Current Issues in Health Insurance UAHU Annual Education Symposium Grace-Marie Turner Galen Institute May 12, 2010

Americans satisfied with own care 55% say the current system is good or excellent, up from 35% when Obama first proposed his reform ideas last May 75% say their own coverage is good/excellent Only 7% say their coverage is poor 71% believe taxes will increase for the middle class under ObamaCare “55% Rate U.S. Health Care System Good or Excellent,” Rasmussen Reports, May 3, 2010 at _good_or_excellent.

Americans OPPOSE ObamaCare 54% - Want the health overhaul law repealed Rasmussen 52% - Say it will reduce the quality of care 56% - Believe cost of health care will go up 59% - Say it will increase the deficit Two-thirds say it will increase the national debt Fox News 56% believe it will increase health costs Just 12% think the bill should go into effect in its current form

Americans are Ideologically Consistent How U.S. adults responded to the question: Do you consider yourself to be liberal, moderate or conservative? Source: Wall Street Journal/NBC News polls; margin of error for January 2010: +/-3.1 percentage points.

Architecture of the new law Mandate on individuals to buy insurance Employer mandate to “Play or Pay” Strict federal regulation of health insurance and care delivery Major expansion of Medicaid Cuts to Medicare New and higher taxes to finance insurance subsidies and expanded entitlements

Early Warning Signs Congressional members voted themselves out of health insurance $14 billion in company write downs – –Rep. Waxman summons companies then admitted “the companies acted properly…These one-time charges were required by applicable accounting rules.” They learned that major companies are considering dropping employee health benefits

More Danger Signs Report from Medicare Actuary Rick Foster validates fears – –People will lose coverage – –Huge fines for companies – –Spending increases – –You can’t keep your doctor – –Coverage but no care CBO – ObamaCare will raise family premiums by $2,100 in 2016.

ObamaCare So Far 41 states have filed various challenges against ObamaCare 19 states opt out of high-risk pools $115 billion higher price tag RAND study – health premiums could rise 17% for young adults Businesses required to file 1099 with the IRS for every business transaction totaling more than $600

Push-back coming from… Doctors and patients: Losing control over medical decisions Small businesses and big employers: New taxes, penalties, and mandates States: Higher costs for Medicaid Consumers: Higher costs for insurance and fewer choices Seniors: Cuts to Medicare Constitutionality of the individual mandate

It’s Not Government’s Job More Americans now say it’s not the federal government’s responsibility to make sure all Americans have health care coverage than say it is – a first in Gallup’s polling of this question that started nearly a decade ago. Do you think it is the responsibility of the federal government to make sure all Americans have health care coverage, or is that not the responsibility of the federal government? Source: Newport, Frank. "More in U.S. Say Health Coverage Is Not Gov’t. Responsibility." Gallup. 13 Nov Gallup, Web. 27 Jan

Some realities

Source: Mercer's National Survey of Employer-Sponsored Health Plans; Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April) ; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey (April to April)

What we know for sure SCOPE: Americans are frightened about sweeping changes in any 2,800-page law – whether offered by Democrats or Republicans TRANSPARENCY: They want to be engaged and consulted in an open debate COMPLEXITY and COST: This is a huge, far- reaching law that was poorly-drafted and that most Americans don’t believe we can afford

R-E-P-E-A-L Repeal ObamaCare’s massive new taxes Repeal ObamaCare’s massive new taxes Eliminate job-killing mandates on businesses Protect citizens from IRS enforcers by repealing the individual mandate Eliminate cuts in benefits to seniors on Medicare Advantage Avoid crippling the states with expensive mandates Limit government intrusion into personal medical decisions

R-E-P-L-A-C-E Real help for people to purchase health insurance they choose Real help for people to purchase health insurance they choose Expand states’ ability to help people with pre-existing conditions Expand states’ ability to help people with pre-existing conditions Put Medicare savings into saving Medicare Put Medicare savings into saving Medicare Lawsuit abuse reform Lawsuit abuse reform Allow doctors and patients to control medical decisions Allow doctors and patients to control medical decisions Control costs though consumer-friendly health reform Control costs though consumer-friendly health reform Expand access through cross-state purchasing of health insurance

Starting a fresh conversation   Engaging patients as partners in managing health costs and getting the best value for health care dollars

Putting Patients First Money for the uninsured: Expand access to health insurance through fairness in tax subsidies, starting with the uninsured More options for coverage: Allow opportunities to buy affordable, portable insurance, including from other states Help for those with pre-existing conditions: Funding for states to create guaranteed access to help those with higher health risks purchase and maintain insurance coverage

The future? There is a global move toward consumerism, driven by greater patient demand for information and more control over decisions. Democracy and innovation must prevail. Health overhaul is law and would fundamentally change the relationship between government and citizens. Americans don’t want it!!!

Contact: Grace-Marie Turner Galen Institute (703)

J. Michael McGinnis, Pamela Williams-Russo, and James R. Knickman. The Case For More Active Policy Attention To Health Promotion. Health Affairs, March/April 2002; 21(2):

New Incentives McKinsey & Co. says CDHC plans increase consumer awareness of cost and value. Consumers are: 20% more likely to comply with treatments for chronic conditions 25% more likely to engage in healthy behaviors 30% more likely to get annual physicals 50% more likely to seek less expensive care “If I catch an issue early, I’ll save money in the long run.” McKinsey & Company. “Consumer-Directed Health Plan Report – Early Evidence is Promising.” June Available online at