health care reform three stoogesPresident Obama has made Health Care Reform the heart of his domestic agenda, pledging health insurance reform and coverage for almost all Americans. Health care reform would grant subsidies to those who cannot afford health insurance, strengthen consumer protections, increase funding for prevention and wellness programs, give tax credits to small businesses that provide their employees health coverage and initiate new health information technological strategies. Obama has said he would “establish a new public insurance program” alongside private health care plans. To paraphrase recent statements, “We have taken over the auto companies, banks, A.I.G. and student loans – now it’s health cares’ turn.”

Promising “billions and billions” in savings by reducing administrative costs, improving preventive medicine and chronic disease management, digitizing medical records and fees and higher taxes on the insurance companies, Obama had indicated during the Presidential debates that he would, “Allow consumers to import safe drugs from other countries” because “some companies are exploiting Americans by dramatically overcharging U.S. consumers.” (The administration has since caved-in to the pharmaceutical industry and secretly agreed to oppose the importation of cheaper drugs.)

The proposed reforms could actually mean higher premiums for Americans. The insurance industry has warned that the $6 billion industry-wide fee and other taxes will be passed on to consumers.

The legislation would basically expand health care coverage in four ways:

  • Increase the number of people who qualify for Medicare (e.g. dropping eligibility age from 65 to 55)
  • Increase the number of people who would qualify for Medicaid (e.g. increasing maximum income levels to 150% of the federal poverty level)
  • Ease qualification requirements for private insurance policies
  • Create a new publicly-administered health insurance plan

The latest plan would require all Americans to carry health insurance or pay a stiff fine. It would expand government health programs for the poor and be paid for with cuts in Medicare and Medicaid. There would be no federal program developed to compete with private insurers who would now be unable to deny coverage based on someone’s personal health history.

Supporters of the “public option” plan have said it could save money by using Medicare rates and fee schedules to pay hospitals and doctors.

That is exactly what worries health care providers, who say Medicare pays them less than market rates paid by private insurers and see the public option as a step toward a single-payer system in which the government would end up paying most of the nation’s health care bill and supplanting private insurers.

Obama denies that he wants to drive private insurers from the market, but many others support the ultimate goal of “Medicare for all.” Estimates indicate that more than 100 million people might sign up for a government-run insurance plan.

Another option that some legislators have been focusing on is nonprofit, member-owned insurance cooperatives (“co-ops”) that would not be controlled by the government.

With so much emphasis placed on cost and quality, a third principle, “access”, often gets lost in the rhetoric that is directed at one of the economy’s largest and most complex sectors.

Health Care providers know that access is the cornerstone of reform and that by harnessing the power of the Internet they can reap the rewards of an increased market share, strengthened clinical relationships and improved work flow; thus lowering costs to both themselves and the patient.

“Portability” is a catchword this year. Health insurance should be able to accompany people wherever they go. If they move from job to job, the health insurance should follow along. The worker should not have to start all over, dealing with issues like pre-existing conditions and finding the right insurance.

As the health care issue developes, economic factors have drawn an ever increasing number of parties to voice their concerns. As individuals are presented with more choices and greater responsibilities in managing their own health (should everyone pay for others’ unhealthy lifestyles?), the health insurance companies and health care providers are realizing the need to run more efficient operations, improve quality of services and better manage costs.

However health care reform is finally accomplished, most have to agree that with 60 percent of personal bankruptcies occuring because of unpaid medical bills, 47 million uninsured Americans is simply too many.

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