RTCS

Health Care

Return to Common Sense

November 15, 2013

Section: Culture – Health Care

“The longer the federal government delays a transition to patient-centered, consumer-based health care, the more likely the existing health care system will drag the federal government into bankruptcy; and the American public has made their preferences known, if only politicians listened.”

The answer for healthcare is market incentives, not healthcare by a Godzilla-sized government bureaucracy.Mitt Romney.

 

Philosophy (Background, Issues, Objectives):

The Department of Health and Human Services (HHS) is the United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.

·         HHS represents almost a quarter of all federal outlays, and it administers more grant dollars than all other federal agencies combined.

·         HHS’ Medicare program is the nation’s largest health insurer, handling more than 1 billion claims per year.

·         Medicare and Medicaid together provide health care insurance for one in four Americans.

The Emergency Medical Treatment and Active Labor Act (EMTALA) was passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA).

·         EMTALA requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay.

·       There are no reimbursement provisions.

·         Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment.

Top ten causes of death in the U.S. for 2010 according to the Centers for Disease Control and Prevention:

Medicare is the federal government’s health insurance program for all Americans age 65 and older and for the disabled.

·         In 2010, the program covered 47 million enrollees.

·         Medicare is projected to spend $549 billion in 2011, increasing to $891 billion per year by 2019.

·         Medicare Part A and Part B together are sometimes referred to as traditional Medicare or Medicare fee-for-service (FFS).

Medicare is facing insolvency as the baby boom generation goes fully into retirement.

o   In 1965 Medicare was enacted as part of the social security program for all those over 65.

o   Life expectancy has risen and the fastest growing portion of the population is over 65.

o   Currently over 40 million elderly and disables people enrolled in Medicare.

o   Defensive medicine practices have driven the cost of Medicare up dramatically

o   From 1970 to 2005, average spending per Medicare beneficiary rose 8.9%.

o   Medicare's cost had soared from 42 billion to over $468 billion between 1970 and 2008 - an 11-fold, or 1000 percent, increase.

Medicaid is unfit to meet the needs of working families without health care coverage.

o   Health care costs are invisible to beneficiary since the company pays the premiums.

o   In 2006 companies now pay $9,000 for a family policy.

o   Total federal and state Medicaid expenditures will reach $349 billion in 2007, of which 57% is federal.

§  Medicaid typically pays physicians 56% of the amount that private insurers pay.

o   Medicaid is now the largest government health care program, surpassing the cost of Medicare.

o   Medicaid patients have poorer health outcomes, than privately insured patients.

o   65% of adults between 19 and 64 would prefer private health care coverage over Medicaid.

o   With huge budget deficits and exploding costs, states are over-extended and have begun rationing.

Federal government intervention has resulted in higher costs and lower efficiency.

o   Compulsory health insurance was defeated under Presidents FDR, Truman, and Nixon.

o   In 1973 the Employee Retirement Income Security Act (ERISA) allowed large employers (300+) to “self-insure” and be exempt from McCarran-Ferguson.

§  IRS decision allowed health insurance benefit to be tax-free.

§  ERISA coverage was employer based, but was not employee portable.

o   In 2005 public health programs account for $2 trillion spent on U.S. health care (16% of GDP).

o   80% or more of all medical-care pricing is based on government reimbursement rates set by Medicare.

o   Government regulations imposed on the industry cost more than $330 billion a year.

o   Federal negotiation of drug prices has resulted in a reduced and older drug list at the VA’s National Formulary (VANF).

o   Medicare’s market clout is in fact, inferior to that of the largest existing pharmacy benefit managers (PBMs).

o   Doctors and hospitals routinely “cost shift” by charging private insurance higher prices to cover the Medicare shortfalls.

People are uninsured for various reasons, but a majority chooses to be uninsured.

o   Employer self-ensures under the federal ERISA program, which allows employers to offer their employees health coverage free of state and federal taxes and cumbersome state mandates

o   17%, over 8 million, “can not afford” health insurance.

o   20%, over 9 million, will have insurance again with 4 months after job transitions.

o   27%, over 12 million, are not citizens and ineligible for government assistance.

o   38%, over 18 million, earn enough but choose not to be insured.

o   80% are working uninsured, while at least one member of the family has a job.

o   Extensions to SCHIP are being proposed to cover more people including adults.

o   Minnesota and five other states spend their SCHIP dollars largely on adults, not kids.

o   SCHIP extension is based on a 1993 Hillary Clinton political strategy to subliminally expand into a universal healthcare program.

