Roll Call published the following Op-Ed by Representative Jim Langevin on March 9:
Universal Health Care Requires Paradigm Shift
By Rep. James LangevinSpecial to Roll Call
Sunday, March 9, 2008; 11:59 pm
Health care costs in the United States are rising at an alarming rate. Yet despite the fact that we spend more per capita on health care than any other industrialized country, we produce some of the worst outcomes by a number of important health measures.
Furthermore, the U.S. remains the only developed nation that does not guarantee health coverage as a right to its citizens. Today, nearly 47 million Americans lack health insurance — leaving one in six without access to proper medical care. Even more shocking is that more than 80 percent of the uninsured come from working families. Health care costs are imposing an increasing burden on families and placing employers at a further competitive disadvantage. It is time for policymakers to offer a new vision for health care — one that is based on shared responsibility and provides universally mandated, affordable coverage to all.
Instituting meaningful, systemic reforms will require a fundamental shift in how we view employer-provided coverage and health care delivery. While it is critical that businesses maintain a role, we must change our perspective of health insurance as a privilege or benefit tied to employment. Instead, we must consider it a right and responsibility to be shared by the community. Individuals, employers, health care providers and the government all have key roles to play in reaching a truly inclusive and efficient health care model. It is in this vein that I have joined with Rep. Christopher Shays (R-Conn.) to introduce a bipartisan, universal health care proposal that will guarantee every American access to the same coverage as Members of Congress.
The American Health Benefits Program Act (H.R. 5348) is based on a program that has stood the test of time — the Federal Employees Health Benefits Program. Currently, more than 8 million federal employees, retirees and their dependents receive health coverage under the program.
The program, negotiated by the federal government, employs a system of managed competition between private insurance carriers and provides enrollees with a large menu of coverage options. Its use of bulk purchasing helps contain costs and brings stability to the system. In 2007, this resulted in an average premium increase of just 1.8 percent, compared with the private market average of 6.1 percent. H.R. 5348 would use this successful model as a template to provide similar benefits to all Americans, establishing the first ever American Health Benefits Program.
Under the program, employers who wish to continue negotiating with private insurance carriers may do so, as long as the coverage they offer meets a basic standard set by the program. However, employer-sponsored coverage is proving to be more and more prohibitive for businesses as health care costs continue to outpace inflation and insurance options drastically fluctuate from plan to plan. That is why the program allows companies to choose instead to pay a fixed, predictable payroll tax according to their size and average employee earnings. For many businesses, this may cost less than they currently spend on premium contributions and health plan administration.
This new revenue will create a funding stream to allow for a fixed government contribution of 72 percent toward the health care premiums of every participating American. Individuals participating in the program will have a responsibility to pay the remaining share, to the extent they can afford it, with the lowest-income earners receiving subsidies to ensure affordability.
This expanded system of managed competition will ensure that plans compete for enrollees on the basis of benefits, as well as efficiency, service and price. No one will be denied coverage or discriminated against based on their health status or pre-existing condition. The program will offer portable and continuous coverage, and it will incentivize investment in disease prevention and long-term preventative care, which decrease the cost of care over time. Investments in health information technology also will lower costs while increasing quality and efficiency.
The unsettling truth is that society already pays for the uninsured, and it does so at tremendous cost and with staggering inefficiencies. The uninsured are most often forced to seek care from doctors and emergency rooms only after their illnesses reach catastrophic levels, drastically increasing the risk of complications and the costs of treatment. Recent estimates place total uninsured medical expenses at nearly $125 billion a year. Approximately $41 billion of this total comes in the form of “uncompensated care,” which is predominantly borne by the government and financed by the taxpayer. This cost is only compounded by the lost income due to reduced employment and job productivity.
Instituting a system of mandatory coverage will be integral to the success of any comprehensive health care reform. Requiring full participation in the system will bring a younger, healthier population into the insurance market, spreading the risk more evenly. In addition, mandated health coverage will stabilize the insurance market by decreasing insurers’ legitimate fears of attracting a disproportionate share of unhealthy patients. This will result in greater efficiency as well as significantly reduced administrative costs that otherwise would be dedicated to underwriting and target marketing.
Sen. Hillary Rodham Clinton (D-N.Y.) has shown that she recognizes the importance of mandated coverage, and the principles of both personal and shared responsibility in her own universal health care proposal. Furthermore, her plan speaks to the need for any universal mandate to be supplemented with an appropriate subsidy to guarantee affordability. It also must be accompanied by a greater emphasis on early diagnosis, prevention and evidence-based treatments to ensure quality and reduce costs.
