Senator Christopher Dodd’s Health Plan

Abstract

Our health care system is plagued by four overriding deficiencies: lack of universal coverage, high costs, inadequate chronic illness prevention and management, and deficient public health preparedness. An inadequate information technology infrastructure and suboptimal quality of care are aspects of one or more of these four challenges. As a result of these shortcomings, the American people are actually less healthy than our counterparts in developed nations around the world. This travesty saps our potential as individuals and as a country. Lost productivity associated with having 47 million uninsured people costs up to $205 billion per year. Accordingly, I have proposed a comprehensive plan for health care reform marked by its inclusiveness and balance. PUTTING UNIVERSAL COVERAGE FIRST Universal coverage forms the predicate of solving many of our health system problems. Without the continuity of access universal coverage promotes, effective chronic disease management that improves health outcomes and generates savings will be much harder to attain. Certainly, disaster preparedness becomes dramatically more difficult while large pockets of uncompensated care and reliance on hospital emergency rooms remain significant characteristics of American health care. My health care plan provides for unequivocal universal health care coverage through universal responsibility. Americans will be able to get their private insurance through a health insurance marketplace called Universal HealthMart. Modeled after the Federal Employees Health Benefits Plan, Universal HealthMart will provide Americans with the same benefits as every Member of Congress. Insurance company discrimination based on condition will be ended. Every employer and individual will be given the chance to go to Universal HealthMart to purchase high-quality, affordable health care or, if they wish, keep their existing insurance arrangements. If a person is unable to pay for insurance or cover the entire cost, their costs will be subsidized on a sliding scale based on income. Business contributions will also be based on ability to pay. Every American with an income below 100 percent of the Federal Poverty Level will become eligible for Medicaid while changes in the federal match will assure that states are held harmless for this expansion. My plan is the only plan to provide for automatic enrollment and a defined timeline to implement universal coverage. Coverage will occur through direct enrollment as people choose their plans or automatically when people file their tax returns, complete W-4's, or show up for health care with a provider. Through the process of automatic coverage and enrollment, universal coverage is guaranteed. Within 2 years of enactment, all children, young adults to age 29, and adults age 55-64 will be covered. Over the next two years, all remaining adults between 30-54 will be enrolled. MAKING HEALTH CARE MORE AFFORDABLE My plan will make healthcare more affordable because health insurance premiums will be based on ability to pay. In addition, my health care plan will reduce costs throughout the system, especially administrative costs. First, as more and more Americans participate in the marketplace, the agency contracting with health plans on their behalf gains increasing leverage to require sensible efficiencies and price accountability. Second, according to McKinsey Global Institute, medical underwriting and marketing costs alone account for $64 billion in excess insurance company expenses. My plan eliminates insurance company discrimination based on condition, while marketing will be consolidated and streamlined. It explicitly redirects premium dollars to prevention and management of chronic illness, the effects of which are discussed more fully below. IMPROVING CHRONIC ILLNESS MANAGEMENT Chronic illness accounts for 74 percent of private health insurance medical spending and 96 percent of Medicare spending. …