Texas has aggressively addressed tort reform.

Americans have expressed their preferences (Gallup Polls) on health care reforms:

Health Savings Account (HSA) and Health Reimbursement Account (HRA) have been proposed.

Health issues have been sensationalized based on poor research and exaggerated implications.

o   Secondary smoke research has reached no real causal conclusions, only inferences.

o   1993 EPA report on secondhand smoke was vacated in 1998 based on poor research methodology and lack of scientific proof.

o   Oregon has begun to offer assisted suicide drugs when prescriptions are not covered.

o   If a physician prescribes a lethal overdose, when that physician completes the death certificate, he or she is required to list the underlying disease as the cause of death.

State health insurance experiments to tailor their health care needs have uncovered problems.

The Organization for Economic Co-operation and Development (OECD) reported on health care and found the U.S spends substantially more per capita on health care, yet does not have superior health system performance.

o   Infant Mortality - three overlapping infant mortality measures: Infant (deaths in the first year per one thousand live births); Neonatal (deaths in the first twenty-eight days per one thousand live births); and Perinatal (deaths in the first week after birth, plus fetal deaths after twenty-eight weeks of gestation or fetuses that exceed a weight of one thousand grams).

o   Life Expectancy - can be measured at birth or at older ages such as forty, sixty, etc. but incorporates infant mortality and not identically measured across all countries.

o   Premature Mortality - determined by potential years of life lost (PYLL), though it is also strongly influenced by infant mortality but does not factor in lifestyle.

National Health Care systems in other countries have proven that there is a big difference between universal coverage and actual access to medical care.

o   TaxPayers’ Alliance in London estimates low quality health care killed more than 17,000 Britons in 2004.

o   NHS has determined drug-coated stents are not cost effective so they are rationed.

o   National Institute for Health and Clinical Effectiveness (NICE) has denied anti-dementia drugs to Alzheimer’s patients.

o   Vision care sector of NHS has been deregulated and partnered with private opticians.

o   Britain claims to fund dental care, but many have incredible difficulty obtaining care.

o   One in ten dentists has stopped offering treatment under Great Britain’s NHS.

o   More than 70,000 Britons, known as 'health tourists,' have gone as far as India, Malaysia and South Africa for major operations, and is expected to rise to almost 200,000 by the end of the decade.

o   The health care system is so overburdened that hundreds of thousands in need of medical attention wait for care, or participate in lotteries to win appointments with the local family doctor.

o   Total waiting time between referral from a general practitioner and treatment increased to 18.3 weeks in 2007.

§  Total number of procedures where patients are waiting for surgeries in 2006 is 770,641.

§  Modern medical equipment like CT Scans, MRIs, and mammograms are very limited.

§  Many doctors are leaving Canada because of the long time it takes to be paid.

§  Access to a waiting list is not the same thing as access to healthcare.

o   By 2035 six of ten Provinces will spend half of their tax revenue on health care expenses.

o   The Canadian single-payer system does not cover prescription drugs on a universal basis with only about one-third of the Canadian population eligible for various government-financed drug programs.

o   Canada does not fund dental care and vision care excludes standard vision tests.

o   Canadian physicians send patients to the U.S. and the Canadian government spends over $1 billion each year on health care in the United States.

International health care priorities are set by politicians, not health care professionals.

·         UN spent $3 billion on AIDS programs in Africa, while only $30 million on safe water projects.

Other countries have implemented successful market based health care programs.

o   Individuals contribute much more money at the point of purchase with the payment mechanism varying according to treatment and patient.

o   Government doctors and facilities compete with private health care workers.

o   Singaporeans are required to contribute to health savings accounts and purchase a catastrophic insurance plan.

o   There is an insurance pool for the severely disabled and a fund to pay their bills.

o   There are subsidies to providers based on their level of service.

o   Singapore healthcare includes MediSave (mandatory pension program), MediShield (national insurance program for serious illness), MediFund (fund unable to pay), and ElderShield (private disability insurance).

o   Singaporeans are considerably healthier than Americans, yet pay, per person (3.7% GDP), about one fifth of what American pay for their healthcare (15.4% GDP).

 

Principles:

Health care is a noble idea, but not a Constitutional right:

Healthcare regulation must be fact based and statistically valid, not junk science!

