Dr. Emanuel proposes new health care system

December 11, 2008 7:56:20 PM PST
The status of the nation's healthcare system and why it needs improvement is the subject of a book that's getting a lot of attention these days. In fact, one high-ranking member of the Obama Administration calls the plan "a game changer."

The book is "Healthcare Guaranteed" by Dr. Ezekiel Emanuel. In it, he outlines how a labor shortage after World War II shaped our current health care system and he suggests a plan for how we might move forward.

A lot has changed since U.S. troops came marching home from World War II. We don't drive the same cars or don't sit around the living room radio, but we are dealing with the same employer-based health care system.

"It was a way around the wage and price controls of World War II to allow employers to attract workers, so it was a make do arrangement during a very stressful war time situation," said Dr. Ezekiel Emanuel, Ph.D., the director of Bioethics the National Institutes of Health.

Dr. Emanuel says after the war many Americans expected to spend their careers at a single company.

"And so having your insurance, as well as your pension, tied to one employer was not a big surprise," said Dr. Emanuel.

But now Americans change jobs rapidly. Not all employers offer good health care benefits and Dr. Emanuel says the system is dysfunctional.

"A lot of people are inhibited from quitting work or starting their own company because of health insurance issues; we also know that it's actually suppressed wages," explained Dr. Emanuel.

General Motors, for example, figures every car they make costs $1,500 more because of the money they have to pay in healthcare coverage. And then there are the health care taxes we pay.

"We're paying for Medicare in a tax, we're paying for Medicaid through a tax," said Dr. Emanuel.

In his book, Dr. Emanuel outlines a new idea to give everyone a voucher that pays for standard health care benefits, offer a choice of plans, fund the plan though a value added tax of 15 to 16 percent, eliminate the tax benefits for employer paid plans, and phase out Medicare, Medicaid and SCHIP.

"Workers would have higher wages, decrease in state taxes, decrease in Medicare tax, and in exchange there would be a value added tax," said Dr. Emanuel.

And his plan is reaching the highest levels of the Obama team, in part because Dr. Emanuel's brother is Rahm Emanuel, Barack Obama's new chief of staff. Rahm has called his brother's plan a game changer.

"We talk about a lot of things, but I think look, this is going to be the big issue with health care reform, as we look forward, is one of politics and getting something passed," said Dr. Emanuel.

Rahm Emanuel is not enthusiastic about getting his brother's plan passed because there would be too much fear over things like phasing out Medicare and Medicaid. When the economy improves, Dr. Ezekiel Emanuel is hoping people will see the advantages.

By the way there is a third brother, Ari, who is just as famous in some circles.

You can read about the Emanuel brothers in The Back Story.


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