Frank Bernheisel: The View From Here
Frank Bernheisel
Frank Bernheisel
Posted 02.10.10
Just Outside Washington


The Republican health care bill

As I mope around the house nursing my cold (eye, nose, and throat infections -- hooray for modern antibiotics and walk-in clinics, even though you pay out of pocket and out of program) I am musing on health care. Yes, America has really good and maybe the best health care, if you can afford it.

A couple of weeks ago my friend Bill asked: Why not the Republican health care plan? OK, here goes. Off their website ( you can get the summary and the bill.

Their summary has the following points and I have added some comments. It does not lower costs, solve the paperwork and records problem (France has a card for each individual with a chip that contains all his/her health records and billing information), or cover everyone.

Lowering health care premiums

The GOP plan will lower health care premiums for American families and small businesses by forcing states that do not have them to set up reinsurance and risk pools. It provides for federal bonus payments to states that make the premiums go down, according to a formula that takes into account 10-year history of premiums, inflation, and demographic information. It allocates multi billions for these payments. There is no discussion of cost to the states of the new federal administrative rules required by the act or the marketing website for insurance plans. The implication is it is free but there is no free lunch.

Establishing Universal Access Programs to guarantee access to affordable health care for those with pre-existing conditions

The GOP plan creates Universal Access Programs that expand and reform high-risk pools and reinsurance programs to guarantee that all Americans, regardless of pre-existing conditions or past illnesses, have access. But it forces the states to carry the water. The states have to set up the high-risk pools and back them. The bill limits premiums to 150 over the average and guarantees that insurance companies will not lose money.

Ending junk lawsuits

The GOP plan would help end costly junk lawsuits and curb defensive medicine by enacting medical liability reforms modeled after the successful state laws of California and Texas. Now who could be against that? Not me. It does limit payments to injured people and to the lawyers that take their cases. My niece, who has had multiple operations on her knee, would have no chance against the insurance company except for the lawyer who was willing to take the case on contingency. We need tort reform but not one-sided politically motivated. Also, the bill is silent on policing the medical community and getting the incompetents, drug addicts, and crooks out of the profession.

Prevents insurers from unjustly cancelling a policy

The GOP plan prohibits an insurer from cancelling a policy unless a person commits fraud or conceals material facts about a health condition. That is good idea. However, the bill provides for the insurance company to appeal individual cases.

Encouraging Small Business Health Plans

The GOP plan gives small businesses the power to pool together and offer health care at lower prices, just as corporations and labor unions do. Another good idea and implementation is the responsibility of the states.

Encouraging innovative state programs

The GOP plan rewards innovation by providing incentive payments to states that reduce premiums and the number of uninsured. Another good idea. And one that the plan sets up federal payments, as noted above.

Allowing Americans to buy insurance across state lines

The GOP plan allows Americans to shop for coverage from coast to coast by allowing Americans living in one state to purchase insurance in another. OK and this provision forces states to accept insurance policies, which do not meet the requirements of the state's insurance laws as long as a policy is accepted in one state.

Promoting healthier lifestyles

The GOP plan promotes prevention & wellness by giving employers greater flexibility to financially reward employees who adopt healthier lifestyles. Says that premiums can be changed by 50 percent if there is a standards-based wellness program, which is not defined.

Enhancing Health Savings Accounts (HSAs)

The GOP plan creates new incentives to save for current and future health care needs by allowing qualified participants to use HSA funds to pay premiums for high deductible health insurance. I like it.

Allowing dependents to remain on their parents' policies

The GOP plan encourages coverage of young adults on their parents' insurance through age 25. That is good and it covers kids that are not in school. Those in school are covered already in some states and under some plans.