A reformed and sustainable Medicare program should be based on five key principles:

Patient-centered, consumer-driven health care reform key principles:

10 Essential Principles of Health Care Reform:

1)     Every American should be encouraged and incentivized to take personal responsibility for his or her health.

2)     Every American should have genuine access to quality, cost-effective care that best meets his or her individual needs.

3)     Every American should have health insurance coverage (private or public) that is affordable, accessible, and portable -- no matter where he or she chooses to work or live.

4)     Health care providers should deliver the best possible care based upon best evidence or best practice.

5)     Every provider of care, from doctors and nurses to pharmacists and hospitals, should be interconnected with an electronic health record for every American.

6)     Payment to providers should be based on the quality of care delivered, not the number of transactions or services provided.

7)     Cost, quality, and performance information should be available and accessible to all consumers.

8)     Government should promote and encourage competitive, market-based solutions in the private sector.

9)     Government should offer effective, efficient, and sustainable public programs for those who need them.

10)                        Government should aggressively invest in targeted clinical research, laying the foundations for future breakthroughs and cures.

 

Recommendations:

Short Term, improve health care coverage and performance.

o   Deliver Medicaid as a block grant to states to allow flexibility and eliminate overspending.

o   Separate OMB forecast income and spending as a discrete entitlement expense.

o   Budget long term (30 year) to identify shortcoming long before they become problems.

o   Require program reauthorization every four years based on sustainability.

o   Comply with GASB 45 to establish an accrual accounting approach to report the cost of benefits as an expense during the years in which the employee is working.

o   Include a complete and objective cost benefit analysis in any healthcare regulations.

o   Include State Children’s Health Insurance Program (SCHIP) as separate line item.

o   Promote personal ownership of health insurance that is portable.

o   Let free markets (cross state) provide the insurance and health care services that people want.

o   Encourage employers to provide a portable health insurance benefit.

o   Assist those who need help through civil society, the free market, and states.

o   Protect the right of religious conscience and newborn children.

o   Reduce Food and Drug Administration funding by 62% to FY2008 levels.

o   Reduce Health Resources and Service Administration by 34% to FY2008 levels.

o   Reduce Indian Health Service funding by 46% to FY2008 levels.

o   Reduce Center for disease Control and Prevention funding by 28% to FY2008 levels.

o   Reduce National Institute of Health by 37% to FY2008 levels.

o   Reduce National Institute of Mental Health by:

§  Eliminate the Division of AIDS Research ($184 million) as duplicative.

§  Eliminate the Intramural Research Program ($172 million) as better done with research grants to universities.

§  Shut down the Substance Abuse and Mental Health Administration ($3.4 billion) as ineffective.

o   Abolish the Office of the Surgeon General.

o   Repeal McCarran-Ferguson Act that restricts competitive interstate insurance markets.

o   Reject any expansion of the State Children’s Health Insurance Program (SCHIP).

o   Promote individual responsibility and realign economic incentives for the purchase of value-based health care.

o   Restructure health care financing to assist low income Americans in purchasing coverage.

o   Create opportunities for individual health savings accounts

o   Continue improvements like Medicare Advantage (2003) to expand personal choice in health care options.

o   Provide health care tax credits to ensure equity between individual and business based health insurance plans.

o   Offer direct subsidies to lower income workers and families for purchase of private health care.

o   Liberalize the tax treatment of health insurance for individuals and families.

§  Ensure guaranteed renewability.

§  Provide assistance to low and moderate income workers for basic insurance coverage.

§  Provide block grants of Medicaid and SCHIP back to the states.

§  Incorporate state uninsurable risk pools.

o   Establish a system for those retiring after 2011 based on Federal Employees Health Benefits Program.

o   Restructure Medicaid financing to be patient centered, helping to identify higher cost cases.

o   Give states greater flexibility to experiment with adjustments in their Medicaid programs.

o   Eliminate individual incentives to qualify inappropriately for Medicaid long term care services.

o   Ensure inclusion of catastrophic protection.

o   Return fiscal responsibility for individuals with mental illness to the states.

o   Discontinue federal government insurance premium collections.

o   Abolish federal healthcare revenue redistribution to states.

o   Allow states to put conditions on SSI and SSDI payments.

o   Transform drug benefit into targeted benefit for low income seniors who lack coverage.

§  Require a means test to the Medicare prescription-drug benefit.

o   Reduce benefit levels, number or types of treatments covered.

o   Increasing premium costs, deductibles or co-payments.

