Grace-Marie Turner
Grace-Marie Turner is president of the Galen Institute, a public policy research organization that she founded in 1995 to promote an informed debate over free-market ideas for health reform. She speaks and writes extensively about incentives to promote a more competitive, consumer-driven marketplace in the health sector.
The Galen Institute has been instrumental in promoting Health Savings Accounts and other consumer-friendly ideas that transfer power over health care decisions from bureaucracies to individuals.
In December of 2004, Grace-Marie was invited by President Bush to speak on HSAs and consumer-directed health reform at the White House Economic Summit. She recently was appointed by former HHS Secretary Tommy Thompson to serve as a member of the National Advisory Council of Healthcare Research and Quality.
Grace-Marie also is founder and facilitator of the Health Policy Consensus Group, which serves as a forum for analysts from market-oriented think tanks around the country to analyze and develop health policy recommendations.
She is the editor of Empowering Health Care Consumers through Tax Reform, published by the University of Michigan Press.
In 1995-96, Grace-Marie served as executive director of the National Commission on Economic Growth and Tax Reform. For 12 years, she was president of Arnett & Co., a health policy analysis and communications firm in Washington, D.C.
Her early career was in politics and journalism, where she received numerous awards for her writings on economics and politics.
Tuesday, October 7, 2008Paying Workers to go Abroad for Health CareBy Grace-Marie TurnerCategories: Medical TourismInsured Americans are starting to see some unusual options in their health provider networks: doctors and hospitals in Singapore, Costa Rica and other foreign destinations, writes The Wall Street Journal. Until recently, most Americans who traveled abroad for medical care were uninsured or were seeking procedures not covered by insurance, such as cosmetic dentistry or aesthetic surgery. Now, a handful of plans are beginning to cover treatment overseas for heart surgery, hip and knee replacements and other major surgical procedures. While medical tourism isn't expected to be a solution to the country's soaring health care costs, the practice is intended to produce savings for insurers, employers and workers. Open-heart surgery, which can cost roughly $100,000 in the U.S., can be done at an internationally accredited hospital in India for just $8,500, for instance. To make travel abroad more attractive, plans that offer medical-tourism programs often throw in a bonus for employees if they agree to undergo elective surgeries abroad, or they offer to split the cost savings between the employer and worker. Travel and accommodation costs also are sometimes reimbursed.
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Monday, October 6, 2008California Mandate v. the Supreme CourtBy Grace-Marie TurnerCategories: CaliforniaThe Ninth Circuit Court of Appeals, already notorious for having the highest reversal rate by the U.S. Supreme Court, is poised for another test after ruling last week that San Francisco's play-or-pay mandate for employers is legal. San Francisco passed a law in 2006 that requires most employers to provide health insurance to their workers or pay into a government fund. The Ninth Circuit ruled on Tuesday that the law does not violate the Employee Retirement Income Security Act (ERISA), a 1974 law that pre-empts state laws governing private employer-based health plans. "This decision opens the floodgates to every state and locality seeking to develop its own version of health reform, creating an impossible environment for major employers -- and the millions of American workers who value their employer-sponsored health plans," American Benefits Council president James. A. Klein said in a statement. Maryland passed legislation in 2006 that became known as the Wal-Mart bill that would have required all employers with more than 10,000 workers in the state to pay at least 8% of their payroll for health insurance. The Fourth Circuit said the law was invalid because it violated ERISA.
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Friday, October 3, 2008The Massachusetts Plan, On Your DimeBy Grace-Marie TurnerCategories: Massachusetts, MedicaidMassachusetts has won another round in its effort to get U.S. taxpayers to help fund its experiment in universal coverage. Gov. Deval Patrick announced Tuesday that the federal government has approved an extension of its waiver, allowing the state to continue to provide Medicaid subsidies to people making as much as $63,600 a year. Federal taxpayers will be paying nearly $11 billion to help the Bay State fund its $21-billion health reform plan over the next three years. Gov. Patrick has been boasting that 439,000 more people in the Bay State have health insurance since the reform law was passed in 2006. But at least 56% of them are getting free or heavily-subsidized coverage, jointly funded by the state and by federal matching Medicaid dollars. The jury is still out on how the state will juggle growing opposition to the individual mandate and soaring health costs, but U.S. taxpayers apparently will continue to fund the plan to see if it works. While the federal government would have been funding part of Massachusetts’s Medicaid program in any case, the big open question is how the government can now deny similar requests from other states that want to follow suit and also increase Medicaid eligibility to 300% of poverty -- $63,600. Before that happens, it might be wise to have a national debate on whether or not Medicaid should be the vehicle to expand taxpayer-funded health coverage to millions more middle-class Americans.
