Who Decides “Essential” Health Care Benefits?


What’s In The GOP Health Care Plan For Americans?

GOP Health Care | Photo Credit Fox News

The GOP Health Care Plan has been reported on a great deal, but most of the stories fall within the politics and procedures. For individual Americans, however, what’s most important is what’s actually within the benefits.

Rather than focusing on the winners and losers of the political debate over the bill, Americans want to know how this new bill will truly help Americans. Beyond help, are there also points that hurt Americans?

Doctor Reveals Truth About Health Care Plan

GOP Health Care | Photo Credit Fox News

According to Dr. Marc Siegel:

This bill “would get rid of the individual mandate and the business mandate where you go to the doctor and you’re stuck with one of two choices. You’ve got an insurance policy that has essential benefits, a very high premium, a very high deductible, a narrow network of choices, and it’s dysfunctional.”

“Now we’re in a country where five percent of Americans are paying for 50 percent of the health care. So you can imagine that there’s a counter argument that says, these policies should not be loaded up with everything. It should not be cost-sharing, [nor] should it be spread across the entire population.”

“So what we’re seeing in the American health care act, now, in its final form through the House, are that the essential benefits have been stripped out, and shifted through the states, with the federal government giving 15 billion dollars to the states. I predict that that might bring down premiums.”

What Are Essential Benefits?

GOP Health Care | Photo Credit Fox News

At this point, the question is whether or not the government should be determining “essential” benefits when the market would do a better job. Basically, everyone should have emergency services, vaccinations, and epidemics, but the government doesn’t need a role in every single health benefit.

NYU Medical Center Professor Andy Slavitt also added:

“I recognize that the individual mandates are not very popular, but neither are the vegetables for my kids, but sometimes you’ve got to find something to keep this thing healthy. If you want to cover all Americans and you want to cover pre-existing conditions, then you have to find a way to keep people in the pool.”

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