"But for Wales?" Stuart Butler and the Heritage Foundation Health Care Proposal of 1990
Reading Stuart Butler today and contrasting him with the Stuart Butler of a decade or so reminds me of this scene:
Of course, Stuart Butler doesn't even get a cool chain of office with the dragon of Wales on it...
As explained by Heritage Foundation Vice President Stuart Butler, the Official Heritage Foundation Health Care Proposal had not only a required benefit package, an individual mandate, exclusion of pre-existing conditions, but also a public plan!
Stuart Butler:
Using Tax Credits to Create an Affordable Health System | The Heritage Foundation: Why the Current System Does Not Reach These Goals: The current health care system does not achieve these or many other goals. Most of the uninsured, and even many of those with basic insurance, find they cannot afford certain necessary heal th services. Few would contend, moreover, that the current system promotes efficient use of medical services.... And there is growing anxiety that basic medical decisions are being made by distant government or insurance company officials....
Under the Heritage proposal, the unlimited tax exclusion for company-provided health benefits would be phased out over several years....
Offsetting this change in the tax code, a new system of personal tax credits for family health spending would be introduced... a family could claim a credit when filing its 1040 tax form... an above-the-line credit, so the family would not have to itemize its re turn to claim the credit. It would be refundable, meaning that if the credit exceeded the family's total tax liability, the taxpayer would receive a check for the difference from the IRS.... The second central element in the Heritage proposal is a two-way commitment between government and citizen. Under this social contract, the federal government would agree to make it financially possible, through refundable tax benefits or in some cases by providing access to public-sector health programs, for every American family to purchase at least a basic package.... In return, government would require, by law, every head of household to acquire at least a basic health plan for his or her family. Thus there would be mandated coverage under the Heritage proposal, but the mandate would apply to the family head, who is the appropriate person to shoulder the primary responsibility....
The Heritage proposal also would allow complete portability of a workers health coverage, since it would no longer be tied to the place of employment If a worker changes jobs, or has a spell of unemployment, he or she wo uld not lose the insurance or have to change coverage, nor would his or her family face the possibility of exclusions for pre-existing conditions and similar insurance restrictions common today when a worker changes jobs an health benefits....
Under the Heritage proposal, the government would give generous refundable tax credits to families facing high premiums or out-of-pocket expenses. And since the higher-risk family thus would be able to afford the higher premiums needed to provide extra services, that part of the insurance market would be... attractive to insurers... insurers and hospitals under the Heritage proposal would develop special health plans, including insurance and specialized medical services, for Americans with chronic medical problems.... These plans would be far better products for these special-needs Ameri cans than the typical one-size-fits-all-employees company plans...
The last constructive contribution Stuart Butler made to the health care reform debate appears to have some last... June 26... when he wrote that:
Senate Finance "MedPAC" Health Proposal Needs Savings Guarantee
But by July 1, 2009 we findStuart Butler was denying the "refundable above the line tax credit" part of his own previous proposal:
How to Design a Tax Cap in Health Care Reform: The Obama Administration and congressional Democrats have recently opened the door to a change in the tax treatment of employer-sponsored health benefits as part of health care reform.... A threshold principle in designing a cap on the tax exclusion... is that... revenue raised from a tax cap from some workers should go to other taxpaying workers to help pay for coverage. The revenue should not go toward... subsidies to families below the federal tax threshold...
And by July 31, 2009 Butler looks to have gone into full hack mode:
Big Bang Approach All Wrong for Health Reform: We must and can get health reform. But it will never be achieved if Americans are pressured to agree to Big Bang change on a ridiculously short timetable--and based on central planning, rather than on better incentives for American creativity and federalism.
He still does not seem to have come out. Too bad. He's a smart guy and could make a real contribution to implementing ObamaCare: a plan that, after all, he was backing on behalf of the Heritage Foundation within the memory of man...