Long Term, privatize all health insurance to transition to patient centered care.

o   Enable health insurance portability, moving with the individual.

o   Create open market for health insurance aligned with moral principles.

o   Limit mandates to allow more custom design of policies.

o   Make physician pricing fully transparent.

o   Make treatment pricing fully transparent.

o   Phase out employer-sponsored health insurance replaced by individual insurance.

§  Businesses pay employees monies directly, that are currently spent on healthcare premiums.

o   Allow health insurance providers to establish risk pools to lower costs.

o   Individuals choose their own health care coverage based on their individual needs.

o   Retired workers able to use small fraction of accumulated funds to buy long term nursing home insurance.

·         Provide five year transition for current recipients (over 50-55) with program as currently exists.

o   Everyone will be responsible for their own health care planning, protecting those with pre-existing conditions.         

 

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Medicaid’s Soaring Cost” by Jagadeesh Gokhale dated by July 19, 2007 published by Cato Institute at http://www.cato.org/pub_display.php?pub_id=8485 .

State Health Reform: How Pooling Arrangements Can Increase Small-Business Coverage” by Edmund F. Haisimaier dated July 23, 2007 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/wm1563.cfm .

Cheese Headcases” dated July 24, 2007 published by Wall Street Journal Opinion Journal at http://www.opinionjournal.com/editorial/feature.html?id=110010374 .

Trust Fund Dysfunction” by James C. Capretta dated July 26, 2007 published by National Review Online at http://article.nationalreview.com/?q=MDQ5MmUyOGIzN2QxM2ZlM2I1ZWE3NzUyMDUwY2Q3ZjM= .

SCHIP A Step Towards Socialism” by Mike Franc Dated July 27, 2007 published by Human Events Online at http://www.humanevents.com/article.php?id=21705 .

HillaryCare Exposing Itself as a Catastrophe” dated July 29, 2007 published by Free Republic at http://www.freerepublic.com/focus/f-news/1873219/posts .

Beyond SCHIP: A Serious Proposal to Reduce Uninsurance” by Robert E. Moffit dated July 30, 2007 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/wm1577.cfm .

Health Care Tax Credits: The Right Prescription for Expanded Health Care Coverage” by J.D. Foster dated July 31, 2007 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/wm1579.cfm .

Health Insurance Blues: Give Choice a Chance” by Chuck Muth dated August 6, 2007 published by Town Hall at http://www.townhall.com/columnists/ChuckMuth/2007/08/06/health_insurance_blues_give_choice_a_chance .

Private Sector Healthcare Can Also Be ‘Universal’” by Emily Beuhler dated August 9, 2007 published by The American Magazine at http://www.american.com/archive/2007/august-0807/private-sector-healthcare-can-also-be-universal .

Nanny State? No, Thanks; Government Should Quit Mandating Health-care Perks; Edicts Hike Costs; Shrink Coverage” by Michael Franc dated August 6, 2007 published by The Heritage Foundation at http://www.heritage.org/Press/Commentary/ed080607b.cfm .

Kids First…” by David Freddoso dated August 22, 2007 published by National Review Online at http://article.nationalreview.com/?q=MzA3YzNlYTUzNzZkZjBkODRhM2JiYTk4ODE5ZTkyYTU= .

The SCHIP Open: Hidden Incentives for States to Spend Federal Funds” by Robert B. Helms dated August 2007 published by American Enterprise Institute at http://www.aei.org/publications/filter.all,pubID.26708/pub_detail.asp .

The ’47 Million Uninsured’ Myth” dated August 29, 2007 published by Investors Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=273280379232127 .

Healthy Medical Reforms” by David Hogberg and Jeremy Taglieri dated September 11, 2007 published by The American Spectator at http://www.spectator.org/dsp_article.asp?art_id=11995 .

Compulsory Universal Health Insurance – Neither a New Idea, Nor a Good Idea” by Diana West dated September 12, 2007 published by Town Hall at http://www.townhall.com/columnists/DianaWest/2007/09/12/compulsory_universal_health_insurance_--_neither_a_new_idea,_nor_a_good_one .

Sinking SCHIP – A First Step toward Stopping the Growth of Government Health Programs” by Michael F. Cannon dated September 13, 2007 published by The CATO Institute at http://www.cato.org/pubs/bp/bp99.pdf .

How The Swiss Do Health Care” by Bill Steigerwald dated September 14, 2007 published by Town Hall at http://www.townhall.com/columnists/BillSteigerwald/2007/09/14/how_the_swiss_do_health_care .

