White Paper Proposal 3: Business


The individual insurance mandate is applicable to virtually every American business, so I must evaluate the American insurance market as a whole as opposed to just one specific business/company.  The source that I will be utilizing in order to do this is the U.S. Chamber of Commerce website.  Although this source tends to lean to the right, it does offer valuable insights and opinions regarding the positives and negatives of the mandate as well as suggestions for the future.

The source is especially useful because it includes links to the reports that it cites.  A particularly interesting report is from the National Health Expenditure projections between 2010-2020.  It says that health spending as a percentage of GDP remained constant 2009-2010, but is expected to grow faster 2011-2013 due to an improving economy, and even more so in 2014 due to the enactment of the ACA.  Also in 2014, Medicaid enrollment is expected to increase by 19.5 million people due to a change in eligibility requirements (138% of the federal poverty level).  New health insurance exchanges are expected to provide insurance to an additional 13.9 million Americans in 2014 as well.  Expanded coverage is expected to result in more money being paid to physicians and less to hospitals and long-term care because the newly insured people will be younger and healthier than current people covered by exchanges are.  It is, however, somewhat worrisome that healthcare spending between 2010-2020 is expected to outpace GDP growth by 4.7%.

While increasing health insurance coverage is ultimately beneficial to the American health system, the Chamber of Commerce does point out the problem that the expanding coverage does not take the rising costs of healthcare into account.  The U.S. government is actually currently facing over $36 trillion in debt resulting from Medicare coverage.

The Chamber of Commerce website also has a section that offers suggestions for improving the nation’s healthcare debacle, which could be useful in the policy suggestions portion of my final white paper.  The general suggestions include things like: repeal the ACA mandate (probably not the direction I will choose to go, but worth looking at), expand access to care, make plans more attractive to small businesses by increasing transparency and flexibility, fix reimbursement so that it rewards quality over quantity (this will include increased compensation for physicians), address medicare and Medicaid fraud (I think this is an excellent idea, but will have to conduct further research to learn more about the methodology), and offer benefits to companies that provide wellness incentives to employees (this may include a fitness center at work, smoking cessation support, etc., I also am particularly fond of this suggestion).


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