Paul Ryan Proposes Universal Health Coverage via Tax Credits
Ryan proposed a variation of John Goodman and Mark Pauly’s proposal to provide universal coverage through a refundable tax credit: “Patient-centered reform means replacing the inefficient tax treatment of employer-provided health care with a portable, refundable tax credit that you can take with you from job to job, allowing you to hang onto your insurance even during those tough times when a job might be hard to find.”
Portable health insurance also solves the pre-existing condition problem that is an artifact of our employer-sponsored system. “Instead of top-down price controls imposed by 15 bureaucrats at IPAB, let’s try bottom-up competition driven by 300 million consumers.”
The Goodman/Pauly article is a classic.
That is a much better proposal that others put forward, such as the FEHBP-For-All or Medicare-For-All. A Tax-Credit-For-All allows far more flexibility for individuals to find health coverage that meets their needs.
Good concept.
Agree. Classic article.
Paul Ryan’s one of the most sensible politicians in Washington. Good for him.
When will we see the Republican presidential candidates grapple with this challenge (not that the soundbite duels wrongly defined as “debates” will allow them to)?
Daniel Henninger’s column in today’s WSJ profiles Herman Cain’s 1994 discussion with President Clinton on Hillarycare. At the time, Cain was running the National Restaurant Association and struggled with proposing health reform that would work for his members.
Cain “said the restaurant association tried hard to devise a health-insurance program able to serve the needs of an industry whose work force is complex—executives and managers, full-time workers, part-timers, students and so forth. Any conceivable insurance system would require great flexibility in plan-choice and design.”
Imagine how much business energy was wasted by these restaurants on this issue, which in a sane world they wouldn’t concern themselves with for one minute!
Imagine if we had employer-sponsored housing, and the restaurant industry had to struggle over how to house CEOs like Herman Cain and part-time burger-flipping students and every employee in between. What a madhouse of complexity that would be.
And yet we tolerate it for health care.
It will be interesting to see when the actual Ryan Bill comes out. This might push some of the Republican candidates to start talking about actual solutions in health care.
Consumer-driven plans in the private sector are being delivered for about $7500 to $9000 per employee in best practice companies. Our average household is now about 2.2 persons. So Goodman’s swag at $2500 per adult and $15000 per child is not far off what best practice costs in the private sector.
So, it is entirely possible that $8000 could buy a decent policy with deductibles and off-setting personal health accounts, which I presume Goodman would allow to continue.
Government payers are typically more than $20,000 per employee and Cadillac plans for unionized companies are at the infamous $28,000 “Cadillac” level.
His plan has the beauty of simplicity., the antithesis of today’s concoction.