| Plan |
Heritage Foundation Design Principles for a Patient-Centered, Consumer-Based Market | |
| Date |
April 2008 | |
| Overall Approach |
Six principles for patient-centered, consumer-driven health care reform: individual consumers as key decision makers; individual ownership; individual choice; wide range of available choices; price transparency; regular opportunities to make coverage choices. | |
| Universal Coverage |
Yes | |
| Guaranteed Coverage |
Yes | |
| Portability |
Yes | |
| Voluntary Employer-Based System |
No | |
| New Programs |
Not addressed | |
| Expansion of Existing Public Programs/Federal Law |
Not addressed | |
| Insurance Pool |
Not addressed | |
| State Responsibility |
Not addressed | |
| Individual Mandate |
No | |
| Employer Mandate |
May include automatic payroll deduction
May include assisting their employees with information and guidance in making health care choices
May include provision of workplace clinics; health promotion programs; information on the costs, risks, and benefits of common treatments; and comparative data on the quality and results of health care providers | |
| Private Insurance Mandates |
Prohibited from increasing rates for change in health status
Required to accept all customers regardless of their individual health status
Required to adhere to a standard set of basic rules for reporting premiums | |
| Individual Subsidies |
Provide disadvantaged individuals with the necessary funds to buy into the same consumer-centered system that everyone else uses | |
| Individual Vouchers |
Not addressed | |
| Employer Subsidies |
Not addressed | |
| Individual Plan/Provider Choice |
Yes | |
| National Health Board |
Not addressed | |
| Tax Changes |
Not addressed | |
| Premium/Co-Pay/Deductible |
Not addressed | |
| Health Quality Improvement |
Not addressed | |
| Information Technology / Electronic Medical Records |
Not addressed | |
| Individual Responsibility for Health and Lifestyle |
Yes | |
| Preventive care |
May include premium discounts for participation in wellness or disease management pro grams, or cash rebates to subscribers who successfully meet agreed-upon health improvement goals | |
| Transparency |
Establish basic pricing rules for both provided services and insurance premiums, which enable consumers to comparison shop effectively | |
| Drug Reimportation |
Not addressed | |
| Medicare Rx Drug Price Negotiation |
Not addressed | |
| Medical Personnel Education |
May include inducements to health professionals to practice in rural or economically depressed areas | |
| Mental Health Parity |
Not addressed | |
| Other Provisions |
Limit provider rules beyond those necessary to ensure basic provider competence and patient safety
Limit regulations that needlessly micromanage providers, stifle innovation in clinical practices, or favor one set of providers over another
Limit micromanaging the market by imposing coverage mandates for specific conditions or treatments or by stipulating how plans must contract with providers | |
| Cost |
Not addressed | |
| Cost Containment |
A consumer-centered system begins to control costs because it creates increased pressure to justify costs better in terms of demonstrated benefit | |
| Financing |
Not addressed | |
| Source |
Edmund Haislmaier, "Health Care Reform: Design Principles for a Patient-Centered, Consumer-Based Market," Heritage Foundation, April 23, 2008 | |
