.

Race, Medicine, and Public Policy

American Enterprise Institute Event

Friday, November 12, 2004, 9:00 a.m. – 12:00 p.m.

Washington, D.C.

For additional details and RSVP information, go to:


Workshop Addressing Health Insurance Solutions

Flint Hills Center for Public Policy and Kansas Health Partners Benefit Association Event

Friday, November 12th, 2004 at 10:30 a.m.

Kansas City, Missouri

For additional details and RSVP information, go to:


Health Policy Matters is a weekly newsletter containing summaries of timely and informative studies and articles on free-market health reform. It features research and writings by participants in the Health Policy Consensus Group, articles of interest from the health policy world, and announcements of coming events. Health Policy Matters is published by the Galen Institute, a not-for-profit public policy organization specializing in information and education on health policy. For more information about the newsletter and our organization, please visit our website at

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