Republicans are dusting off proposals that date back more than a decade: allowing individuals to buy health insurance across state lines, helping small businesses band together to buy insurance, offering generous tax deductions for the purchase of individual policies, expanding tax-favored health savings accounts and reining in medical malpractice suits.
Many of these ideas were included in a package offered by Republicans in November 2009 as an alternative to legislation pushed through the House by Democrats. The Congressional Budget Office found that the Republican proposal would have reduced health insurance premiums by 5 percent to 10 percent, compared with what they would otherwise have been.
The budget office said that the Republican proposal, offered by Representative John A. Boehner of Ohio, who is now the House speaker, would have provided coverage to 3 million people, leaving 52 million uninsured.
We should welcome 5-10 percent savings, though the other effects (how many remain uninsured, for one) matter a great deal to many Americans too. More than that, we should welcome a diminution in the rate of growth of health care premiums (costs, spending), again, provided we’re comfortable how that diminution is achieved. In any case, if that curve isn’t bent, 5-10 percent savings would be overcome by health care inflation in a few years, a cautionary note for interpreting enthusiastic pronouncements (from across the political spectrum) of one-time reductions in spending.
I hope all policymakers look carefully at the myriad of options, in the ACA and not, that would help public and private insurers spend more wisely, more efficiently, over time. Indeed, it is not the spending level we should be so concerned about, but how the money is spent, what it buys. Health is important and worth paying a lot for, provided that’s in fact what we’re getting for our money.