Health Care
Every American should have freedom of choice in health care. Learn More... Statement of Purpose 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 heath 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 those providers are directly accountable to patients for their quality of care.

Featured Research

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.

Latest Research

How a Public Health Plan Will Erode Private Care

December 22, 2008

President-elect Obama's rationale for a new public health plan is that it would give Americans who are not enrolled in employment-based health insurance coverage, or those with insecure coverage, the opportunity to obtain stable, affordable health insurance with a guaranteed set of government-standardized benefits. But while this might look like a prescription for consumer choice and competition, the reality is very different.

Employer-Based Health Insurance: Why Congress Should Cap Tax Benefits Consistently

December 5, 2008

Too many Americans do not fully understand how the health insurance they receive through their employer is financed. Formal premium payments to health insurance companies are made by employers just as employers pay for other fringe benefits. Placing a cap on tax benefits for employer-sponsored health insurance increases health plan transparency and places a greater emphasis on plan quality, not size.

How a Federal Health Board Will Cancel Private Coverage and Care

December 4, 2008

President-elect Barack Obama,Senator Max Baucus, and former Senator Thomas Daschle (D-SD)—Obama’s choice for Secretary of the U.S. Department of Health and Human Services—have outlined policy proposals that, if enacted, would negatively impact private health care for millions of Americans.

Other Publications

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.

Latest Commentary

Conservative Nation: All is not Left.

November 25, 2008

One question surfaces repeatedly as the pundits obsess over the exit polls. Have Americans lurched to the Left in any meaningful way? If so, are they likely to sign long-term leases in Hotel Obama, or are they simply on loan until they experience the consequences of modern-day liberalism?

Competing health-care remedies

November 24, 2008

About 47 million Americans lack health coverage. It's a huge problem. To their credit, both major presidential candidates have ponied up ambitious plans to deal with it. Their approaches are expansive and expensive. That's where the similarities end.

What Obama Will Do on Health Care

November 24, 2008

Little guesswork is required to imagine what a liberal White House victory and bigger liberal majorities in the House and Senate would mean for health care in America in 2009. Given his ambitious, comprehensive, and expensive health plan, one could expect a President Obama to start filling in the missing but crucial details and sending key provisions up to Capitol Hill in bits and pieces.

Think Small

November 18, 2008

In this installment of Health Care Watch, Stuart M. Butler and Ezekiel Emanuel talk about what President-elect Barack Obama should and shouldn't do on health care reform.

Exchange We Can Believe In

November 14, 2008

The president-elect didn't invent the idea of a health exchange. He came up with his own version of an idea that's been refined by people like us at the Heritage Foundation and already field tested. Frankly, we prefer the original.

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.

Obama’s Phony Health Care Facts

12/23/2008

The ‘Participant Guide‘ for President-elect Barack Obama’s Potemkin ‘health care community discussions’ includes an ‘Over of the Problem’ section that is filled with false facts. The false claims include: “Large medical bills have contributed to half of bankruptcies and foreclosures.” This widely reported factoid simply isn’t true. Bankruptcy expert George Mason University law professor Todd Zywicki   Read More...

Room Full of Obama Lovers Love Obama’s Health Care Plan

12/23/2008

That is not the headline to the New York Times story on one of Obama’s Potemkin ‘health care community discussions’ today, but it should be. Here are some highlights from the article: When a dozen consumers gathered over the weekend to discuss health care at the behest of President-elect Barack Obama, they quickly agreed on one   Read More...

Liberal Media in Tank for Obama’s Socialized Medicine

12/23/2008

This morning we highlighted the Obama Administration’s flagrant attempt to pass off their Potemkin “health care community discussions” as actual open and transparent democratic government. If the prestigious Columbia Journalism Review is representative of the liberal media establishment, we should expect the silencing of dissenting health care reform views to continue. CJR’s Trudy Lieberman writes: Ezra   Read More...

Morning Bell: Deck the Halls With Odes to Socialized Medicine

12/23/2008

If you are anything like us at The Heritage Foundation, the last two weeks of December are a time for visiting friends and family, securing last minute Christmas gifts, and planning your Christmas and New Year’s menus. But President-elect Barack Obama wants to add another item to your to-do list. Remember how Michelle Obama said her   Read More...

HHS Conscience Clause Regulation: Securing the Blessings of Liberty

12/18/2008

Never do anything against conscience, even if the state demands it.—Albert Einstein Individual liberty is elemental to what is means to be an American. But in recent years the personal liberty and freedom of conscience of our doctors, nurses, and pharmacists have been threatened. Although “conscience clause” protections have been federal law since the 1970s and   Read More...

Health Care Plan 'Crowds Out' Family Coverage

October 03, 2007
Health care plan 'crowds out' family coverage
  • Health Care Plan 'Crowds Out' Family Coverage
  • Percentage of Children with Private Health Insurance
  • SCHIP Distribution of Children by Income Level
  • SCHIP Eligibility Above 200 Percent of Federal Poverty Level
  • SCHIP: No Child Left Off Welfare
  • State Children's Health Insurance Program Plan Activity as of January 18, 2007
  • States Exceeding 50 Percent Medicaid Threshold
  • States that Cover Adults Under SCHIP
  • Teens Who Wait Stay in School Longer
  • The 'SCHIP Plus' Alternative: An 8-to-1 Win for Kids
  • U.S. on collision course to 'socialized medicine'

DoctorState and federal lawmakers are increasingly focusing on patient-centered health care reform that maximizes value for individuals and families so that they receive more benefit and better results for their health care dollars, both as patients and as consumers. If policymakers are serious about real patient-centered, consumer-driven health care reform, they should ensure that their legislative proposals embody six key principles:

Health Care Reform: Design Principles for a Patient-Centered,
Consumer-Based Market


State Health Reform: Six Key Tests

Another Round in the National Debate on Health Care Reform


While Americans are eagerly awaiting the details of President-Elect Barack Obama's health care reform proposal, it is well to recall the last national debate on health care reform: the debate over the 1993 Clinton Health Plan. While many of the issues are strikingly similar- rising costs, large numbers of Americans without health insurance and gaps in coverage- today the circumstances are different. One thing that has not changed is that popular support for broad goals- a slowing of health care costs and an expansion of health insurance coverage- does not automatically translate into popular support for specific health policy measures, particularly when the trade-offs embodied in those health policy measures are made transparent to the millions of Americans who would be affected by them. It is not “bumper sticker” slogans, but crucial details, that matter. Check out the Heritage Foundation's analysis of the 1993 Clinton Health Plan and its leading alternative, The Consumer Choice Health Security Act, based on major changes in the tax code, the insurance markets and principles of personal choice and competition.



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Heritage Experts on Health Care

Media Information Line: (202) 675-1761

Stuart

Stuart M. Butler Ph.D.

Vice President, Domestic and Economic Policy Studies , Domestic Policy

Greg

Greg D'Angelo

Policy Analyst , Center for Health Policy Studies

Edmund

Edmund F. Haislmaier

Senior Research Fellow in Health Policy Studies , Domestic Policy

Robert

Robert E. Moffit Ph.D.

Director , Center for Health Policy Studies

Nina

Nina Owcharenko

Senior Policy Analyst , Center for Health Policy Studies

Dennis

Dennis G. Smith

Senior Fellow in Health Care Reform , Center for Health Policy Studies