Improving Healthcare and Controlling Its Costs

Topics

Reducing Healthcare Costs & Expanding Access for Americans

Protecting Medicare for Today’s Seniors & Modernizing It for the Next Generation

Reducing Healthcare Costs & Expanding Access for Americans

Our healthcare system is under threat in America, with out-of-control costs, reduced access to health services, and millions without health insurance. While some say that Obamacare, also known as the “Affordable Care Act,” is the solution, the facts show otherwise—as it raises costs and harms our fragile economy. Not only must conservatives continue to fight Obamacare, as costs continue to rise and middle class wages stagnate, it’s absolutely critical that we address this cost issue, which amounts to a pay cut for many working families.

Americans deserve a healthcare system where insurers compete for our business, keeping prices down and quality high, and allowing Americans to see the doctor of their choice. We need to make prices transparent, so Americans aren’t left in the dark when it comes to the price they’re paying for the services they use. We need to allow small businesses to pool together to offer healthcare at a lower cost, and we need to let insurers compete with one another across state lines. Most of all, we need to put patients first, empowering Americans to choose the kind of affordable insurance that’s best for them and their families.

YG Network Poll Data:

72% of Americans are worried the cost of health insurance will increase under Obamacare (May poll).
- Conservatives: 89%
- Moderates: 71%
- Liberals: 54%

65% agree that “higher health insurance premiums paid by employers mean lower wages for workers” (May poll).

62% are worried they won’t be able to receive care from the doctor of their choice (May poll).
- Conservatives: 79%
- Moderates: 66%
- Liberals: 37%

57% are worried they will not be able to keep their current healthcare plan (May poll).
- Conservatives: 74%
- Moderates: 55%
- Liberals: 37%

YG Network Focus Group Data:

“Obamacare is putting our healthcare in jeopardy.”
– Tea Party participant, Palm Beach
“Obamacare (isn’t good for the middle class). Part of my job is choosing health care plan for 35 employees. They are preparing us for shock, saying we will see 100% health care increases.”
– Swing participant, Phoenix
“Obamacare was an incentive for wages not to go up.”
– Swing participant, Palm Beach

YG Network Dial Tests:

Respondents are very concerned about the direction of our health care system, and out-of-control costs are hurting middle class families. While respondents find some intentions of the Affordable Care Act appealing, they are concerned about the future of health care, and they think we indeed can do better than the Affordable Care Act. Respondents support having a different approach to health care. They believe that choice and competition will control health care costs and improve outcomes.

