Health Policy Matters

Grace-Marie Turner

A Washington Post/ABC News poll reports this morning that the American people trust President Bush by a 55-37% margin to handle the major problems facing Americans - except health care. The poll shows that they disapprove 34-57% of the way he is handling the "cost, availability, and coverage of health insurance."

The problems in our health sector have deep and complex roots and will not be solved by next year. A PricewaterhouseCoopers survey last year explained the many factors fueling rising costs, including new technologies, rising provider expenses, increased consumer demand, litigation, and government mandates and regulation.

The health sector is struggling mightily to cope. And with 45% of the nation's health care financed through public programs and the other 55% heavily regulated by federal and state governments, change does not come easily.

The main legislative initiative to help some of the uninsured keep or get coverage - refundable tax credits contained in the Trade Adjustment Act of 2002 - will be an important start. Yet they also are extraordinarily complex to implement and only 250,000 to 500,000 people will be eligible.

The Bush administration is determined to make the tax credits work and to expand - and improve - them to cover millions more of the uninsured.

A briefing on Tuesday sponsored by the Healthcare Leadership Council provided insights into the heroic efforts to make them work by officials at Treasury, HHS, Labor, and the IRS, plus outside groups like the National Association of Health Underwriters, the Lewin Group, and others.

These smart people are working very hard to create the financial intermediary infrastructure and to work with the states to create purchasing options to meet the August deadline.

It's never easy to create new free-market options within the regulatory morass of the health care system, but these smart and dedicated people are doing it.

It's an important start but the credits need to be made available to millions more of the uninsured - and soon - to begin to energize the private market for health insurance. That, coupled with the creativity of employers in structuring consumer-directed health care options, can begin to turn things around - and not a moment too soon!

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