Health Care Reform 2009

Like me, I am certain you are frustrated by the paucity of quality information on health care reform legislation in the media (both on the right and the left) these past months. Speaking with your congressional representatives can help to provide perspective (with no guarantees) as you sort through the plethora (dis)information.

Which brings us necessarily to that overwhelming question: has anyone in the media or in Congress for that matter read all 1018 pages of the House bill? (And have they understood it?) We know from public statements, for example, that Jim Inhofe will vote against any health reform bill without reading it.

My hope with this post is to point you in the right (non-partisan) direction in developing your own INFORMED perspective on health care reform.

Summary

I had an extended telephone conversation with John Myers this afternoon who currently serves as Senator Specter’s health advisor. I did not seek his permission to share quotes from our conversation publicly; instead, I’m using my conversation with him on background only.

From my conversation with Mr. Myers, who provided some useful clarification, and through my reading of the House bill and listening to the debates in Congress, the following details emerge:

  • This is not the beginning. We have been working towards health care reform for a very long time. This will not be the end. Reform of this magnitude takes time to get right. We’ve been waiting long enough. It’s time to pass something.
  • There is a lot of agreement on both sides of the isle regarding several key aspects of health care reform. The thought alone that we might actually end discrimination based on pre-existing conditions is huge.
  • The national health insurance exchange (together with the public option) is central to the cost containing strategy codified by the House bill. This is, of course, in addition to the regulations that are intended to govern the Exchange itself.
  • The public option serves as an additional layer of competition (added to the national health insurance exchange) and, in my humble but relatively informed opinion, would result in the need for a less highly regulated Exchange.
  • None of the proposals on the table include a single payer option. Employers cannot force employees to select the public option. Once on the Exchange, employees will be able to select the plan (public or private) that meets their individual needs. That being said, several proposals in the Senate call for building a “firewall” around the public option, preventing employers with existing programs from participating in the Exchange. This may be a wise compromise.
  • In terms of co-ops, it’s important to understand what kind of co-op we’re talking about. Are we talking about a purchasing co-op? Or are we talking about the kind that serves as a health care provider? In terms of purchasing co-ops, the GAO March 2000 report on these sorts of cooperatives was sour on their ability to reduce overall cost. http://ow.ly/kpgJ

Based on this information, I cannot understand the continued concern with and vocal opposition to the inclusion of a public option in a comprehensive health care reform bill.

That being said, I do have my own concerns regarding the House bill that I will articulate in a future post – concerns that have been overshadowed by debate (if you can call it that) on the public option. Part of my concern, ironically, is with the public option (yes, you read that correctly), medicare, and the establishment of reimbursement rates. Finally, as a so-called conservative, I am always concerned with the impact any legislation will have on deficits and the national debt. At the end of the day, the only legislation that is acceptable is that which is debt neutral.

Further Reading

There are three links that I think you will find especially useful:

  1. Fact Check has posted a long list of claims regarding the House bill and a detailed analysis of their veracity. Some of the claims are true but very few. http://ow.ly/o6XP
  2. Anne Underwood from the New York Times has posted a solid overview of the health insurance exchange that corrects a number of important misconceptions. http://ow.ly/nQe6
  3. Finally, all of your questions are addressed in the actual House bill. I think it’s important to cite primary sources in all arguments! http://ow.ly/nDsc