Insure All Americans

Project Mission The mission of the Insure All Americans project is to expand insurance coverage to every American citizen within five years. We can achieve 100% coverage by reducing healthcare costs, which will make insurance more affordable.

David Merritt Project Director

This can be done by fundamentally changing four central tenets:

1. the way individuals view their health and healthcare;
2. how culture and society influences individual behavior;
3. the way we deliver care; and
4. how health insurance is financed.

Project Overview:

The uninsured crisis is an enormous anchor on healthcare system, our economy, and our future. While the problem is massive in scope, and its consequences felt throughout society, we must never forget that behind the statistics and headlines, there are individual Americans and their families who are struggling every day. They are unnecessarily locked out of the healthcare system. Covering the uninsured is, indeed, a moral imperative.

To date, we have found that nearly every proposal to expand coverage to the uninsured, from presidential candidates to state efforts to industry groups to think tanks, badly misses the mark. They will fail because they only focus on financing the current system. This does nothing more than prop up a broken and unsustainable system. That is why our plan seeks to transform health and healthcare as we know it by addressing the root cause of why millions of Americans do not have health insurance – rising costs.

In collaboration with our members, CHT is developing a four-box solution that will reduce healthcare costs and give every American the ability to purchase affordable health insurance. We focus on influencing individual behavior and responsibility, so that Americans choose to be healthier; redesigning public and private institutions to encourage individuals to make the right choices; improving the actual delivery and administration of care; and changing how we actually finance insurance.

Through bold changes that break with the current system, we can lower the cost of care to give every American the ability to purchase affordable health insurance. For more a lengthier overview on the Center’s Insure All Americans project, please click here.

A detailed proposal will be released in later this year.

Box One: Individual rights, responsibilities, and expectations of behavior

• Engage and incentivize consumers to focus on health, wellness, prevention, and early intervention.
• Design insurance products to reward healthy lifestyles and wellness and penalize poor health.
• Make the management of chronic disease the priority of public programs such as Medicare and Medicaid.
• Require that anyone who earns more than $50,000 a year must purchase health insurance or post a bond.
• Encourage the use of personal health records for portals to health education, cost and quality data, and personal health histories.
• Enlist faith-based organizations to educate the value of personal responsibility, health, and wellness.
• Reach out to minority communities to develop culturally-appropriate solutions and services.

Box Two: Maximize cultural and societal patterns for a healthy community

• Create a culture of health by reforming public and private institutions to encourage personal responsibility.
• Require physical education five days a week for every student in grades K through 12.
• School lunches, breakfasts, and vending machines in public schools should promote healthy foods, so that unhealthy alternatives are penalized or prohibited.
• Students should be weighed, their body mass index calculated, and the results and relevant educational material sent home to parents.
• Provide tax incentives to grocery stores in poor neighborhoods that carry a wide selection of fresh fruits and vegetables.
• Redesign the food stamp and WIC programs to incentivize the purchase of healthier foods. State and local governments should dramatically invest in bike paths, sidewalks, public parks, and active recreation programs to encourage physical activity.
• Engage large employers to focus on health, wellness, prevention, and early detection through workplace wellness programs, incentives for healthier lifestyles, opportunities for active community involvement and exercise, and encouragement of well visits to physicians.
• Consumers need tools to be better educated on their choices, as Safeway has done by creating an online portal where consumers can view their own specific food purchases and receive recommendations on healthier alternatives.

Box Three: Create an effective, efficient, and productive health delivery system

• Fundamentally change the provider reimbursement model from a transaction-based to an outcome-based model. This will incentivize providers to adhere to clinical guidelines, the latest best practices, and adopt the tools to deliver better care, such as electronic health records and other technologies.
• Create a public-private partnership to facilitate the analysis of de-identified healthcare data for new treatments, health management, and trends.
• Information on provider performance and price, as well as that of insurance companies, should be available to consumers - before they receive care.
• Encourage the growth of convenient, low-cost settings to receive care.

Box Four: Transform healthcare financing to enable a 300,000,000-payor system

• Pass federal legislation to allow individuals and families to buy insurance from other states, creating a truly competitive, nationwide market. In effect small businesses and the self employed would have the same national market advantages which big businesses enjoy today under ERISA.
• Allow Internet purchasing of Health Savings Accounts with high-deductible health plans, approved for sale in individual states but not otherwise sold nationally.
• Pass H.R. 506, the Health Partnership Through Creative Federalism Act, and S. 325, the Health Partnership Act. These bipartisan bills support President Bush’s pledge in his State of the Union address to allow individual states or multi-state collaborations to try new approaches to expand coverage to the uninsured.
• Provide tax rebates to small businesses that contribute to their employees’ Health Savings Accounts.
• Extend and expand grant funding to high-risk pools across the country.
• Provide low-income families with $1000 in direct contributions to a Health Savings Account, along with a $2000 advanced tax credit to purchase an HSA-eligible high-deductible health plan.
• Allow Health Savings Account dollars to be used to pay for health insurance premiums.
• Give consumers the option to open a Health Savings Account without having to purchase a high-deductible health plan.
• Eliminate any existing state premium taxes and unnecessary mandates on health insurance.
• Equalize the tax benefits for individuals who purchase their own insurance and employers who provide coverage.

To learn more about the Insure All Americans project, please contact David Merritt at (202) 375-2001 or dmerritt@gingrichgroup.com.