Leadership for America

Health Care

STATEMENT OF PURPOSE

Health care is a huge and growing sector of the U.S. economy. 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 health 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 individuals and families have a broad choice of health plans and providers and that those providers are directly accountable to patients for their quality of care.

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OBJECTIVES

  1. 1. Transform private health insurance so that individuals and families are able to own and control their own policies and take them from job to job without tax or regulatory penalties. Currently, nine percent of Americans directly purchase their own health insurance. We want this figure to increase to 50 percent in 10 years.

  2. 2. Transform health care financing to create new opportunities for individuals and families so they control the flow of dollars into the system. Currently, only $3.50 out of every $100 is spent by individuals for the direct purchase of private coverage. We want to increase that amount to $50 out of every $100 over the next 10 years.

  3. 3. Transform Medicare, Medicaid, and SCHIP so that individuals and families have a broad choice of health plans and providers and that those providers are directly accountable to patients for their quality of care.

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Our Work on Health Care

Experts From This Initiative

  • Robert A. Book, Ph.D. Robert A. Book, Ph.D.

    Robert A. Book is a Senior Research Fellow in Health Economics at The Heritage Foundation's Center for Data Analysis. Before joining Heritage in December 2008, Book taught economics courses adapted to the needs of senior military officers and civilian national security professionals at the National Defense University 's Industrial College of the Armed Forces. While there as an Assistant Professor, he annually served on a faculty team that led a group of 16 students through an in-depth, five-month study of the health care industry. Book also has taught economics and mathematics courses at George Mason University, Loyola University in Chicago and the University of Chicago. He also worked as a Senior Associate for The Lewin Group, a health care policy research and consulting firm in Falls Church, Va. While there, he conducted a detailed study of the cost structure of the specialty pharmacy industry in the wake of the 2003 Medicare Modernization Act. At Lewin, he also analyzed the growth of diagnostic imaging and cost changes resulting from improved technology; forecasted effects of Medicare payment changes on the long-term, acute care, and rehabilitation hospital industries; analyzed costs in pharmacy and physician practices; and studied the impact of medication therapy management by pharmacists. In 2002, Book earned a doctorate in economics and an MBA from the University of Chicago for his thesis on "Public Research Funding and Private Innovation: The Case of the Pharmaceutical Industry." He also has a master's in computational and applied mathematics from Rice University, and bachelor's degrees in mathematics and history from Duke University. An Eagle Scout, Book serves as Scoutmaster for Troop 1818 in Fairfax, Va. ...

  • Stuart Butler, Ph.D. Stuart Butler, Ph.D.