WHAT:	WHY:
Description of the health care problem
“Health care is an issue that affects each of us. Our broken health care system has created a crisis in America that has led to out-of-control costs, less access to health services, and millions without health insurance. The liberals’ solution to the health care crisis is the Affordable Care Act, also known as Obamacare. It’s a solution that puts quality medical care in jeopardy.”	Respondents are very concerned about the direction of our health care system, and the out-of-control costs are hurting middle-class families.
Premiums
“President Obama promised that this law would reduce health care costs. But despite these claims, under the Affordable Care Act, health insurance premiums are continuing to rise significantly. In Vermont, they will rise by 10% next year. In Rhode Island, by 18%, and in Maryland, by 25%.”	Respondents are not experiencing the reduced health care costs that President Obama promised. In fact, many have seen their health care premiums skyrocket since the law was passed.This is designed to focus on the theme that there are differences between what President Obama promised and what is really happening in our health care system.
Age rating
“A study from the American Academy of Actuaries reports that starting in 2014, the insurance premiums of 21-29 year olds in the individual market will rise between 10% and 20%. This is because of Obamacare rules that require insurers to charge their oldest customers no more than three times as much as their younger ones. Basically young people just out of school, starting families, paying off student loans, trying to save to buy a house—they have to pay higher premiums for elaborate plans they don’t want or need so older people, who usually require more health care,can pay less. It doesn’t seem fair.”	Respondents think that it’s unfair that younger people will have to pay higher health insurance rates so that older customers, who typically require more health care services, can pay lower rates.
Losing current plans
“President Obama promised that if we liked our current health care plans, we’d get to keep them. Instead, the Congressional Budget Office estimates that between 5 million and 20 million Americans will lose their current plans because of Obamacare. Why? Many employers will find it more feasible just to pay the tax penalties for not providing health insurance to their employees.”	Respondents are concerned that some workers are not going to be able to keep their current health care plans because it will be more cost feasible for some employers just to pay the tax penalties for not providing health insurance to their employees.This is designed to focus on the theme that there are differences between what President Obama promised and what is really happening in our health care system.
New taxes in the health care law
“President Obama promised us that this law would reduce costs and help our economy. But the law includes at least 20 new taxes, including one on medical equipment. So if you need a pacemaker to stay alive, or you’re a wounded warrior and need an artificial limb—it’s going to cost more. That’s wrong.”	Respondents are concerned about the new taxes included in the Affordable Care Act. They are particularly concerned about the new tax on medical equipment, which makes it more difficult for the people who rely on medical equipment to improve their lives.This is designed to focus on the theme that there are differences between what President Obama promised and what is really happening in our health care system.
Part-time workforce
“And many employers are cutting employees’ hours from full-time to part-time to avoid the costs associated with the health care law. How does that take care of the working poor?”	This is designed to focus on the negative economic impacts of the Affordable Care Act. Fewer hours means lower take-home pay for workers.
The Affordable Care Act
“There are some good intentions in the law, such as the desire to take care of the health care needs of the uninsured, and those with pre-existing conditions. But the law is proving to be a massive and complex mess. We can do better.”	While respondents find some intentions of the Affordable Care Act appealing, they are concerned about the future of health care, and they think we indeed can do better than the Affordable Care Act.
A different health care approach
“Let me offer a different approach that focuses on providing the highest quality of care, while reducing costs through increased competition, improving outcomes, and expanding choices. To start off, we need a health care system where health insurers compete for our business, forcing them to keep their prices down.”	Respondents support having a different approach to health care. They believe that choice and competition will control health care costs and improve outcomes.
Transparency
“And then we need to make prices transparent, so people know how much they’re paying for the services they’re using.”	Respondents believe that transparency is important to controlling health care costs. People need to know how much they are paying for the care and services that they are receiving so they can make more informed decisions about the health care they seek.
Fostering competition
“We need to allow small businesses to pool together to offer health care at lower prices. We need to allow Americans to buy policies across state lines, to foster more competition so we can bring prices down and encourage greater quality of care.” AND “We need to empower patients to choose, through competing health plans, the kind of insurance that’s best for them. Competition will do a better job of controlling costs and providing quality of care than heavy-handed Washington regulations.”	Respondents believe that these are viable ideas for fostering competition and keeping health care costs down.
Promoting wellness
“We need to promote wellness and prevention by giving employers greater flexibility to reward their employees for healthy lifestyles.”	Respondents support the idea of promoting wellness and prevention because those ultimately reduce health care costs.
Tax credits
“Right now, the tax code penalizes Americans who have to buy their own health insurance. What would be fairer would be to provide insurance tax credits for all Americans, not just employers, so they have the resources to buy the plans of their choice.”	This addresses respondents’ concerns about fairness. They think that Americans who have to buy their own health insurance should have the same tax credits as employers so that all Americans are treated fairly.
Small businesses
“Despite the administration’s controversial decision to delay forcing companies to join Obamacare for a year, the U.S. Chamber of Commerce says three-quarters of small businesses are planning to duck the costly law by firing workers, reducing hours of full-time staff, or shifting many to part-time. This is no way to run a healthcare system.”	Respondents are concerned about the negative economic impacts of the Affordable Care Act. This is designed to focus on a very credible source—the U.S. Chamber of Commerce—that is expressing significant concerns about the impacts of the health care law.
Increasing affordability
“We all want a healthy America. And when Americans get sick, we all want them to receive the best care possible, and we all want that care to be affordable. We need to focus on health care reforms that will increase affordability, treat everyone fairly, and provide the flexibility for Americans to make the best health care decisions for themselves and their families.”	This language summarizes the entire argument for reducing healthcare costs and expanding access for Americans.

Protecting Medicare for Today’s Seniors & Modernizing It for the Next Generation

This much is sure: Medicare is running out of money and time is running out to fix it. We need innovative approaches to protect Medicare for seniors—both today and in the future—because if Medicare goes broke, it can’t help anyone. Respondents agree, when informed of Medicare’s unsustainable path, that to protect this critical program we need to give future Medicare recipients the flexibility to shop for the best coverage among a set of quality plans—plans that would compete for their business and which offer guaranteed minimum benefits. American seniors deserve affordable, high-quality medical care, and with smart reforms, we can continue to deliver that needed care.

