My colleague Joe Antos sketches out a market approach to healthcare reform with the goal of better care at lower cost. Please read the whole thing. It’s not long, just a few pages. Here is a bit on deregulation (bold is mine):
Regulatory reforms are needed to promote innovation in health care delivery and to provide better options for consumers. The ACA added a new layer of federal insurance regulation, but simply reverting to state regulation is not the answer. We need smarter regulation to protect consumers without imposing greater inefficiency on the health care market. Increasing the number of people with insurance is an important step in improving population health, but offering coverage that consumers want at a price they are willing to pay works better than mandating that they buy only what satisfies government requirements. Avalere Health reports that 76% of those eligible for the highest subsidies—those with incomes between 100% and 150% of the poverty level—enrolled in exchange plans, but enrollment dropped off sharply as subsidies declined.
Insurers need greater flexibility to offer a wider array of benefit packages. Counterproductive regulations, including restrictions that discourage the use of proven patient management methods, should be eliminated. Government controls on insurance pricing attempt to make coverage more affordable for some groups but drive up the average premium to allow for this redistribution. For example, states have typically limited agerated premiums to a 5:1 ratio, indicating that an older individual will pay no more than five times the premium costs a younger person would pay. Starting in 2014 the ACA limited the ratio to 3:1, which drives up premiums for young people with the lowest typical health costs and discourages them from enrolling in insurance. If we want to help those who most need financial assistance, we should provide that help directly rather than distort market prices. Reforming the open-ended subsidies already available would provide an opportunity to better focus aid on the least fortunate.
Medicare and Medicaid need greater flexibility to meet the needs of beneficiaries without dictating how health care must be provided. Although traditional Medicare is thought of as a uniform national program, it operates in local markets that have varying needs and resources. Restructuring the program would give it greater ability to promote local delivery system innovations, to price services to reflect local conditions, and to become more competitive in a premium support setting. States also need more autonomy in running their Medicaid programs. State innovation waivers under ACA section 1332 allow states to change how they implement ACA requirements, beginning in 2017. However, that authority is limited, and states that wish to make adjustments to Medicaid must apply to the Centers for Medicare and Medicaid Services (CMS) for additional waivers. CMS has granted waivers to several states that expanded Medicaid eligibility, but the agency has not allowed states full control over how they run their own programs.
from AEI » Latest Content http://ift.tt/1MEoysX
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