    Stuart M. Butler has guided The Heritage Foundation's domestic policy research for more than 30 years. As Vice President of Domestic and Economic Policy Studies, Butler's steady hand has helped shape the debate on critical issues from health care and Social Security to welfare reform and tax relief. By the 1980s, National Journal, Washington's premier magazine of politics and policy, had named him as "one of 150 individuals outside government who have the greatest influence on decision-making in Washington." Two decades later, Butler continues to be in the thick of the action. In a recent example, he is a regular speaker on the national Fiscal Wake-Up Tour. He joined a group of nonpartisan, ideologically diverse budget realists who travel the country seeking to build public support for tackling the growing threat posed by runaway federal spending on the "Big Three" entitlement programs-Medicaid, Medicare and Social Security. Featuring former U.S. Comptroller General David Walker and experts from Heritage, the Brookings Institution and the Concord Coalition, the tour has visited dozens of cities to meet with editorial boards, business leaders, academics and town hall gatherings of regular citizens. Even before the recession took hold, regional and national media--including CBS' 60 Minutes--devoted attention to the Fiscal Wake-Up Tour. Butler joined Heritage in 1979, when it was a relatively obscure conservative think tank, as a policy analyst specializing in urban issues. His first widely recognized policy proposal was the concept of "enterprise zones" to encourage development in blighted neighborhoods. How? By offering tax and regulatory relief to entrepreneurs who were willing to start businesses there. Butler introduced the idea in an early paper for Heritage. It caught the attention of then-Rep. Jack Kemp (R-NY), who co-sponsored legislation implementing the concept with then-Rep. Robert Garcia, a Democrat from the South Bronx. Today, at least 70 zones exist in cities across the country. Butler grew up in Shropshire, in the west midlands of England. The son of a mechanic who left school at age 13, he says his modest roots strongly influenced both his personal values and his approach to policy. Although he holds bachelor's degrees in physics and math, and also economics, and a doctorate in American economic history from the University of St. Andrews in Scotland, Butler believes that empowering ordinary people--not experts or government officials--is the best way to solve social problems. Butler became a U.S. citizen in 1996. In his early days as a policy analyst, he visited tenements in the South Bronx and Washington, D.C., to discuss with residents how best to address the festering problems of public housing. The encounters led him to help design such approaches as tenant ownership and school choice. Butler's abiding passion is health care reform. He has argued for a restructured system based on consumer choice and state-led innovation. In 1989's "A National Health System for America," Butler and Heritage colleague Edmund F. Haislmaier explained how distortions in the tax code created a health care system that denies individual choice and drives up costs. When President Clinton began his bid to federalize health care upon taking office in 1993, Butler was one of the nation's most-quoted experts on why the Clinton proposal wouldn't work. But he also consulted with lawmakers to develop an alternative reform. At the time, liberal pundits were among those who thought the Butler approach was superior. Michael Kinsley, then editor of The New Republic, called it "the simplest, most promising, and in an important way, the most progressive idea for health care reform." More recently, National Journal again noted Butler's influence, calling him one of Washington's 12 "key players" on health care. In the debate over President Obama's health proposals, Butler again argued for an alternative based on consumer choice and state-led efforts, not federally directed ones. In health care as in other areas of policy, Butler has been a leading proponent of reaching across the ideological spectrum to find bipartisan ways to achieve reform. For instance, Butler and Henry Aaron of the Brookings Institution authored a major article that encouraged some of the most liberal members of Congress, as well as some of the most conservative, to craft and introduce House and Senate bills to foster bold state initiatives to reduce the number of uninsured Americans. Butler has been published in leading academic journals, including Journal of the American Medical Association and Health Affairs, and in leading newspapers, including The New York Times. He is also a member of the editorial board of Health Affairs. He has testified before Congress dozens of times, been the subject of a profile in The Washington Post, and appeared as a guest commentator on all of the major television networks. In addition to dozens of research papers for Heritage, Butler is the author of three books: Enterprise Zones: Greenlining the Inner Cities (1981), Privatizing Federal Spending (1985) and--with Anna Kondratas--Out of the Poverty Trap (1987). In 2002, he accepted an invitation to spend a semester as a fellow at Harvard University's Institute of Politics. He currently is an adjunct professor at Georgetown University Graduate School. Butler, who is married and has two children, resides in Washington, D.C....

  • Edmund Haislmaier Edmund Haislmaier

    Edmund F. Haislmaier is an expert in health care policy and markets at The Heritage Foundation – and is frequently asked to assist federal and state lawmakers in designing and drafting health reform proposals and legislation. In 2006, Massachusetts enacted a major health reform plan that included health insurance reforms designed by Haislmaier. His innovation was to develop a blueprint for how states can use their authority to regulate insurance to create a consumer-centered health insurance market. Under the approach, employers can opt to enroll their workers in a state health insurance “exchange,” through which each worker then buys coverage of his or her choice. Thus, employers avoid the hassles of having to administer a group plan while each worker can pick the coverage he or she wants and take it from job to job – all without losing the current tax preferences and other benefits of employer-sponsored insurance. Since Gov. Mitt Romney signed the Massachusetts reforms into law in April 2006, 15 more states have asked Haislmaier and his colleagues to help them develop similar consumer-focused solutions for their health systems. Haislmaier's expertise also covers: health care tax policy, Medicare, Medicaid, foreign health systems, pharmaceuticals, and health care price controls. He is in demand as a speaker at conferences on health policy and has testified before numerous federal and state legislative committees. He also appears as a guest on television news shows, and his commentaries have been published in The Washington Times and National Review Online. Before rejoining Heritage in 2005 as a Research Fellow, Haislmaier was a health policy consultant from1998-2004 and director of health care policy in Pfizer Inc.'s Corporate Strategic Planning and Policy division from 1994-1997. He originally joined Heritage in 1987 as the think tank's first-ever health care Policy Analyst and was named a Senior Policy Analyst in 1994. In 2007, he was named a Senior Research Fellow.He is also a member of the board of directors of the National Center for Public Policy Research. Haislmaier holds a bachelor's degree in history from St. Mary's College in Maryland....

  • Robert Moffit, Ph.D. Robert Moffit, Ph.D.

