The Show-Me Institute, a St. Louis-based free market think-tank, joins the health care debate with the unveiling of a study featuring a Missouri perspective on the prognosis for national health insurance. The study outlines concerns about proposals to expand the role of government in the health care market. But, more importantly, it puts forward proposals for expanding access to health care and cutting costs.

"Clearly, health care is a huge expenditure," said Jenifer Zeigler Roland, the Show-Me Institute’s Director of Policy. "Whatever reform is passed on the federal level is going to have implications at the state level because if it’s expansion of Medicaid or Medicare that is going to require Missouri to meet costs or extend coverage or if it has to do with regulations or mandates, there’s going to be a cost at the state level, as well."

The Show-Me Institute, like the Obama Administration, acknowledges the current health care system is broken, but proposes free market solutions to fix what is broken. Roland points to what the Institute calls "the health care wedge" as standing in the way of the free market system working.

"The sorts of things that create a health care wedge are government mandates, insurance mandates and regulations that keep the insurance industry from having the freedom to offer lower cost or higher deductible policies," said Roland.

The study offers recommendations for dealing with the health care wedge, such as encouraging individual ownership of insurance policies, instead of having third party employer-based insurance.

"If you purchase that insurance on your own you don’t have to risk losing it if you lose your job or if you move to another job," said Roland. "It takes away a lot of that uncertainty."

Other proposals include reforming tort liability laws, reallocating the majority of Medicaid spending into simple vouchers for low-income individuals, reducing the number of mandated benefits that insurers are required to cover, and allowing interstate purchasing of insurance.

As for costs, the study concludes greater government involvement in the health care system would impose an additional financial burden of $4,382 on every man, woman, and child in Missouri during the next decade. That estimate is based on what Show-Me Institute economists see as a projected 8.9 percent increase in national health care expenditures by 2019, an increase in medical price inflation by 5.2 percent above what it would have otherwise been by 2019, and a 5.6 percent increase over the next decade in total federal expenditures – provided the extra expenditures are not financed by a tax increase. 

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