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Getting businesses out of the health-care business.


Health-care reform continues to be the main event on Capitol Hill, and most of the major contenders are taking their well-deserved lumps.

The Clinton plan is battered bat·ter 1  
v. bat·tered, bat·ter·ing, bat·ters

v.tr.
1. To hit heavily and repeatedly with violent blows.

2. To subject to repeated beatings or physical abuse.

3.
 and bleeding: too complicated, too bureaucratic bu·reau·crat  
n.
1. An official of a bureaucracy.

2. An official who is rigidly devoted to the details of administrative procedure.



bu
, too costly, too limited on individual choice, and too certain to lead to government-directed rationing rationing, allotment of scarce supplies, usually by governmental decree, to provide equitable distribution. It may be employed also to conserve economic resources and to reinforce price and production controls. . Not a pretty picture.

Another leading plan--known as "Clinton-lite"--also is faltering. Why? Because, as The Washington Post has pointed out, the Cooper-Grandy "managed-competition" plan and the Clinton plan "are more alike than either side finds it convenient to acknowledge."

With Congress' Independence Day recess just ahead, maybe it's time It's Time was a successful political campaign run by the Australian Labor Party (ALP) under Gough Whitlam at the 1972 election in Australia. Campaigning on the perceived need for change after 23 years of conservative (Liberal Party of Australia) government, Labor put forward a  for business executives to give their senators and representatives some needed advice: Instead of arguing about business "mandates," let's get business out of the health-care business altogether.

Only one plan would remove business from of the business of health care: The Consumer Choice Health Security Act, sponsored by Sen. Don Nickles Donald Lee Nickles (born December 6, 1948) is an American political leader who was a United States Senator from Oklahoma from 1981 until 2005. He is a member of the Republican Party. While in the U.S. , R-Okla., and Rep. Cliff Stearns Clifford Bundy "Cliff" Stearns, Sr. (born April 16 1941), American politician, has been a Republican member of the United States House of Representatives since 1989, representing Florida's At-large congressional district (map). He was born in Washington, D.C. , R-Fla. This bill, which has 25 Senate and 20 House co-sponsors, is the legislative progeny PROGENY - 1961. Report generator for UNIVAX SS90.  of a plan my colleagues at the Heritage Foundation devised in 1989 when our experts realized health-care financing was rapidly reaching the crisis stage.

The idea behind the Nickles-Stearns plan is that because people think someone else is picking up the tab for their health care, they don't pay attention to costs. As a result, neither do doctors, hospitals, and others in the medical business. Prices outpace out·pace  
tr.v. out·paced, out·pac·ing, out·pac·es
To surpass or outdo (another), as in speed, growth, or performance.


outpace
Verb

[-pacing,
 the general rate of inflation, because demand is unlimited.

The Nickles-Stearns plan would remove this demand distortion by ending the current tax exclusion for employer-provided benefits. The additional revenue (some $80 billion to $88 billion per year, state and federal) the government would realize from the expanded tax base would be returned to taxpayers in the form of an individual tax credit or vouchers for the working poor who currently don't have health benefits.

From the day this legislation would take effect, businesses could "cash out" of health care--that is, they could convert the value of their employees' health benefits into cash, increase their wages by an equivalent amount, and get out of the health-benefits business.

Employees would use the additional pay to buy their own health plans, either directly from an insurer or HMO HMO health maintenance organization.

HMO
n.
A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial,
, or through some group with which they feel a special affinity, such as a professional society, a union, a religious organization, a health charity, the state manufacturers association.

If the employees of Citibank, for example, now get a $6,000-a-year health plan as a free benefit, that $6,000 would be considered taxable income Under the federal tax law, gross income reduced by adjustments and allowable deductions. It is the income against which tax rates are applied to compute an individual or entity's tax liability. The essence of taxable income is the accrual of some gain, profit, or benefit to a taxpayer.  under the consumer-choice plan. Each employee would use the pay increase to buy his own health plan. If an employee can find a health plan that meets his family's needs for just $4,200 per year, he pockets the $1,800 he has just saved (less taxes, of course). The health plan would be the employee's--not the company's--and would go with him if he changed jobs.

Consider the effect of such a plan on the cost of health care. Individuals would have as wide a range of choices as the market could provide. This would mean not only intense competition between insurers and health-care providers for the business of each individual and family, it would mean each family could pick the plan that best suits its individual circumstances and pocketbook.

Once consumers are empowered to buy their own insurance without the employer middle man, they'll pay more attention to the money they spend. Normal market forces will impel im·pel  
tr.v. im·pelled, im·pel·ling, im·pels
1. To urge to action through moral pressure; drive: I was impelled by events to take a stand.