The challenges we face in fixing our ailing health care system are great; however, the costs of inaction are even greater. The time has come for policymakers at all levels and across the ideological spectrum to take meaningful action toward developing a health care system that really works for our nation: one that offers Americans choice, calls for shared responsibility and is affordable to all. I look forward to working with my colleagues, advocates and families across the country to achieve a new vision for health care in America.
Rep. James Langevin (D-R.I.) is a co-sponsor of the American Health Benefits Program Act.
Friday, April 4, 2008
AHBP Guiding Principles
Universal Coverage: AHBP will provide health insurance to all Americans.
Choice: Provide Americans a choice of their health plan.
Shared Responsibility: Individuals, employers, the government, hospitals and insurers all have a responsibility to ensure an efficient, affordable healthcare system.
Affordability: The plan must be affordable for individuals and employers.
Portability: If you leave an employer or change states, you can take your plan with you.
Continuity: Those who have coverage now should not have their benefits reduced to cover everyone.
Preventative Care: AHBP must promote healthy living and wellness.
Healthcare Reinvestment: 90 cents of every dollar of the insurance premium will be reinvested into healthcare.
Choice: Provide Americans a choice of their health plan.
Shared Responsibility: Individuals, employers, the government, hospitals and insurers all have a responsibility to ensure an efficient, affordable healthcare system.
Affordability: The plan must be affordable for individuals and employers.
Portability: If you leave an employer or change states, you can take your plan with you.
Continuity: Those who have coverage now should not have their benefits reduced to cover everyone.
Preventative Care: AHBP must promote healthy living and wellness.
Healthcare Reinvestment: 90 cents of every dollar of the insurance premium will be reinvested into healthcare.
Providence Journal - AHBP is a "Good Idea"
The Providence Journal published the following editorial on the AHBP on February 23.
EDITORIAL - Langevin's health reform
23 February 2008
© 2008 Providence Journal/Evening Bulletin. Provided by ProQuest Information and Learning. All Rights Reserved.
Rep. Jim Langevin, a Democrat, has introduced a health-care plan to cover all Americans. Co-authored by Rep. Christopher Shays, a Republican from Connecticut, this is the first bipartisan proposal for universal coverage to emerge in the House. How does it sound? Pretty good.
The model is the Federal Employee Benefits Program, which covers 8 million federal workers - including members of Congress. Mr. Langevin's plan would create a new federal agency that would negotiate with private insurers to offer a variety of insurance options.
Every uninsured American would have to sign up for one of the plans. Those who don't would automatically be enrolled in the lowest- cost plan in their region. That's important. A system of subsidized medical care that doesn't require everyone to join lets healthy people pay nothing into it until they get sick. We need everyone contributing to the insurance pool.
Employers who don't offer health coverage to their workers would have to pay a tax into the federal system. That money would be used to cover 72 percent of the premiums, with the individuals paying the rest. Low-income people would have their share subsidized.
One especially appealing piece of this proposal is the requirement that participating insurers spend 90 percent of the premiums on actually delivering health care. That would prevent insurance-company executives from turning a taxpayer-supported program into a scheme to enhance their own private fortunes.
Representative Langevin has a very interesting idea, but we find one thing he said curious. He said: "It's not single payer. It's not one size fits all." It happens that the very successful and popular Medicare program, which covers the elderly and disabled, is mostly a single-payer plan. It is simple, and 98 percent of the money Medicare spends goes for health care, with only 2 percent siphoned off for administrative costs. Sometimes one size serves all.
That said, Mr. Langevin's plan seems well-thought out. In terms of the politics, it's not likely to go anywhere in the waning months of the current administration. But sometimes good ideas must be introduced time and again before they become reality.
This plan seems a good idea.
EDITORIAL - Langevin's health reform
23 February 2008
© 2008 Providence Journal/Evening Bulletin. Provided by ProQuest Information and Learning. All Rights Reserved.
Rep. Jim Langevin, a Democrat, has introduced a health-care plan to cover all Americans. Co-authored by Rep. Christopher Shays, a Republican from Connecticut, this is the first bipartisan proposal for universal coverage to emerge in the House. How does it sound? Pretty good.
The model is the Federal Employee Benefits Program, which covers 8 million federal workers - including members of Congress. Mr. Langevin's plan would create a new federal agency that would negotiate with private insurers to offer a variety of insurance options.
