Politics: Some other random thoughts on health care reform

Can vouchers and tax credits to help lower income people buy insurance slowly replace the existing Medicaid program which is going broke? Could that also eventually be tried to transition out of Medicare which is also going broke?

As a general rule, taxes should be broad based. If all will benefit, all should pay. As it is, the current reform bill has all sorts of taxes on narrow groups: "cadillac" insurance tax, the wealthy, fees on brand name drugs, medical devices makers, tanning bed companies, insurance industry, etc.

They say it is "fair" to tax these groups. I think it is fair when something that benefits all is paid for by all.

Health insurance exchanges (HEI) are an interesting idea.

In essence, the Federal Employee Health Insurance Benefits Program is an HEI.

The tough question is how you structure the HIEs.

Does it have the light hand of helping buyers get clear information to make choices on insurance?

Or will it have a heavy hand of regulation?

Potential pitfalls would be the power to cap rates and mandate benefits as the ticket to enter the HIE.

Speaking of a regulation that could be heavy handed, came across the news that there will be a Federal Health Insurance Rate Authority as part of the reform.