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Tuesday, September 30, 2008Making ithe Most of an HSABy Grace-Marie TurnerCategories: HSAs, etc. Forbes.com says "while the number of people using HSAs has grown in recent years, a lot of Americans are still leaving the option on the table. A recent article
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Monday, September 29, 2008The Ineffectiveness of Cost-Effectiveness CriteriaBy Grace-Marie TurnerThee use of cost-effectiveness criteria, while lowering the cost of health care in the short term, threatens to harm future patients by stifling vital medical innovations. So argue health economists Tomas J. Philipson and Anupam B. Jena argue in a book published by the American Enterprise Institute. Cost-effectiveness criteria:
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Friday, September 26, 2008Medical Licensing Makes Health Care More Expennsive, Less AccessibleBy Grace-Marie TurnerHealth care professionals sell medical licensing to Americans as a vital public health safeguard. But a new report from the Cato Institute argues that medical licensing not only fails to protect consumers from incompetent physicians; raising barriers to entry makes health care more expensive and less accessible. Consumers would benefit if states eliminated professional licensing in medicine, leaving education, credentialing, and scope-of-practice decisions entirely to the private sector and the courts. Without legislatively-mandated requirements or restrictions, hospitals and other providers could better adjust their workforces when demand shifts or when opportunities arise to reduce costs -- either by making care more convenient or by saving patients money -- while maintaining quality. The report is written by Shirley Svorny of California State University.
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Thursday, September 18, 2008What the Lack of a National Insurance Market is Costing YouBy Grace-Marie TurnerCategories: Insurance Regulation, New Jersey, WisconsinPublic officials and health care experts have suggested a number of reforms to reduce the cost of individual health insurance, but most of the proposals fail to address the contribution of mandated benefits to the high cost of insurance in many states, write Devon Herrick and Ariel House. Although most insurers operate in multiple states, their plans must be tailored to each state's specific requirements, resulting in fragmented markets and large price differences. For example, a family purchasing a health insurance policy in Wisconsin would pay about $3,087, but that policy would cost $10,398 in New Jersey. The difference in premiums is largely the result of state mandates that inhibit the creation of a national market, not regional variations in health care costs. Allowing residents to purchase coverage across state lines would create more competitive insurance markets, write Herrick and House. In addition, letting insurers experiment with different designs to create innovative and cost-effective health plans will decrease the number of people who cannot afford care
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Wednesday, September 17, 2008Who Uses Retail Health Clinics?By Grace-Marie TurnerCategories: Retail ClinicsA new RAND Health study examines the types of patients who use retail health clinics and the health care services delivered by the clinics, which they say are growing in number and popularity. Researchers analyzed details about more than 1.3 million visits to retail clinics from 2000 to 2007. Key findings:
Daniel Costello, a reporter for the Los Angeles Times, writes about retail clinics "bulls" and "bears" and their differing visions of where this new site of health care is heading. Costello also describes the history of retail clinics, drivers of growth, quality of care issues, and regulatory concerns.
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Tuesday, September 16, 2008Ending the Expansion of SCHIPBy Grace-Marie TurnerCategories: SCHIPLast year's SCHIP debate appeared to be less about providing affordable health care to low-income children than about bailing out states that had overextended their budgets, says Dennis G. Smith of The Heritage Foundation. Among the states that received nearly $1.3 billion in additional federal funds in 2006 and 2007 because of budget shortfalls, seven received 79% of the funds and covered children at high income levels, adults, or in some cases, both. Congress can return SCHIP to its original focus on uninsured low-income children by setting a firm cap on eligibility that applies to both SCHIP and Medicaid and by restoring fiscal discipline. Blindly expanding SCHIP up the income scale would eclipse the potential of other more desirable ways of expanding health coverage for children in lower- and lower-middle-income families -- especially refundable health care tax credits, an option that has already attracted a broad bipartisan and philosophical consensus.
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Monday, September 15, 2008When Tax Policy Shapes Employment ChoicesBy Grace-Marie TurnerMalathi R. Velamuri, a lecturer in the School of Economics and Finance at Victoria University of Wellington, examines whether the availability of health coverage through a spouse's health plan influences a married woman's decision to become self-employed. The Tax Reform Act of 1986 (TRA86), which introduced a tax subsidy for the self-employed to purchase their own health insurance, provides an opportunity to isolate the effect of the price of health insurance on employment-sector choices. The findings in this paper suggest that in the pre-TRA86 period, the high cost of health insurance created a significant wedge in the price of health insurance between the wage-salary sector and self-employment. Women who had a preference for working in the self-employment sector and who enjoyed spousal health benefits were able to exercise their preference and select into self-employment. On the other hand, for some women with a preference for the self-employment sector but restricted in purchasing their own health insurance, it was too costly to opt for this sector. For these women, the TRA86, by narrowing this price wedge, lowered the price of selecting into their desired sector of employment.
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