YG Network Poll Data:

Only 39% agree that “Medicare spending has to be reduced to get the debt under control,” while 54% disagree (May poll).
- Conservatives: 47% agree to reduce Medicare spending, 45% disagree
- Moderates: 40% agree to reduce Medicare, 55% disagree
- Liberals: 30% agree to reduce Medicare, 64% disagree

By a two to one margin, respondents favor modernizing Medicare by providing choices to consumers so competition can control costs and the economy isn’t burdened by higher taxes (59%) over the federal government raising taxes on wealthy seniors and limiting payments to doctors and hospitals to avoid fundamental changes to Medicare (30%) (May poll).

When informed that Medicare is on an unsustainable path to insolvency, 65% favor reducing benefits for seniors with higher incomes (March poll).
- Conservatives: 63% reduce benefits
- Moderates: 65% reduce benefits
- Liberals: 68% reduce benefits

53% favor gradually raising the eligibility age from 65 to 67 for future retirees (March poll).
- Conservatives: 59% favor
- Moderates: 49% favor
- Liberals: 50% favor

56% believe that Medicare eligible seniors should be allowed to use government subsidies to stay on their private health plans instead of automatically enrolling in Medicare (March poll).
- Conservatives: 66% allow subsidies
- Moderates: 52%
- Liberals: 50%

YG Network Focus Group Data:

Focus Group participants felt that Medicare needed reforms, but were only vaguely familiar with how it works or what it costs.

“It’s shaky. I don’t know if it’s financially sound.”
– Swing participant, Manassas
“More competition to bring prices down.”
– Swing participant, Minneapolis
“I just had a CT scan and it was covered so I have no idea what it costs.”
– Swing participant, Manassas

YG Network Dial Tests:

Protecting Medicare comports with respondents’ values because we are keeping a promise to our seniors by helping them get the health care they need, and we are helping the most vulnerable. Also, respondents strongly agree with the idea that seniors have earned their Medicare benefit after paying into the system all of their working lives. It is not a handout. When informed that Medicare is on an unsustainable path, they understand that changes need to be made for the program to continue serving seniors well. It’s important to respondents that those age 55 and older will have the peace of mind of not having any changes to Medicare. Respondents believe that market competition will help control costs, and they liked the description of the Medicare Part D model and how that could be used to create choice and competition in all of Medicare.

