GOP health alternative

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After months of criticizing Democrats' health-care reform plans, congressional Republicans have finally unveiled their alternative, an admittedly modest proposal that claims to lower premiums and expand coverage without major structural changes in the health system.

The GOP plan would reward states for reducing the number of uninsured, limit damages in medical malpractice lawsuits and allow small businesses to band together to buy insurance exempt from most state regulation.

Unlike the House Democrats' plan, the Republicans wouldn't require people to buy insurance or employers to offer it. They also envision no expansion of Medicaid or subsidies to help lower-income people purchase insurance. Neither would they bar insurance companies from denying coverage to people with pre-existing conditions.

The Republican initiative is certainly cheaper than the Democrats' plans, which over 10 years carry price tags of around $900 billion, although offset by savings and new revenue. But the GOP plan makes virtually no dent in the number of Americans without insurance. The Congressional Budget Office estimates that after 10 years 17 percent of the non-elderly population -- about 52 million people -- would lack coverage.

In addition, while the CBO validated Republican claims of lower insurance premiums, the reductions vary depending on whether people get coverage through small or large businesses or buy it themselves. And the lower rates are averages, which suggests a big difference in what the healthy and less healthy would pay. By weakening requirements that insurance cover certain services, the cheapest policies under the Republican plan won't cover much.

While Americans satisfied with the status quo should welcome the GOP plan, the current system, with its millions uninsured, which shifts medical costs onto the insured, and its emphasis on fees for service, which encourages unnecessary and expensive procedures, is unsustainable and demands the substantive change Democrats advocate.