Every uninsured American would have to sign up for one of the plans. Those who don't would automatically be enrolled in the lowest- cost plan in their region. That's important. A system of subsidized medical care that doesn't require everyone to join lets healthy people pay nothing into it until they get sick. We need everyone contributing to the insurance pool.
Employers who don't offer health coverage to their workers would have to pay a tax into the federal system. That money would be used to cover 72 percent of the premiums, with the individuals paying the rest. Low-income people would have their share subsidized.
One especially appealing piece of this proposal is the requirement that participating insurers spend 90 percent of the premiums on actually delivering health care. That would prevent insurance-company executives from turning a taxpayer-supported program into a scheme to enhance their own private fortunes.
Representative Langevin has a very interesting idea, but we find one thing he said curious. He said: "It's not single payer. It's not one size fits all." It happens that the very successful and popular Medicare program, which covers the elderly and disabled, is mostly a single-payer plan. It is simple, and 98 percent of the money Medicare spends goes for health care, with only 2 percent siphoned off for administrative costs. Sometimes one size serves all.
That said, Mr. Langevin's plan seems well-thought out. In terms of the politics, it's not likely to go anywhere in the waning months of the current administration. But sometimes good ideas must be introduced time and again before they become reality.
This plan seems a good idea.
Representatives Langevin and Shays Introduce Universal Health Care Legislation
Representative Jim Langevin (D-RI) and Christopher Shays (R-CT) recently introduced their legislative proposal to reform the nation’s health care system. The American Health Benefits Program (AHBP) Act, based on the existing Federal Employees Health Benefits Program, would offer affordable health coverage to all Americans.
AHBP is a proposed system of managed competition, which recognizes that any successful health insurance program must be based on three principles:
· Choice - A system of managed competition that encourages private insurance companies to develop a range of health care packages based on quality, efficiency, service and price.
· Shared Responsibility - Individuals, health care providers, the business community, and the government all have key roles to play in providing meaningful reforms to America’s ailing health care system.
· Affordability - By spending health care dollars more efficiently, we can make coverage affordable for all.
AHBP mirrors the Federal Employees Health Benefits Program, which is a successful template that insures over 8 million federal employees, retirees and their dependents. AHBP would leverage the negotiating power of the Federal government to extend a range of affordable health coverage options through private insurance carriers to every American. Americans not covered by Medicare, Medicaid, TRICARE/CHAMPUS, Indian Health Services, or Veterans programs will be able to choose a health care package through AHBP or an equivalent employer-sponsored plan.
The total cost of the bill will be evaluated by the Joint Committee on Taxation and the Congressional Budget Office. However, coverage costs will be primarily paid through a trust fund financed by a payroll tax. The Federal Government will pay 72 percent of the total premium. Individuals will be responsible for 28 percent of their premium, with low income individuals eligible for a sliding scale subsidy.
AHBP is designed to be a system of portable, continuous coverage that is not tied to an individual’s employment. Once in the system, enrollees will be better able to receive long-term, preventative care from a doctor of their choice.
AHBP is a proposed system of managed competition, which recognizes that any successful health insurance program must be based on three principles:
· Choice - A system of managed competition that encourages private insurance companies to develop a range of health care packages based on quality, efficiency, service and price.
· Shared Responsibility - Individuals, health care providers, the business community, and the government all have key roles to play in providing meaningful reforms to America’s ailing health care system.
· Affordability - By spending health care dollars more efficiently, we can make coverage affordable for all.
AHBP mirrors the Federal Employees Health Benefits Program, which is a successful template that insures over 8 million federal employees, retirees and their dependents. AHBP would leverage the negotiating power of the Federal government to extend a range of affordable health coverage options through private insurance carriers to every American. Americans not covered by Medicare, Medicaid, TRICARE/CHAMPUS, Indian Health Services, or Veterans programs will be able to choose a health care package through AHBP or an equivalent employer-sponsored plan.
The total cost of the bill will be evaluated by the Joint Committee on Taxation and the Congressional Budget Office. However, coverage costs will be primarily paid through a trust fund financed by a payroll tax. The Federal Government will pay 72 percent of the total premium. Individuals will be responsible for 28 percent of their premium, with low income individuals eligible for a sliding scale subsidy.
AHBP is designed to be a system of portable, continuous coverage that is not tied to an individual’s employment. Once in the system, enrollees will be better able to receive long-term, preventative care from a doctor of their choice.
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