WHAT:	WHY:
Saving Medicare
“We need some innovative approaches to save Medicare, and thereby give peace of mind to the seniors of today—and tomorrow.” AND “And it’s really not fair that people who have paid into Medicare all through their working years face an uncertain health insurance future. Medicare is a benefit that our seniors have earned.”	The idea of protecting Medicare comports with respondents’ values because we are keeping a promise to our seniors by helping them get the health care they need, and we are helping the most vulnerable. Also, respondents strongly agree with the idea that seniors have earned their Medicare benefit after paying into the system all of their working lives. It is not a handout.
The challenge we face with Medicare
“The program has paid out more than it has taken in for years. That trend will worsen as the American population ages, the Baby Boomers retire, and the proportion of Americans under age 65 shrinks. And the longer Congress and the President wait to deal with it, the more painful the solutions will be, according to the Medicare trustees. This isn’t news. We’ve known for years about this problem. Why hasn’t anything been done about it?”	Respondents agree that as the Baby Boomers retire, more seniors will enroll in the program, and waiting to reform Medicare to put it on a sustainable path will lead to painful consequences.
Medicare reimbursements
“Actually, since the 1970s, attempts have been made to reform Medicare. One supposed fix that has been tried several times, and is being tried again through the Affordable Care Act, or Obamacare, is price controls. Medicare will simply limit the reimbursement paid to doctors and hospitals. That’s wrong. Reducing reimbursements can force doctors to lose money every time they see Medicare patients. A doctor facing a break-even or deficit situation might decide to limit how many Medicare patients she takes, or the amount of time spent with each patient. Reduced access to physicians and lower quality care is not an acceptable solution. It’s not fair for the government to be limiting patient access to doctors.”	Respondents believe that it is unfair for doctors to just break even or even lose money when they see Medicare patients. They are concerned that limiting the reimbursement paid to doctors and hospitals that treat Medicare patients will reduce seniors’ access to doctors, which goes against the value that respondents have of caring for seniors.
A better idea for protecting Medicare
“So, here’s a better idea for protecting Medicare: Let’s keep it from going broke, because if it’s broke, it can’t help anyone. To keep costs in check, we need to give future Medicare recipients the flexibility to shop for the best coverage among a set of quality plans—plans that would compete for their business—and that offer guaranteed minimum benefits.” AND “Our plan preserves Medicare, improves quality, and controls costs by allowing seniors to make choices about their own health care.”	Respondents recognize that Medicare is on an unsustainable path and that changes need to be made for the program to continue serving seniors well. Respondents believe that market competition will help control costs, and they liked the description of the Medicare Part D model and how that could be used to create choice and competition in all of Medicare.
The Medicare Part D model
“Something similar has been tried in one part of Medicare, and it’s actually succeeded. I’m talking about Medicare Part D, the prescription drug benefit enacted in 2003. Under Medicare Part D, seniors are presented with private prescription-drug coverage options, with different premiums and deductibles. They get to choose the plan that best fits their needs. The federal government applies a certain amount of money toward their preferred plan. If seniors choose plans that cost more than the money they’re allotted, then they can make up the difference themselves. A survey published last October shows that 90 percent of seniors are satisfied with Medicare Part D. A government service with high levels of satisfaction is pretty amazing. Even more amazing is that Medicare Part D’s actual costs have been lower than government projections. Premium costs are 27% lower than anticipated. Part D costs are 40% lower than the Congressional Budget Office initially predicted. That’s unheard of in a government program. Government programs always cost more than initially predicted. That’s the potential power of market competition.”	Choice and competition are appealing to our respondents. They want to be able to choose the plan that best fits their needs, and among those familiar with Medicare Part D, they believe that the Part D model could be used for all of Medicare. They also like that the Part D costs are lower than initially predicted, which shows that choice and competition work.
People age 55 and older exempted
“Our proposal first and foremost strives to preserve quality medical care for seniors. In America we must take care of the most vulnerable. It also seeks to preserve the peace of mind of seniors already receiving or about to receive Medicare. To that end, for those who are age 55 or older, our proposal preserves Medicare in its current fee-for-service form. No one who is in the system or near the system is going to experience any change.”	Respondents like that those age 55 and older will have the peace of mind of not having any changes to Medicare.
People under age 55 included
“Our challenge is to preserve these health care benefits for the next generation of retirees. They will have the option of a new type of Medicare that will allow for more choice, save the government money, assure the long-term viability of the program, and protect them when they’re old. Workers who turn 65 in 2024 or later could choose traditional fee-for-service Medicare, or they could direct a federal subsidy, adjusted for inflation, toward health insurance provided by a private company. Just like Medicare Part D, there would be a wide variety of pre-approved plans with guaranteed minimum benefits to choose from. Under our Medicare proposal, if they choose a plan more expensive than the subsidy they would have to pay the difference; if they choose a less expensive plan they would get a rebate. Just as in Part D, private companies would be competing for seniors’ business and would have incentives to keep costs low by rooting out waste and fraud in the system.”	Respondents support the idea of having choice to meet their health care needs. Also, they believe that market competition will incentivize private companies to root out waste and keep costs low, which will lead to lower health care costs.
The liberals’ plan for Medicare
“Liberals in Congress talk about protecting Medicare, but, again, Medicare can’t help anyone if it runs out of money. They are committed to the status quo—an unsustainable, one-size-fits-all Medicare program that does nothing to encourage choice and competition, and controls costs only by reducing quality and access.”	Sustainability is important. Everyone wants to protect Medicare for the long-term, and respondents believe that the status quo is not a long-term solution to the challenges that Medicare faces.
Allowing seniors to opt out of Medicare
“Speaking of choices, some seniors would like to opt out of Medicare and make their own accommodations for health care. But according to rules that date back to the Clinton Administration, any senior that opts out of Medicare loses his or her Social Security benefits. All of them. This doesn’t seem fair. After all, they’ve been paying into the Social Security trust fund for decades. They’ve also been paying into Medicare. But they’re not asking for that money back. Allowing seniors to opt out of Medicare will save the system money. When the federal government has to pay for the health care of fewer seniors, that saves money. Even those over the age of 65 should have the freedom to manage their own health care—without the government interfering.”	Respondents agree that allowing seniors to opt out of Medicare could be beneficial because it would save the government money by providing health care coverage to fewer seniors.