In addition to the presidential candidates, other players in the health care arena are also unveiling their own detailed plans to provide health care coverage for all or most Americans.
The Commonwealth Fund's proposal, called “Building Blocks,” seeks to cover 44 of the 48 million Americans estimated to be uninsured in 2008. At the center of the proposal is a national health insurance connector that would allow small businesses and individuals without large employer insurance to shop for a health plan.
The connector would feature private plans and a “Medicare Extra” option. The latter would offer monthly premiums of $259 for individuals and $702 for families, 30% lower than the average premium charged to employers today, said the Commonwealth Fund, a private foundation that supports research on health policy reform.
The plan also calls for expanding Medicaid and the State Children's Health Insurance Plan to cover all adults and children below 150% of the federal poverty level and would include individual and employer mandates for health coverage.
Using modeling from the Lewin Group, the Commonwealth Fund estimated the proposal would add $15 billion to current total health spending in the United States during the first year and about $218 billion over 10 years. But it could save $1.6 trillion over 10 years if it is combined with other reforms such as changing Medicare payments to hospitals and physicians, investing in better health information technology, allowing Medicare to negotiate drug prices, and improving public health.
In the meantime, the Healthcare Leadership Council, a coalition of hospitals, health plans, and pharmaceutical and device manufacturers that aims to improve the quality and affordability of health care, has brought forward its own market-based proposal aimed at covering all Americans. Called “Closing the Gap,” it calls for subsidies and tax breaks to help individuals afford coverage, improving health care quality through health information technology and care coordination, and realigning the financial incentives in the health care system to pay for value.
The plan calls for the government to provide premium subsidies to help employees afford their employer-sponsored insurance premiums and for the same tax breaks to be applied to individually purchased health insurance as applied to employer-sponsored coverage. The group did not endorse individual mandates.
The plan also calls for a move away from a payment system that rewards physicians and hospitals for the volume of services provided, instead paying for evidence-based care and prevention, said Dr. Denis Cortese, chair of the Healthcare Leadership Council and president and chief executive officer of the Mayo Clinic, at a press briefing to release the plan.