One Flew Over the Bird Flu’s Nest” by Michael Fumento dated September 14, 2007 published by The American Spectator at http://www.spectator.org/dsp_article.asp?art_id=12014 .

Hazards of the Individual Health Care Mandate” by Glen Whitman dated September/October 2007 published by CATO Institute at http://www.cato.org/pubs/policy_report/v29n5/cpr29n5-1.html .

The 2008 Presidential Candidates on Health Care Reform” updated September 17, 2007 published by Council for Affordable Health Insurance at http://www.cahi.org/cahi_contents/resources/pdf/2008CandidatesHealthCareReform.pdf .

Hard to Swallow” by Andrew Cline dated September 18, 2007 published by The American Spectator at http://www.spectator.org/dsp_article.asp?art_id=12035 .

Republicans Can Win on Health Care” by Karl Rove dated September 18, 2007 published by Wall Street Journal Opinion Journal at http://www.opinionjournal.com/forms/printThis.html?id=110010620 .

Hillarizing Health Care” by Peter Ferrara dated September 18, 2007 published by National Review Online at http://article.nationalreview.com/?q=MjM5OWRhYjk1NWM3MDk0MWMzOTY1OTMzZWY0MTA2NGY= .

Looking at HillaryCare” by Jennifer Rubin dated September 19, 2007 published by Human Events Online at http://www.humanevents.com/article.php?id=22456 .

No More Free Lunch at the Health Care Buffet” by Frank Pastore dated September 23, 2007, published by Town Hall at http://www.townhall.com/columnists/FrankPastore/2007/09/23/no_more_free_lunch_at_the_health_care_buffet .

Hillary and Health Care Prove a Toxic Mix Again” by Kevin Hassett dated September 24, 2007 published by Bloomberg at http://bloomberg.com/apps/news?pid=20601039&refer=columnist_hassett&sid=a1z0CUu7cB_g .

HillaryCare II: A Big Leap in Federal Control” by Robert E. Moffit dated September 24, 2007 published by Human Events Online at http://www.humanevents.com/article.php?id=22490 .

Optional Federal Charter for Insurers; FAQ” by Eli Lehrer dated October 2, 2007 published by Competitive Enterprise Institute at http://www.cei.org/gencon/004,06170.cfm .

Diet and Fat: A Severe Case of Mistaken Consensus” by John Tierney dated October 9, 2007 published by New York Times at http://www.nytimes.com/2007/10/09/science/09tier.html?ref=science&pagewanted=print.

Not True That Thousands Died for Lack of Health Insurance, Critic Says” by Pete Winn dated October 11, 2007 published by Cybercast News Service at http://www.cnsnews.com/ViewPrint.asp?Page=/Nation/archive/200710/NAT20071011a.html .

Newer Reforms Prescribe Doses of Competition” by David S. Broder dated October 12, 2007 published by Investors Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=277074871527128 .

The Freedom to Spend Your Own Money on Medical Care” by Kent Masterson Brown dated October 15, 2007 published by CATO Institute at http://www.cato.org/pubs/pas/pa601.pdf .

Friends Want Friends to Do Health Care” by Michael F. Cannon dated October 16, 2007 published by National Review Online at http://article.nationalreview.com/?q=NWJlZjA3ZTQ4ZmQ2NmEzZDZiOGI1MjY0ZjViZGU5N2Q= .

Freedom to Choose” by Jennifer A. Marshall dated October 17, 2007 published by National Review Online at http://article.nationalreview.com/?q=MDNiODcxOGE4MWI0Mzg1OTJkM2Y0NGZiM2Y2MTJhNzM= .

Rationalize Health Care” by Byron Schlomach dated October 17, 2007 published by National Review Online at http://article.nationalreview.com/?q=NDZjMGUzMjczYzQ2YmFlN2U0ZDBiNzY5N2M4M2RjYWE= .

Universally Bad” by Sally Pipes dated October 18, 2007 published by National Review Online at http://article.nationalreview.com/?q=NmQ3MjFiOTQ5ZTJhNmJiMDcyN2Y5YjBlNzI4MjZhN2E= .

Medicare for All?” by James C. Capretta dated October 19, 2007 published by National Review Online at http://health.nationalreview.com/post/?q=MjAxOTMzY2Y0NmVjMWYzNGMyNDRiYWIyMWYxY2JiYzE= .

