Fair Care

Solutions to fix the problem of the estimated 47 million Americans without health insurance usually entail the creation of yet another cumbersome government bureaucracy riddled with red tape. Authors J. Patrick Rooney and Dan Perrin take a different approach in their new book America’s Health Crisis Solved: Money-Saving Solutions, Coverage for Everyone.

Rooney, famed for creating the first health savings account (HSA) and former chief executive of Golden Rule Insurance Company, and Perrin, President of HSA Coalition, proposed a health care insurance plan they dubbed “Fair Care” that focuses on fixing the finance mechanism of the current health care equation. Fair Care aims to redistribute the money available in the government’s health care budget in what they deem a more “fair” manner by ceasing “tax givebacks” and giving out a refundable tax credit instead.

“The money is there,” Rooney and Perrin insist. “Let’s just distribute it differently—more fairly.”

The proposed refundable tax credit is tax-free money, and the authors suggest the federal government pay each family $5,000 per year and each employee $2,000 per year. This could be interpreted as a tax increase plus a subsidy, and the authors admit Fair Care requires that “those in the upper tax brackets will have a tax increase.”

Nonetheless, Roony and Perrin boasted that “Under Fair Care, Americans in the highest tax brackets would be treated equally. Today they are not treated equally; they’re treated better, since the tax forgiveness they receive on the employer’s contribution toward health benefits is generally greater than what they will receive from the refundable tax credit that would go to every American.”

This money would be available for all who are not already on a government-sponsored program such as Medicare or Medicaid. Specifically, the authors hope Fair Care would benefit the unemployed, the self-employed and those whose employers do not provide health insurance. It also could benefit those who do have employer-provided health insurance because “these people can use Fair Care dollars to pay for their employer’s plan, or they can opt out and buy their own if they don’t like their employer’s choice,” explained Rooney and Perrin.

They criticize the current system because the set-up for employer-provided health insurance leaves the consumer stuck with whatever plan, if any, the employer is offering.

“Today employees don’t have any choices except to take what is given—or not—by the employer,” Rooney and Perrin wrote. “With Fair Care, employees can purchase the health insurance they choose.”

In addition to introducing the Fair Care proposal, Rooney and Perrin also advocated reform in other sectors of the healthcare arena including fighting skyrocketing prices charged by nonprofit hospitals and championing medical savings accounts (MSAs) for seniors (HSAs are called MSAs when referring to people over 65).

According to their book, nonprofit hospitals “get away with the excessive prices and pay their chief executives huge amounts of money” by overcharging patients who are uninsured. Rooney and Perrin list numerous examples of average Americans who are billed sometimes ten times what an insured person is charged. One cited example that exemplifies such price gouging is Scott Ferguson, who received a bill of $67,000 for a heart treatment while the established price for those covered by Medicare was less than $8,000.

In response to cases such as Ferguson’s, Rooney and Perrin called for the establishment of fair medical prices in their book by increasing patient awareness of what constitutes a fair price tag and providing a how-to-guide on thwarting hospital harassment. Rooney and Perrin challenge nonprofit hospitals to stop acting in their own self-interest and “do what fairness and justice demand.”

The duo also argue, “Medical savings accounts for seniors would reduce the total cost of Medicare to the U.S. government of Parts A and B by 5 or 10 percent, eliminate the Treasury’s Part D costs, and make seniors happier.”

Rooney and Perrin posed the question: “Which would you prefer: insurance in which you had deductibles and copayments, or money in a savings account that fully covers your deductible until the insurance clicks in to pay the rest?”

Emily Miller is an intern at the American Journalism Center, a training program run by Accuracy in Media and Accuracy in Academia.