HEALTH CARE REFORM: Thomas May Push Big Changes

      Rep. Bill Thomas (R-CA) told Health Legislation this week that he "was taken a little by surprise" by House Speaker Newt Gingrich's (R-GA) enthusiasm for his proposal that would change the tax code to shift health coverage from the current employer-based system to one in which individuals would get tax breaks "to purchase their own coverage in an all-encompassing private insurance market." Thomas said he is being urged by GOP leaders to "[speed] up the production line" so the bill can be introduced this session. He said his proposal is part of what Gingrich was urging when the Speaker told the House GOP's health care task force to focus on a "bolder" vision in its quest to reform the nation's health care system.

Details Not Included
      The details of the Thomas proposal have not been hammered out, but tentatively "the plan would end the tax break employers receive for buying workers' coverage and use a mechanism such as a refundable tax credit for individuals that 'would give all Americans the full dollar benefit' of the tax benefit" that employers now enjoy. Probable features of the plan include a universal community-rating provision and "individual mandates to buy insurance," Health Legislation reports. Thomas said the proposal could "solve two major problems of the current system -- continued erosion of the insured population and the bad habits fostered in patients, employers and providers by their ignorance of the true costs of health care." The plan could "potentially [replace] the publicly funded Medicare and Medicaid programs," and Thomas is seeking support for the proposal from the National Bipartisan Commission on the Future of Medicare, of which he is administrative chair. He claims that "dealing with the special needs of the elderly would be much simpler ... if all Americans have a basic health care package available to them" (6/3 issue).