[John Kerry] Kerry Healthcare Plan Will "Stop Spiraling Costs, Provide Coverage for Nearly 95 Percent of Americans, Cover Nearly all Children, and Allow Americans to Access the Same Health Care Plan As Members of Congress
I. Controlling the Spiraling Costs of Health Care
Health insurance has become too expensive. Double-digit increases in health care premiums make it hard for Americans and businesses alike to afford health care. Companies that do the right thing by providing good health insurance for their workers are getting squeezed by rising costs. As a result, more companies are asking workers to contribute a greater share of their
health care costs through higher premiums and increased cost sharing – and even sometimes reducing their benefits to keep costs down. Skyrocketing costs have also wreaked havoc on state budgets, putting pressure on state health care programs at a time when job losses leave more Americans needing coverage protections. Some increases in cost are due to advances in health care. However, too many of these rising costs are driven by waste, fraud, and abuse in the system; loopholes that keep prescription drug
prices too high; meritless lawsuits; medical errors that undermine quality health care and raise costs; and too much bureaucracy and paperwork that contributes to 25 percent of health care costs today. Many employers and purchasers have worked to make improvements, and their efforts demonstrate that progress is possible. But we need a national commitment to assure system-wide changes that can improve quality and reduce costs and keep health care from becoming too expensive.
John Kerry believes that all parts of the health care system – insurers, providers, lawyers, employers and patients -- have a responsibility to help make the health care system more affordable. John Kerry has a five-point plan that will save Americans, purchasers and the Federal government billions in health care costs every year.
(1) CREATING A NEW APPROACH TO CONTROL SPIRALING HEALTH CARE
COSTS – AND PASSING THE SAVINGS ON TO WORKERS. In 2001, only 4/10 of one percent of private insurance claims was for individuals with health expenses in excess of $50,000. However, these claims accounted for nearly 20 percent of medical expenses for private insurers. John Kerry believes that health care is becoming too expensive. He has a proposal for a new 'premium rebate' pool that will make health care more affordable for all employers and
employees by helping out with certain high cost health cases. Under this proposal the pool would reimburse employee health plans for 75 percent of the catastrophic costs they incur above $50,000 as long as they guarantee such savings are used to reduce the cost of workers’ premiums. Helping out with catastrophic costs would strengthen the employer-based market by
making health care more affordable for purchasers. It will also make health care more affordable for those who buy into the Congressional Health Plan. To be eligible for this 'premium rebate' pool, employers and their insurers would have to:
• Provide Affordable Health Coverage to All of Their Workers. Many companies work to provide quality coverage to all their workers. However, too often large companies have stringent rules that prevent their low-wage workers from obtaining affordable health care. For example, they will require employees to work for many months before even offering coverage, and then subsidize it at a low amount. To join the premium rebate pool, employers
would have to provide affordable coverage to all their employees.
• Demonstrate That Workers Will Receive the Savings. By removing catastrophic costs, John Kerry's proposal will make it easier for employers to offer affordable coverage. To be eligible, however, savings from this relief must be directly passed to workers. The premium pool is estimated to save workers as much as 10 percent – or $1000 off a Family Plan.
• Encourage Disease Management to Improve Care Quality and Decrease the Costs of Care. Chronic diseases, such as asthma, cancer, cardiovascular diseases, and diabetes make up 78 percent of all medical costs. Disease management and health promotion programs provide an opportunity to improve patient outcomes and limit spending by identifying and monitoring high-risk populations. Some purchasers have worked to implement these
approaches and have found good results. For example, a Bank of America health promotion program found that insurance claims were reduced an average of $164 per beneficiary per year while costs increased by $15 per person for the control population.