Sunday, March 14, 2010

Push For Healthcare Reform

It appears that we are approaching the defining votes on healthcare reform. From what I understand, the House of Representatives will pass the bill the Senate passed, while the reconciliation process will be used to change some of the Senate's language to be more aligned with what the house passed.

Conservatives need not fear. The public option is, unfortunately, not on the table. It's a shame, because I still feel that a public plan would be a necessary counterbalance to private insurance companies.

There are severe costs to doing nothing. There is evidence indicating that, had health care reform been implemented in the past, US health care spending would be much less than it currently is and would be more in-line with spending in other developed countries. The average family premium was $12,300 in 2008 and is expected to increase to $23,842 in 2020. This sort of cost escalation is unsustainable, either if the family purchases insurance privately or if it is employer purchased. Add this to private company denials of coverage, rescissions, and the like and it is clear that the already horrifying condition of health coverage will only get worse.

The House and Senate bills have a number of areas of agreement already:
--Individual mandate to purchase insurance
--Greatly increased regulation of private insurance companies
--Eliminates preexisting conditions
--Eliminates rescission (companies cannot drop people who are ill)
--Eliminate annual & lifetime caps
--Medical loss ratio of 80-85% (how much of every insurance $ is spent on care)
--Eliminate anti-trust exemption
--Expands coverage for preventive care
--Increased emphasis on primary care
--Increased support for public health
--Incentives for small businesses to provide insurance
--Creation of a health insurance purchasing exchange
--Support for health information technology
--Support for comparative effectiveness research
The President's proposal looks more like the Senate bill, but does have some proposals that reflect the House (and Republican) preferences.

Polling suggests that the country is divided about 50/50 regarding the legislation. Interestingly, if you discuss the policies and changes that are actually included in the legislation, support increases. People are distrustful of the process used to reach the current proposal and are skeptical that it will benefit them. However, if you discuss the specifics of the legislation, people increasingly support the proposals.

The general public is more likely to support legislation that includes the following pieces:
--Stop insurance covers from denying coverage.
--Require insurance companies to spend $ on care, not on insurance company profit.
--Helping small businesses to afford health insurance.
--Fix Medicare drug benefit.
--Help control costs and make good insurance available for all.

The current legislation provides for all the above. Opponents of reform have worked hard and, unfortunately, fairly successfully to criticize the proposal by being less than honest with what is actually contained in the legislation (death panels, anyone?).

This legislation cannot wait, and must be passed ASAP. Too many people die yearly, too many people defer care, and too many people are left behind for us to delay.

(By the way, don't fall for Republican claims that budget reconciliation is an underhanded, devious technique. Worked fine for them in the past on bills that dramatically increased budget deficits. It's just another attempt to pull attention away from what matters.)

If you read this, call your legislators and ask them to vote for health care reform. Now is the time, and this is the opportunity.

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