Former President Jimmy Carter's health care legacy
August 25, 2015 11:34 AM
Overview:
During his time in the White House, former President Jimmy Carter, who died XXXX, made the creation of a comprehensive program of national health insurance a top priority. In 1979, he proposed to Congress a National Health Plan. His plan never passed, but many of the plan's proposals have been enacted in some form or another by succeeding administrations, including in Obamas Affordable Care Act.
Protection from catastrophic expenses
No American should live in fear that a serious illness or accident will mean bankruptcy or a lifetime of debt.
Carters National Health Plan proposed that all employers would provide catastrophic coverage for full-time employees and their families, with subsidies to ease the burden on small businesses. No family would be required to pay more than $2500 for medical expenses in a single year. Americans who were not covered elsewhere could obtain affordable catastrophic coverage from a special Federal program. Under this special program, no one would be denied coverage because he or she is labeled a "bad medical risk."
Carters National Health Plan proposed that all employers would provide catastrophic coverage for full-time employees and their families, with subsidies to ease the burden on small businesses. No family would be required to pay more than $2500 for medical expenses in a single year. Americans who were not covered elsewhere could obtain affordable catastrophic coverage from a special Federal program. Under this special program, no one would be denied coverage because he or she is labeled a "bad medical risk."
Expanded benefits for the elderly
The cost of health care falls most cruelly on America's older citizens who, with reduced incomes, have the highest medical expenses, Carter said.
Under his National Health Plan, the elderly would have had unlimited hospital coverage and would be required to pay no more than $1250 for medical expenses in a single year. Physicians would also have been prohibited from charging elderly patients more than the allowable fee.
Under his National Health Plan, the elderly would have had unlimited hospital coverage and would be required to pay no more than $1250 for medical expenses in a single year. Physicians would also have been prohibited from charging elderly patients more than the allowable fee.
Improved program for the poor
Carters National Health Plan proposed to provide expanded benefits for the poor. The Plan would have extended comprehensive coverage-full physician, hospital and related servicesto all Americans with incomes below 55% of poverty ($4200 for a family of four at the time). In addition, persons with incomes above 55% of poverty would have been able to "spend-down" into comprehensive coverage if their medical expenses in a given year reduced their income to the eligibility level.
Health services for mothers and infants
Prevention is the best way to eliminate the suffering and cost of illness, and one of the most effective preventive health measures we can take is to assure health care for expectant mothers and infants, Carter said in his proposal to Congress.
Under his National Health Plan, employers would have been required to provide employees and their families with coverage for prenatal care, delivery, and infant care to age one, without any cost-sharing. He planned to expand this this coverage, eventually, to include children up to age six.
Under his National Health Plan, employers would have been required to provide employees and their families with coverage for prenatal care, delivery, and infant care to age one, without any cost-sharing. He planned to expand this this coverage, eventually, to include children up to age six.
Extended insurance coverage
Today, many employees and their families suddenly lose all health coverage when the employee is laid off or is between jobs, Carter said in his proposal. Under the National Health Plan, employer-based insurance policies would have been required to maintain coverage for 90 days after employment ends. In addition, employer-based policies would have been required to maintain family coverage for 90 days after an employee's death, and to cover dependents until age 26.
Cost containment
A renewed emphasis on cost containment must accompany new health benefits, Carter said. His National Health Plan proposed a $3 billion annual limit on hospital capital expenditures. The plan would also have provided for a mandatory fee schedule for physicians who serve health care patients.
The fee schedule will curb excessive inflation in physician fees and will reduce the disparities in fees paid to rural physicians as compared to urban physicians, and primary care physicians as compared to specialists, he said.
The fee schedule will curb excessive inflation in physician fees and will reduce the disparities in fees paid to rural physicians as compared to urban physicians, and primary care physicians as compared to specialists, he said.
Increased competition
Carters National Health Plan would have encouraged competition by giving employees and health care beneficiaries new financial incentives to enroll in HMOs or other cost-effective health plans. Employers would have been required to make equal contributions to the various health plans they offer their employees. Employees who choose more cost-effective plans would have been incentivized either by paying lower premiums, receiving additional compensation, or receiving expanded health benefits.
The federal health care program created under Carters plan also would have paid a fixed amount on behalf of elderly beneficiaries who chose to enroll in HMOs.
The federal health care program created under Carters plan also would have paid a fixed amount on behalf of elderly beneficiaries who chose to enroll in HMOs.
