The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Health Care Reform and the GOP Platform

Posted by Alan on September 17, 2008

Party platforms are like cotton candy. They’re tasty and sticky (if a bit too sweet) for a brief moment of time and then they’re forgotten. Who can recall a lawmaker proclaiming their support for a measure because it was consistent with her party platform? Nonetheless, in a recent post I noted the Democratic Party platform’s rejection of a single-payer, government-run system.  Which got me thinking about what the Republican Party platform had to say about health care reform.

The answer is: nothing much different than what John McCain has been saying. Entitled “Health Care Reform: Putting Patients First.” the platform begins with a First Principle: Do No Harm. Here, the GOP explicitly states the party “will not replace the current system with the staggering inefficiency, maddening irrationality, and uncontrollable costs of a government monopoly.” No surprise there. It follows with a call for “patient control and portability.” Here’s where the paty calls for lowering the cost of coverage and calls for empowering employees “the option of owning coverage that is not tied to their job.” They call for eliminating the current difference in tax benefits between insureds who buy their coverage on their own or obtain it through an employer.

The rest of the platform is fairly straightforward calls for lowering costs through prevention, transparency, reducing frivolous malpractice lawsuits, leveraging technology, support of medical research and identifying best practices. These are fairly common proposals and unlikely to raise the hackles of many voters. There are, however, two controversial items.

Declaring the family as the basic unit of society, the Republican platform supports “parental rights to consent to medical treatment for their children including mental health treatment, drug treatment, alcohol treatment, and treatment involving pregnancy, contraceptives, and abortion.” I’m not sure what this means in practice. It doesn’t sound like it would prevent carriers from covering treatment for these services to minors, only that the parent could decide not to take advantage of them. Other than in life threatening situations I’m not aware of anyone forcing a parent to take their addicted child in for drug treatment. So it’s unclear to me whether this is simply a family-friendly statement or if it’s attacking a serious problem.

The second controversial item is a call to “Drive Costs Down With Interstate Competition.” This reflects a pillar of Senator John McCain’s health care reform plan. “A state-regulated national market for health insurance means more competition, more choice, and lower costs.  Families – as well as fraternal societies, churches and community groups, and small employers – should be able to purchase policies across state lines.” I’ve expressed surprise that this approach would find favor in the Republican party. Usually the GOP is in the forefront of allowing states to set their own rules. By allowing a health plan filed and approved in one state to be sold in every other state they undermine the ability of every state to create their own approach to health care coverage. This proposal would encourage jurisdiction shopping in which health plans would seek approval for their offerings in the states with the most lenient regulation and loosest rules.

The goal of encouraging competition is a good one. Even the idea of a national platform of health insurance rules has merit. In many respects, however, the GOP approach of “pick a state, any state” is the worst of all worlds. Moving regulation of health insurance products from the states to the federal government would provide uniformity (meaning products would meet minimum standards regardless of where they’re sold), but at the expense of accepting regulators that are more distant from consumers. The current patchwork of state regulation creates 51 silos that makes achieving best practices more difficult and lessens competition, but it keeps decision making closer to consumers. Allowing jurisdiction shopping neuters the ability of consumers to influence regulators while doing little to achieve uniformity in rules and offerings.

While the interstate competition provision is, in my opinion at least, a violation of the principle of “doing no harm,” the rest of the GOP platform is consistent with the no new taxes, keep government out of it philosophy that is at the foundation of Republican policy making. In that regard it’s not a surprising document. Given the insecurity many Americans feel about their continued access to health care, I am surprised that the Republican Platform doesn’t emphasize the desire to reduce the number of uninsured in the country. On the other hand, by elevating portability to the core of their proposal, they are seeking to reassure those now afraid to change — or lose — their jobs and thereby lose their health insurance.


3 Responses to “Health Care Reform and the GOP Platform”

  1. Ronna said

    RESEARCH TRIANGLE PARK, N.C. — In a new study documenting the costs associated with specific levels of obesity in the American workplace, researchers at RTI International and the Centers for Disease Control and Prevention have found that the average annual per capita increase in medical expenditures and absenteeism associated with obesity ranges between $460 and $2,500 per obese employee, with costs increasing as body mass index increases.

    The findings, which appear in the September/October issue of the American Journal of Health Promotion, show that for men employed full time in the labor market, the combined annual per capita cost of being obese, including medical expenses and absenteeism, ranges from $460 to $2,030. For women the per capita cost ranges from $1,370 to $2,485.
    To put the issue into perspective, the authors estimate that the cost of obesity at a firm with 1,000 employees is about $285,000 per year. The authors believe the high costs of obesity could be getting the attention of employers.

    National Medical Spending Attributable To Overweight And Obesity: How Much, And Who’s Paying?
    Further evidence that overweight and obesity are contributing
    to the nation’s health care bill at a growing rate.

    by Eric A. Finkelstein, Ian C. Fiebelkorn, and Guijing Wang

    More than half of Americans are either overweight or obese. Moreover, the prevalence of overweight and obesity has increased by 12 percent and 70 percent, respectively, over the past decade.1 This trend is alarming, given the association between obesity and many chronic diseases, including type 2 diabetes, cardiovascular disease, several types of cancer (endometrial, postmenopausal breast, kidney, and colon), musculoskeletal disorders, sleep apnea, and gallbladder disease.2
    The excess medical expenditures that result from treating these obesity-related diseases are significant. Roland Sturm used regression analysis to show that obese adults incur annual medical expenditures that are $395 (36 percent) higher than those of normal weight incur.3

    And there’s much more, of course.
    Thank you for keeping me accountable, Mark.

  2. Mark Goodman said

    What does “greatest portion of health care costs” mean? Is it a percentage, a thought, and where did you get the statistic? I’m not necessarily disagreeing but I think you need to support your statement.

  3. Ronna said

    The greatest portion of health care costs is spent on conditions specific to or very closely related to being overweight.
    It doesn’t matter who wins this election because the cause of America’s Health Care crisis begins and ends in the HOME where the family resides…the basic unit of society! The government can not and will not fix this problem for us. We MUST fix it ourselves and we CAN do that.
    What we can’t do is continue to expect our government to bail us out every time we make a poor and/or greedy personal choice. We should all be held responsible for our own actions individually and some states are doing that by ‘charging’ obese workers $25 to help with the costs of their own health care which, by the way, is substantially more than the average weight person.
    We are Americans. Our entire history is based on taking control of a bad situation and making it better so we can ALL benefit.
    We better start Taking It On and quick

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