It has been argued for several years that the healthcare system in the United States needs a reform to cope with the increasing cost and to extend its coverage. The health care reform is in the agenda of president elect Obama. Here is a brief summary of his proposal:
1. Under the proposal all children would be required to have health insurance and a similar requirement for adults if substantial numbers of people do not buy coverage that is deemed affordable would be considered.
2. Continuing participation of employers in the health insurance system. All employers, other than small businesses, would be required to offer health insurance to their employees or contribute to the cost.
3. Eligibility for Medicaid and the State Children's Health Insurance Program (SCHIP) will be expanded by raising income eligibility levels.
4. Small businesses, self-employed individuals, and people who do not have coverage through their employers, Medicaid, or SCHIP would be able to purchase a plan through a new insurance market called the National Health Insurance Exchange. Public and private plans sold through the exchange would have benefits and cost-sharing rules similar to that available to federal employees and members of Congress. All insurance carriers would be required to offer plans to all applicants and could not charge premiums based on health status.
5. Small businesses would be eligible for tax credits to offset their premium costs and individuals would be eligible for income-based premium subsidies. Moreover, it will be offered federal reinsurance for employers that experience catastrophic claims.
6. Other measures to improve quality and efficiency, including changes in payment schemes.
At the CISS we have a permanent study of health insurance systems, named CISS Health Insurance Report. The proposal can be analyzed taking into consideration the experience of the countries analyzed in the report. As can be seen in the next figure that depicts the current overview of the United States health care system we can say that:
1. The United States health care system will not change in term of organization significantly: it would continue to be structured around private insurance markets, with a supporting role played by public insurance programs.
2. The extension of coverage to all or to specific groups (as it is the case of children) using public funding is, as many countries around the continent, one of the main drivers of reform.
3. Obligation to have coverage seem an alternative countries are using to extend coverage, although even in the cases in which the insurance is mandatory, universality is not reached, the tax credits and subsidies represent good incentives in this regard.
4. The United States continue to be one of the countries where the separation of functions is sharper, a tendency in which many countries in the continent are advancing.
1. Under the proposal all children would be required to have health insurance and a similar requirement for adults if substantial numbers of people do not buy coverage that is deemed affordable would be considered.
2. Continuing participation of employers in the health insurance system. All employers, other than small businesses, would be required to offer health insurance to their employees or contribute to the cost.
3. Eligibility for Medicaid and the State Children's Health Insurance Program (SCHIP) will be expanded by raising income eligibility levels.
4. Small businesses, self-employed individuals, and people who do not have coverage through their employers, Medicaid, or SCHIP would be able to purchase a plan through a new insurance market called the National Health Insurance Exchange. Public and private plans sold through the exchange would have benefits and cost-sharing rules similar to that available to federal employees and members of Congress. All insurance carriers would be required to offer plans to all applicants and could not charge premiums based on health status.
5. Small businesses would be eligible for tax credits to offset their premium costs and individuals would be eligible for income-based premium subsidies. Moreover, it will be offered federal reinsurance for employers that experience catastrophic claims.
6. Other measures to improve quality and efficiency, including changes in payment schemes.
At the CISS we have a permanent study of health insurance systems, named CISS Health Insurance Report. The proposal can be analyzed taking into consideration the experience of the countries analyzed in the report. As can be seen in the next figure that depicts the current overview of the United States health care system we can say that:
1. The United States health care system will not change in term of organization significantly: it would continue to be structured around private insurance markets, with a supporting role played by public insurance programs.
2. The extension of coverage to all or to specific groups (as it is the case of children) using public funding is, as many countries around the continent, one of the main drivers of reform.
3. Obligation to have coverage seem an alternative countries are using to extend coverage, although even in the cases in which the insurance is mandatory, universality is not reached, the tax credits and subsidies represent good incentives in this regard.
4. The United States continue to be one of the countries where the separation of functions is sharper, a tendency in which many countries in the continent are advancing.
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