2. To drive forward; propel.
 doctors and hospitals to operate more economically. America's health industry will keep its insurmountable edge in quality and innovation--and add efficiency to the mix.

Wishful thinking wishful thinking Psychology Dereitic thought that a thing or event should have a specified outcome ? Not at all: A working prototype for such a consumer-choice system has existed for 34 years: the Federal Employees Health Benefits Program. Nearly 10 million government employees and retirees and dependents are now covered. They choose from dozens of plans. Does it control costs? According to according to
prep.
1. As stated or indicated by; on the authority of: according to historians.

2. In keeping with: according to instructions.

3.
 a Sept. 1993 news release from the Office of Personnel Management, which administers the program, FEHBP FEHBP Federal Employees Health Benefits Program  costs this year increased just 3 percent, on average, above 1993 levels. Forty percent of enrollees in FEHBP, the release stated, saw their premiums decrease in 1994.

In a special editorial commentary, Barron's called the Nickles-Stearns bill "the closest thing we've yet seen to our goal for national health care," because it incorporates FEHBP's principles of consumer choice and market competition, which "should become the model for the nation."

On the other hand, the Clinton plan is the precise opposite of a consumer-choice system. It offers just one choice: a standard package of benefits, for which employers would be required to pay 80 percent of the "premiums." Even Congress won't go along with this.

And for good reason. According to an analysis by Lewin-VHI, the nation's leading health-care accounting and econometrics econometrics, technique of economic analysis that expresses economic theory in terms of mathematical relationships and then tests it empirically through statistical research.  firm, the costs of the employer mandate would reduce the wages of workers in firms without health coverage by more than $1,200 per worker and kill between 155,000 and 349,000 jobs. By contrast, the Nickles-Stearns Consumer Choice Health Security Act would cause no wage or job losses, the Lewin study found.

Though widely portrayed as a "market-oriented" alternative to the Clinton plan, the Cooper-Grandy proposal establishes the same national network of government-sponsored health alliances, called Health Plan Purchasing Cooperatives purchasing cooperative,
n a group of dental professionals pooling their financial resources to purchase large quantities of supplies and equipment for the purpose of obtaining a discount.
 (or hip-ics). It also would establish a new federal commission with broad regulatory powers, similar to Clinton's National Health Board.

What's more, the Cooper plan would impose heavy new taxes on many businesses. Employers currently can deduct de·duct  
v. de·duct·ed, de·duct·ing, de·ducts

v.tr.
1. To take away (a quantity) from another; subtract.

2. To derive by deduction; deduce.

v.intr.
 from their taxes the full amount of the cost of any health-insurance plan they purchase for their employees as a cost of labor. But under the Cooper plan, if an employer provides health benefits that are more generous than the lowest-cost plan offered by the hip-ic in a given area, the employer's deduction not only would be limited to the lower amount, but anything above that would be taxed. This would mean huge tax penalties for firms now offering generous benefits plans. To avoid a tax penalty, such firms would have to cut back benefits.

Ironically, this provision would hit hardest many of the very firms, members of the Business Roundtable Business Roundtable (BRT), an association consisting of the chief executive officers of major U.S. corporations that was founded in 1972 through the merger of the three preexisting business organizations. , for instance, that have misguidedly endorsed the Cooper plan.

Take, for example, a large energy company with 31,000 employees that pays out $118 million in health benefits per year. If the annual cost of a family health plan is $4,600, and the lowest-cost plan in the area is $4,000, under the Cooper bill the company pays 35 percent taxes on the difference of $600. This is a $210 tax per employee with family coverage. If 22,800 employees have families, this means a new corporate tax of $4.8 million. If the annual cost of the company plan for single employees is $1,700, and the cheapest singles plan in the area costs $200 less, and there are 8,300 single employees, the new Cooper tax comes to $581,000. Total new tax for this company under the Cooper plan: $5.4 million per year.

The reformers on Capitol Hill should leave re-inventing the wheel to the Flintstones. The consumer-choice approach has been tried under FEHBP, and it works. The Nickles-Stearns plan is the only "market-oriented" approach out there--one that business leaders should embrace, not only for their own sakes, but for America's. All the others are pretenders.

Edwin J. Feulner, Ph.D., is president of The Heritage Foundation, a Washington, DC-based public policy research institution. He also serves on the boards of several other foundations and research institutes. Dr. Feulner is the author of "Conservatives Stalk stalk (stawk) an elongated anatomical structure resembling the stem of a plant.

allantoic stalk
 the House."
COPYRIGHT 1994 Chief Executive Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1994, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:Above The Beltway; Nickles-Stearns Consumer Choice Health Security Act
Author:Feulner, Edwin J.
Publication:Chief Executive (U.S.)
Date:Jun 1, 1994
Words:1274
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