Focusing on the Vision

Grace-Marie Turner Hundreds of thousands of Americans now can obtain refundable tax credits to help purchase health insurance, effective August 1. Experts inside and outside government have worked incredibly hard to design and create the infrastructure to make the credits work, and they deserve thanks and congratulations.

This is an important milestone in a process of providing more rational subsidies for health insurance. The next step is opening the door for millions more Americans to have access to credits. Congress can use the $50 billion set aside in next year's federal budget for the uninsured to expand credits to more Americans - and lighten up on the rules and restrictions.

A thousand flowers are blooming. The wheels of public policy are churning to provide many more options for portable, individually-owned health insurance. Two examples:

Sen. Rick Santorum recently introduced the Fair Care for the Uninsured Act (S.1570) to provide credits of up to $3,000 for families who don't have access to health insurance so they can purchase private coverage. Taking a different approach, Rep. Chris Cox has introduced H.R. 1117 to permit 100% tax deductibility of the costs of medical insurance and all other medical expenses.

At the same time, interest in consumer-driven health care options is soaring in the marketplace, as my colleague Greg Scandlen details each week in his Consumer Choice Matters newsletter. The new Health Reimbursement Arrangements (HRAs) created last year by the Bush Administration are giving insurance companies a wealth of new options. I spoke last week in Chicago to more than 100 insurance agents and brokers at a seminar sponsored by the Destiny Institute, and they could not have been more eager to learn about ideas to give their clients new choices.

Two of the most exciting new policy ideas are being developed by Ways and Means Chairman Bill Thomas through Health Savings Accounts and Health Savings Security Accounts. The new savings options have been approved by the House and are part of the Medicare conference negotiations. These and the other policy initiatives will be transformative in beginning to create a true consumer-friendly, competitive market in the health sector in the United States.

And speaking of Medicare: No one has a clear enough crystal ball to tell what will happen this fall, but one thing is clear. The Bush Administration, our friends on the conference committee, and hundreds of outside experts are working incredibly hard to shape the legislation so a competitive model Medicare program can actually work.

It's very important that we keep our eye on this important goal and not focus just on the many, many problems with the free-standing drug benefit - like even having one at all. The drug benefit is a concession to politics and is getting virtually all of the media attention, but the transformative impact of legislation will be in whether or not the new competitive Medicare program actually works. We must remember the vision.

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