    Robert Moffit has been a veteran of Washington policymaking for more than 25 years, and is Director of The Heritage Foundation’s Center for Health Policy Studies. A former senior official at the U.S. Department of Health and Human Services and the Office of Personnel Management during the Reagan administration, Moffit specializes in Medicare reform, health insurance, and other health policy issues. Moffit’s team helped develop the Massachusetts’ health insurance reform initiative in 2005. The Massachusetts plan created an innovative system that empowers employees in small businesses to choose the health plan through a statewide “health insurance exchange.” This market-based approach would enable these Bay State citizens to own a private and fully portable health insurance plan and take it with them from job to job without a loss of generous federal tax breaks for employer-based coverage. Since Massachusetts Gov. Mitt Romney signed this plan into law, officials in almost two dozen states have asked Moffit and his colleagues to help them develop statewide market-based solutions for their health system problems.  Moffit’s research also involves him in continuing debates over how to reform Medicare, how to ensure access to prescription drugs, and how to improve access to private health care coverage. Moffit continues to be an advocate of a consumer-driven approach: He recommends that the government adopt a new program for the baby boomers entering Medicare in 2011 similar to the consumer-driven Federal Employee Health Benefits Plan (FEHBP), which Moffit became familiar with while working at the federal Office of Personnel Management, the agency that runs the program. FEHBP allows members of Congress and federal workers to select coverage from a broad range of competing private health plans. Moffit has been an advocate of the free market principles of consumer choice and competition since the early 1990s, when he chastised Congress for keeping such a system of choice and competition “ exclusively for itself and federal workers while considering ways to impose vastly inferior systems on almost all [other] Americans.” Moffit has been in the middle of national health care policy debates before. After joining Heritage in 1991, Moffit’s first task was to frame Heritage’s response to President Clinton’s plan to nationalize the country's health care system. He started by isolating himself in a room with nothing but the 1,342-page proposal and a few yellow legal pads. After five days of reading and taking notes, Moffit had drafted Heritage’s analysis of the Clinton mammoth plan. His efforts paid off in 1993: The Washington Post ran a feature story detailing Moffit’s criticisms of the Clinton proposal, and newspapers around the country praised Heritage’s proposal for a consumer-driven health care policy that would provide tax credits to help people buy their health insurance from whomever they choose. Since then, Moffit has been a regular source for the media on health care issues. He has appeared on all major cable news channels and the broadcast networks. He has published in professional journals, such as Health Affairs and the Journal of Medicine and Philosophy.  His quotes and op-ed essays have appeared in all the major newspapers, including The New York Times, The Wall Street Journal, The Washington Post and The Washington Times. But health care isn’t Moffit’s only concern. He’s also credited with being the first major policy analyst to cite Great Britain’s partially privatized social security system with hopes of improving on that model to build a similar system in the United States. Then there’s crime. Moffit, who comes from a family of  Philadelphia police officers, co-wrote “Making America Safer,” a how-to guide for local governments to better support their police departments with former Attorney General Edwin Meese III, now a Heritage’s Ronald Reagan distinguished fellow and chairman of its Center for Legal and Judicial Studies. He also co-edited Heritage’s “School Choice 2001: What's Happening in the States.” Moffit received his bachelor’s degree in political science from LaSalle University in Philadelphia and his doctorate from the University of Arizona. During the Reagan Administration, he served as the Assistant Director of Congressional Relations in the Office of Personal Management and as the Deputy Assistant Secretary at the U.S. Department of Health and Human Services....

  • Nina Owcharenko Nina Owcharenko

    Nina Owcharenko is a Senior Policy Analyst for health care at The Heritage Foundation’s Center for Health Policy Studies. In this position, Owcharenko (pronounced oh-CHAH-renko) researches and writes on a variety of health-care policy issues, including the uninsured, Medicaid, and prescription drugs. She has presented before numerous national, states and professional conferences, and has been published in noted publications, such as Health Affairs. She has also been a guest on dozens of radio and television programs advocating her opinions and policies. In 2008, Owcharenko’s work on health care issues, especially on the State Children’s Health Insurance Program (SCHIP), earned her Heritage’s prestigious Drs. W. Glenn and Rita Ricardo Campbell Award. The award is given to the employee who has delivered “an outstanding contribution to the analysis and promotion of a Free Society.” Owcharenko served for nearly a decade on Capitol Hill focusing on health-care issues. Before coming to Heritage in 2001, Owcharenko served as the Legislative Director for Rep. Jim DeMint (R-SC), and Rep. Sue Myrick (R-NC). She started her Hill career working for Sen. Jesse Helms (R-NC). Owcharenko received her bachelor’s degree in political science from the University of North Carolina-Chapel Hill in 1994. Originally from Charlotte, N.C., Owcharenko now lives in Washington, D.C., with her husband and son. ...

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