TAILIEUCHUNG - Can a Public Insurance Plan Increase Competition and Lower the Costs of Health Reform?

Many people think of Social Security only as a retirement program. But some of the Social Security taxes you pay go toward providing survivors insurance for workers and their families. In fact, the value of the survivors insurance you have under Social Security is probably more than the value of your individual life insurance. When you die, certain members of your family may be eligible for survivors benefits. These include widows, widowers (and divorced widows and widowers), children and dependent parents | Can a Public Insurance Plan Increase Competition and Lower the Costs of Health Reform John Holahan and Linda Blumberg1 Senator Barack Obama has proposed having a public plan available to those seeking coverage in a purchasing arrangement such as the Federal Employees Health Benefits Plan. Senators Hillary Clinton and John Edwards had similar proposals. In the academic world Jacob Hacker of Yale University has articulated the same proposal in his Health Care for Americans Likewise the reform approach we with Len Nichols of the New America Foundation outlined in 2001 under the auspices of the Robert Wood Johnson Foundation s Covering America project would have required each participating state s purchasing pool to include its own managed fee for service The basic idea behind this approach is to develop a government-funded plan that would follow the traditional Medicare program in many respects and would compete with private insurers for covered lives. It could be modeled after the traditional Medicare program but that is not a necessity other government selffunded plan models are possible. Using the Medicare example the plan could use Medicare s evolving systems of payment for hospitals physicians and other providers. The levels or rates of payment could be the same or perhaps somewhat higher than Medicare but lower than typical private payments today. The public plan could also use Medicare policies to determine what types of services including new procedures and technologies would be covered and it could take advantage of Medicare research on medical homes chronic care coordination programs and health information technology and adopt them when cost-effective. Benefits would differ from Medicare in that they would be structured more like typical employer-based insurance including pharmaceuticals out-of-pocket maximums and common levels of cost sharing. The expectation is that the administrative costs of the public plan would be below those of the .

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