Unhealthy Health Care” by Linda Halderman dated October 19, 2007 published by National Review Online at http://health.nationalreview.com/post/?q=MTM2N2I4ZGQyYzRiY2E3OWNjMjNhOGIxZWEyNmFkZWQ= .

Quack Michael Moore has mad view of the NHS” by Minette Marrin dated October 28, 2007 published by The Sunday Times at http://www.timesonline.co.uk/tol/comment/columnists/minette_marrin/article2753620.ece .

Creative Destruction” by Jonathan Cohn dated November 12, 2007 published by The New Republic at http://tnr.com/politics/story.html?id=51faeaa7-5021-40d0-95d3-0f260b25edd4 .

Global Warming is the New AIDS” by November 12, 2007 published by American Daily at http://www.americandaily.com/article/20913 .

The Case for Health Care Tax Credits” by Greg D’Angelo dated December 3, 2007 published by Front Page Magazine at http://www.frontpagemagazine.com/Articles/Read.aspx?GUID=2C432783-19B5-4CA1-992D-149DB63582CA .

Rx for Health Care: Pain” by Robert Samuelson dated December 5, 2007 published by Real Clear Politics at http://www.realclearpolitics.com/articles/2007/12/rx_for_health_care_pain.html .

Hungry For Trouble” dated December 18, 2007 published by Investors Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=282873306405019 .

Putting a Plague in Perspective” by Daniel Halperin dated January 1, 2008 published by New York Times at http://www.nytimes.com/2008/01/01/opinion/01halperin.html?_r=1&ref=opinion&oref=slogin .

The Truth About Health Costs” dated January 10, 2008 published by Investor’s Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=284861446430958 .

Bad Medicine” dated January 18, 2008 published by Investor’s Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=285552473520990 .

Health Freezes Over” dated January 29, 2008 published by Investor’s Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=286502291658004 .

A Clear Choice” dated February 1, 2008 published by Investor’s Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=286760850611327 .

Washington Must Pull the Trigger on Explosive Medicare Spending” by Robert E. Moffit and Alison Acosta Fraser dated February 4, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/Budget/wm1796.cfm .

Lines For Swedish Care Grow Longer” dated February 4, 2008 published by Investor’s Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=287022137319357 .

Benefits of the President’s Proposed Standard Deduction for Health Insurance” by J.D. Foster dated February 6, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/wm1799.cfm .

Time to Rechristen SCHIP” by David Gratzer dated February 8, 2008 published by City Journal at http://www.city-journal.org/2008/eon0208dg.html .

Make Medicare Budget Options Compatible with Comprehensive Reform” by Robert E. Moffit dated February 11, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/Budget/wm1807.cfm .

State and Local Governments Must Address Unfunded Health Care Liabilities” by Greg D’Angelo dated February 11, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/wm1808.cfm .

Single Payer Systems Kill” by Deroy Murdock dated February 22, 2008 published by Human Events Online at http://www.humanevents.com/article.php?id=25137 .

What Canada Tells Us About Government Health Care” by Doug Wilson dated February 25, 2008 published by Town Hall at http://www.townhall.com/columnists/DougWilson/2008/02/25/what_canada_tells_us_about_government_health_care .

Promise of Choice” dated February 26, 2008 published by Investor’s Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=288921903474479 .

WHOm Are They Kidding?” by Glen Whitman dated March 10, 2008 published by The American Spectator at http://www.spectator.org/dsp_article.asp?art_id=12865 .

Medicare Prescription” by John Ensign dated March 11, 2008 published by National Review Online at http://article.nationalreview.com/?q=MzE3M2M1Y2RkNmMxZWRhZGE5YzNhNGRiMDI0NGZlMTY= .

America’s Unstable Health Insurance System: Recommendations for increasing Stability and Coverage” by Michelle C. Bucci dated March 12, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/bg2115.cfm .

State Health Reform: Six Key Tests” by Robert E. Moffit dated April 23, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/wm1900.cfm .

Health Care Reform: Design Principles for a Patient-Centered, Consumer-Based Market” by Edmund F. Haislmaier dated April 23, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/bg2128.cfm .

The Singapore Model” by Rowan Callick dated May 27, 2008 published by The American Magazine at http://www.american.com/archive/2008/may-june-magazine-contents/the-singapore-model .

Free Market Universal Care” by Peter Ferrara dated June 11, 2008 published by The American Spectator at http://www.spectator.org/dsp_article.asp?art_id=13352 .

