Health Care For America Now

As President Obama speaks to Congress and the nation this week in his State of the Union address, I hope he will make clear three important points about health care reform:
1. When it comes to the need to make good health care affordable, nothing is different today than it was yesterday.
2. It is imperative that we put a down payment on the promise of health care reform today by passing a health reform bill.
3. Passing a health reform bill now is just the beginning of health care reform, not the end.

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The unpopular truth is that most medical interventions have both positive and negative effects. That is the reality that has led to the new mammography screening recommendations from the U.S. Preventive Services Task Force. And, politics aside, isn't having a team of medical experts reviewing the data and making evidence-based recommendations that doctors can use when giving us, their patients, advice exactly what we want?

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Senator Harry Reid, the Majority Leader, has introduced the Senate's health reform bill. The Patient Protection and Affordable Care Act (H.R. 3590), is projected to reduce the federal budget deficit by $130 billion in the first 10 years. So how does the final Senate bill stack up against the House bill in the categories I discussed in my previous post ("House Health Bill Should Be A Model For The Senate")? Pretty much as expected.

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The House's health reform bill (H.R. 3962) should be a model for the final Senate bill in many ways, including that the Health Insurance Exchange is federally created and overseen, states cannot opt out of the public health insurance plan option, there are better consumer protections to promote transparency and accountability from health insurance companies, affordability protections are broader, there are more requirements for employer involvement, and financing is more progressive. One exception: the House bill's regressive language on abortion coverage.

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The GOP health reform bill does very little to expand health coverage to more Americans, very little to lower overall health care costs, and very little to ensure people will be able to afford the health care they need when they need. So where's the reform?

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Health insurance companies are exempt from federal antitrust laws — laws that protect commerce from monopolies and unfair business practices in most other types of markets. As a result, health insurers have become highly concentrated and premiums have soared. There is movement on Capitol Hill to remove this exemption, but the best way to quickly infuse competition into health insurance markets across the country is with a strong, national public health insurance plan option.

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Some in Congress want to raise funds for health reform by taxing high-premium plans. Not only will such a plan affect middle class families, it also discourages the type of good comprehensive coverage we should all be afforded.

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Neither of the Senate health reform bills regulate health insurers enough and the regulations they do include apply only to the plans in the new health insurance exchange. That is why we need a public health insurance plan option to set a benchmark against which private insurers can be measured.

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America’s Health Insurance Plans (AHIP) is claiming Medicare "has had virtually zero innovation since its inception." A look at the facts, however, shows that Medicare leads and private insurers follow. AHIP itself has in the past admitted that, “Private insurers will take a close look at what Medicare is doing, with an eye to adopting similar policies.” I don’t know about you, but I smell desperation in the air as insurers struggle to discredit the idea of creating a strong, national public health insurance plan option.

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The fact that insurance companies continually break regulations is one of the reasons we need a public health insurance plan to compete with them. It may not keep the insurance companies from continuing to do everything in their power to avoid people who need care, but it will give us all a safe harbor — of stability, accountability, financial security and efficiency — from insurance company abuses.

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