Monday, August 3, 2009

A Moment To Catch Up

So, as we approach the August recess without having a healthcare reform bill to work with, it seems like a good time to catch up with the process. If you are following this process, you know there are dozens of moving pieces to watch. The National Physicians Alliance (NPA) (sort of like the AMA if the AMA were progressive and such) has a site that lays things out pretty well. In a recent e-mail the NPA outlined where the playing field stands. I think that part of that e-mail is worth posting: it outlines where there seems to be bipartisan agreement in the reform movement. Despite the naysayers, these areas of agreement look pretty good:

Areas of agreement (generally bipartisan) include:

-Increased regulation of insurance companies to include: accepting all applicants, regardless of medical history; prohibit charging a higher premium because of medical history or current illness.

-Require nearly all Americans to have health insurance.

-Provide federal subsidies to make insurance affordable.

-Expand Medicaid eligibility to 133% of FPL.

-Require most employers to provide insurance to their employees or contribute to the cost of coverage. There is disagreement on the total payroll threshold at which this requirement would begin ranging from $250,000 to $500,000.

-Creation of health insurance exchanges where people can shop for insurance and compare policies.

-Reduce the rate of growth of payments to hospitals and many other health care providers.

-Eliminates the Sustainable Growth Rate ( formula for determining physician Medicare reimbursement.

-Shift toward paying for value, rather than volume of services.

-Eliminate co-payments for many preventive services.

-Democrats agree that the federal government should create some plan that would compete with private health insurers but there is some disagreement as to the form that plan should take: a public health insurance plan or a nonprofit cooperative.

Obviusly, it is this last point that is causing much of the heartburn out there: "Democrats agree..." implies that "Republicans object..." to the idea of a public health plan. Still, this public plan is part of HR 3200.

This is an important time in the process. As legislators leave DC and go home for the recess, they are going to hear from constituents, lobbyists, etc. It is terribly important that they hear from supporters of healthcare reform and supporters of a public plan. I believe that most Americans see the value of the plan so long as it is not being distorted by opponents. For that reason, we need to make sure that our legislators know that we support the public plan.

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