The Success of Medicare Advantage Plans: What Seniors Should Know” by Robert E. Moffitt dated June 13, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/bg2142.cfm .

Reform of the American Health Care System is Still Achievable” by Tom Price dated June 24, 2008 published by Human Events Online at http://www.humanevents.com/article.php?id=27147 .

Canadian Health Care We So Envy Lies in Ruins, Its Architect Admits” by David Gratzer dated June 25, 2008 published by Investor’s Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=299282509335931 .

Coming Soon: Not-So-NICE Health Care?” by Sally C. Pipes dated June 25, 2008 published by Investor’s Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=299282658708852 .

Have Health Reformers Forgotten Medicare?” by Joseph Antos dated July 7, 2008 published by American Enterprise Institute at http://www.aei.org/publications/pubID.28244,filter.all/pub_detail.asp .

A Fork in the Road” by Michael Tanner dated July 29, 2008 published by Cato Institute at http://www.cato.org/pubs/bp/bp104.pdf .

State Health Care reform: A Brief Guide to Risk Adjustment in Consumer Driven Health Insurance Markets” by Edmund F. Haislmaier dated August 1, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/bg2166.cfm .

Free-Market Medicine” by Paul Howard dated August 20, 2008 published by National Review Online at http://article.nationalreview.com/?q=NjY2ZTUxYjA0ZmYxMWVjNjA1YWI0ZGRiNDBkODQ4YmQ= .

Medicare’s Financial Woes: Bigger Than Official Estimates” by J. D. Foster dated September 2, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/Budget/bg2174.cfm .

Oregon’s Suicidal Approach to Health Care” by Rita L. Marker dated September 14, 2008 published by American Thinker at http://www.americanthinker.com/2008/09/oregons_suicidal_approach_to_h.html .

You’re All Dead – and Don’t Know It” by Phillip Ellis Jackson dated September 20, 2008 published by Intellectual Conservative at http://www.intellectualconservative.com/2008/09/20/you%E2%80%99re-all-dead-and-don%E2%80%99t-even-know-it/print/ .

State Health Reform: How States Can Control Costs and Expand Coverage” by Dennis G. Smith dated September 22, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/bg2183.cfm .

Affordable Health Care” by Walter E. Williams dated October 22, 2008 published by Town Hall at http://townhall.com/columnists/WalterEWilliams/2008/10/22/affordable_health_care .

How a Federal Health Board Will Cancel Private Coverage and Care” by Robert E. Moffit dated December 4, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/wm2155.cfm .

Employer-Based Health Insurance: Why Congress Should Cap Tax Benefits Consistently” by Jason Roffenbender dated December 5, 2008 published by The Heritage Foundation at http://www.heritage.org/Research/HealthCare/bg2214.cfm .

“The Trouble with Canadian Healthcare” by Brett J. Skinner dated December 6, 2008 published by The American Magazine at http://www.american.com/archive/2008/december-12-08/the-trouble-with-canadian-healthcare .

Obama’s Coming Health Care Headache” by Robert Samuelson dated January 9, 2009 published by Investor’s Business Daily at http://www.ibdeditorials.com/IBDArticles.aspx?id=316396380187863 .

How to Reform Entitlement Spending” by Brian M. Riedl and Alison Acosta Fraser dated January 13, 2009 published by The Heritage Foundation at http://www.heritage.org/Research/Budget/sr43.cfm .

Behind the 8 Million Ball” by Peter Ferrara dated February 4, 2009 published by The American Spectator at http://spectator.org/archives/2009/02/04/behind-the-8-million-ball .

Obama’s False Choice” by Phillip Klein dated April 10, 2009 published by The American Spectator at http://spectator.org/archives/2009/04/10/obamas-false-choice .

The Pauper Option” by Jeffrey H. Anderson dated April 15, 2009 published by The Weekly Standard at http://www.weeklystandard.com/Content/Public/Articles/000/000/016/385axoqj.asp .

Health Care Deconstructed” by Bethany Stotts dated April 15, 2009 published by Accuracy in Media at http://www.aim.org/aim-column/health-care-deconstructed/ .

Coming This Summer: Health Care Wars” by Newt Gingrich dated May 27, 2009 published by Human Events at http://www.humanevents.com/article.php?id=32017 .

U.S. health care is not inferior” by Vincent Carroll dated June 23, 2009 published by The Denver Post at http://www.denverpost.com/search/ci_12667987 .

