"FannieMed" Continued...

Issue: "Ready or not, here we go," March 28, 2009

Health professionals also worry about a proposal by Sen. Max Baucus, chairman of the Senate Finance Committee, to reduce the number of uninsured by expanding existing entitlement programs like Medicaid and allowing those 55 to 64 to join Medicare. Without these additional entitlement costs the Centers for Medicare and Medicaid Services estimates that Medicaid alone will grow nearly 8 percent annually during the next decade, hitting $673.7 billion in 2017.

What conservatives say they want to support are proposals that emphasize the power of markets and the ability of individuals to make their own decisions. Examples include:

Greater Adoption of Health Savings Accounts. Created by Congress in 2003, these tax-free accounts allow individuals to pay lower premiums in exchange for higher deductibles. Money not used for premiums are placed in the savings account-in essence increasing that individual's medical rainy-day fund.

Refundable tax credits. With small business unable to pay health insurance for employees, expanding these tax credits would provide greater incentives for small business owners to cover workers.

Association Health Plans. Allowing groups of individuals or organizations to come together would create an economy of scale that could provide affordable group rates and erode the rolls of the uninsured.

Many at the White House health-care summit touted developments in Massachusetts, where a universal coverage law began in 2006. But Kevin Pho, a primary care physician from southern New Hampshire who runs a medical blog, says the state's health-care system has been bombarded with nearly half a million new patients: The wait time for a new patient to see a primary care doctor averaged 50 days, and those who can't wait often resort to emergency room visits-one of the costliest forms of health care. "It's a difficult pill to swallow," reasons Pho. "Health insurance without health-care access is basically useless."

Obama has already announced how he will pay for half of the estimated $1.2 trillion price tag for his health plans. And those specifics mean bad news for the nation's charitable organizations. The budget plan provides a $634 billion down payment for health-care reform with half of that money coming from tax increases for the wealthy. Specifically, Obama wants to reduce-from 35 percent to 28 percent-the deductions families making more than $250,000 can claim for charitable donations and other items.

"Charities are in demand whenever the economy is bad. We will be seeing more clients while being stretched for resources," worries Peggy Hartshorn, president of Heartbeat International, a nationwide network of more than a 1,000 nonprofit, faith-based pregnancy centers.

According to a study released this month by Bank of America and the Center on Philanthropy at Indiana University, 47 percent responding said they would give less if deductions were wiped out, with 10 percent predicting that their gifts would dramatically decrease. Reduced incentive to give could end up ripping a hole in the safety net provided by such charities. Hartshorn doesn't miss the irony in taking from charities to pay for an expanded government role in health care: "Obama is showing no faith at all in faith-based organizations."

Edward Lee Pitts
Edward Lee Pitts

Lee teaches journalism at Dordt College in Sioux Center, Iowa, and is the associate dean of the World Journalism Institute.


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