National Health Care: Law, Policy, Strategy

By Donald L. Westerfield | Go to book overview

6
"Pay-or-Play" Proposals
in Congress

We discussed the concept of the "pay-or-play" plans and the notion of employers and given categories of employees having to subsidize other employers and other categories of employees, especially under the community rating mandate. On the surface, it would seem reasonable to expect all employers would be willing to offer some sort of basic health care packages to their workers, especially if the premiums were uniform across large categories of employers, if the plans were guaranteed renewable, and if it were mandatory for at least some insurers to provide the basic health care plan to all employers.

Those who propose the mandatory "pay-or-play" health care plans base their arguments for employers adopting such plans on some existing facts observed in federal and state regulations related to employee benefits. It is a fact that the federal and state governments already regulate at least some portion of employee benefits, irrespective of the size of the employer. It is a fact that about 62.5% of the uninsured and underinsured are part-time or full-time workers. There is a popular, but as yet unproven, argument that a happy worker is a productive worker, and, presumably, if workers receive more benefits they are happier and more productive.


PEPPER COMMISSION PROPOSALS--
ROCKEFELLER, WAXMAN

Before formally discussing the actual Pepper Commission proposals by Senator John Rockefeller and Representative Henry Waxman, it is

-67-

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National Health Care: Law, Policy, Strategy
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Figures and Tables xi
  • Preface xiii
  • Part I - National Health Care Issues 1
  • 1 - Introduction 3
  • Notes 11
  • 2 - The Uninsured and Underinsured 13
  • 3 - Underwriting, Impaired Risks," and Pooling" 29
  • 4 - Play or Pay" and Subsidies" 43
  • Part II - Health Care Proposals in Congress 53
  • 5 - Major Universal" Plans in Congress" 55
  • 6 - Pay-or-Play" Proposals in Congress" 67
  • 7 - Health Care Reform Proposals in Congress 79
  • Part III - Special Interests, the Law and Political Posturing 91
  • 8 - Special Interests and Legislation 93
  • Notes 100
  • 9 - The Law--Federal Mandates 103
  • 10 - Obstacles Faced By Small Businesses 115
  • Part IV - National Policy and Strategies 127
  • 11 - Other National Models 129
  • Notes 140
  • 12 - Rationing Policies and Strategies 143
  • Part V - A National Health Care Plan 151
  • 13 - Workers Compensation 153
  • 14 - Proposed National Health Care Plan 161
  • 15 - Between Now and 2000 A.D. 171
  • Bibliography 177
  • Index 197
  • About the Author *
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