Markets, Not Mandates” by Ronald Bailey dated July 28, 2009 published by Reason Magazine at http://www.reason.com/news/show/135081.html .

Health Reform’s Taboo Topic” by Philip K. Howard dated July 31, 2009 published by The Washington Post at http://www.washingtonpost.com/wp-dyn/content/article/2009/07/30/AR2009073002816.html .

The Bad Road to Baucus” by William Tucker dated October 20, 2009 published by The American Spectator at http://spectator.org/archives/2009/10/20/the-road-to-baucus .

Bending the Cost Curve” by William Tucker dated March 10, 2010 published by The American Spectator at http://spectator.org/archives/2010/03/10/bending-the-cost-curve-with-a .

Obamacare: The straw that broke the camel’s back” by David Coughlin dated March 23, 2010 published by American Thinker at http://www.americanthinker.com/blog/2010/03/obamacare_the_straw_that_broke.html

 The Entitlement Crisis” dated August 17, 2010 published by The Heritage Foundation at http://www.heritage.org/Research/Reports/2010/08/The-Entitlement-Crisis .

Getting Health Care Reform Right” dated August 17, 2010 published by The Heritage Foundation at http://www.heritage.org/Research/Reports/2010/08/Getting-Health-Care-Reform-Right .

How to Fix Medicare: A New Vision for a Better Program” by Robert E. Moffit and James C. Capretta dated December 13, 2010 published by The Heritage Foundation at http://www.heritage.org/Research/Reports/2010/12/How-to-Fix-Medicare-A-New-Vision-for-a-Better-Program .

 “Sen. Paul Proposes Serious Cuts” by Chris Edwards dated January 31, 2011 published by Cato Institute at http://www.downsizinggovernment.org/sen-rand-paul-proposes-serious-cuts .

Why Accountable Care Organizations Won’t Deliver Better Health Care – and Market Innovation Will” by Rita E. Numerof dated April 18, 2011 published by The Heritage Foundation at http://www.heritage.org/Research/Reports/2011/04/Why-Accountable-Care-Organizations-Wont-Deliver-Better-Health-Care-and-Market-Innovation-Will .

Saving the American Dream” by Stuart M. Butler, Alison Acosta Fraser, and William W. Beach dated May 10, 2011 published by The Heritage Foundation at http://www.heritage.org/Research/Reports/2011/05/Saving-the-American-Dream-The-Heritage-Plan-to-Fix-the-Debt-Cut-Spending-and-Restore-Prosperity .

How the Free Market Can Cure Health Care” by Matt Palumbo dated December 17, 2011 published by American Thinker at http://www.americanthinker.com/2011/12/how_the_free_market_can_cure_health_care.html .

How to Bring Sanity to Our Mental Health System” by E. Fuller Torrey dated December 19, 2011 published by The Heritage Foundation at http://www.heritage.org/research/reports/2011/12/how-to-bring-sanity-to-our-mental-health-system .

US health care: A reality check on cross-country comparisons” by H.E. Frech, Stephen T. Parente, and John Hoff dated July 11, 2012, published by American Enterprise Institute at http://www.aei.org/outlook/health/global-health/us-health-care-a-reality-check-on-cross-country-comparisons/ .

Studies Show: Medicaid Patients Have Worse Access and Outcomes than the Private Insured” by Kevin D. Dayaratna dated November 7, 2012 published by The Heritage Foundation at http://www.heritage.org/research/reports/2012/11/studies-show-medicaid-patients-have-worse-access-and-outcomes-than-the-privately-insured .

The Singapore Cure” by Matthew Continetti dated February 25, 2013 published by The Weekly Standard at http://www.weeklystandard.com/articles/singapore-cure_701312.html .

Ten Years of Tort Reform in Texas: A Review” by Joseph Nixon dated July 26, 2013 published by The Heritage Foundation at http://www.heritage.org/research/reports/2013/07/ten-years-of-tort-reform-in-texas-a-review .

After Repeal of ObamaCare: Moving to Patient Centered, Market-Based Health Care” by Center for Health Policy Studies dated October 31, 2013 published by The Heritage Foundation at http://www.heritage.org/research/reports/2013/10/after-repeal-of-obamacare-moving-to-patient-centered-market-based-health-care .

FreeMarketCare” by Dean Kedenburg dated November 1, 2013 published by American Thinker at http://www.americanthinker.com/2013/11/freemarketcare.html .

 

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