THREE OPTIONS ON HEALTH CARE

In recent weeks, administration officials have sent clear signals that President Bush and Health and Human Services Secretary Tommy G. Thompson want Congress to act on health care legislation in 2003, both because the problems of rising costs and the uninsured are worsening, and because the president would like to rack up some domestic policy accomplishments. Bush has already proposed offering refundable tax credits to help people afford health coverage on their own. Now, Thompson is exploring several models of individual health savings accounts, into which employers and employees would contribute tax-free funds to pay for medical costs up to a certain level; above that, a high-deductible catastrophic health plan would kick in. Read more »

WTC Workers Report Acute Health Problems

Respiratory Protection

Many workers who cleared debris from the site of the former World Trade Center (WTC) following the attack of Sept. 11, 2001, are reporting acute respiratory symptoms, and researchers are worried by the persistence of these health problems.

“We are concerned about what we are seeing because we expected these symptoms to disappear when the exposure was gone, but for some workers, it’s not happening,” said Alison Geyh, assistant professor of environmental health engineering at Johns Hopkins University’s Bloomberg School of Public Health. “It’s absolutely critical that we create the mechanism to track these people in the future.” Read more »

The Legal Implications for Health Care’s Bad Business Practices

Bad, or unethical, business practices have always been a concern for physicians and health care organizations. But recent high-profile business catastrophes refocused our attention on the responsibilities physicians must keep in mind when functioning as officers or board members.

Following federal legislation arising from the corporate scandals at Enron and WorldCom — and in light of the recent litigation against health care organizations for fraud or unethical billing practices — a review of potential ethical conflicts and pitfalls is important. Read more »

SHOULD HEALTH BENEFITS BE TAXED

At a time when Congress is gearing up for a major tax reform debate, a group of mostly conservative economists is pushing an idea that could fundamentally alter the employer-based health care system.

Currently, contributions that employers make to group health insurance policies for their employees are excluded from taxation. The contributions aren’t counted as part of an employee’s income, so employees don’t have to pay payroll taxes or income taxes on the contribution. Read more »

Redefining Competition in Health Care

The wrong kinds of competition have made a mess of the American health care system. The right kinds of competition can straighten it out

THE U.S. HEALTH CARE SYSTEM has registered unsatisfactory performance in both costs and quality over many years. While this might be expected in a state-controlled sector, it is nearly unimaginable in a competitive market — and in the United States, health care is largely private and subject to more competition than virtually anyplace else in the world. Read more »