U.S. inches closer to universal health care

By Money Matters Editors

Those who sampled the Senate Finance Committee’s debate on health care reform on Monday and Friday on C-SPAN undoubtedly came away with one certainty: some type of health care reform bill will be passed this year. It’s exact shape? Stay tuned.

That the United States is likely to reform its gargantuan $2.5 trillion health care sector is a plus, for citizens and corporations alike. That’s because the nation will slowly move away from the current untenable system of the uninsured showing up at hospital emergency rooms for basic care, at a cost of $1,000 per hour and up.

Further, it doesn’t take an MIT mathematician to figure out that any insurance or comparable health care program that enables those without insurance to access primary care from a local doctor/general practice physician eliminates a major cost increase area in the system. The United States should have implemented a basic health insurance plan decades ago: had it done so, many hospitals would not have incurred the enormous costs that they have from treating the uninsured in emergency rooms.


Snowe’s trigger option eyed

What form will the new insurance program take? Although some Democratic Senators on Senate Finance may try to push for a public option, a more moderate bill - one that pays subsidies on a sliding scale basis to the uninsured poor/working poor to help them purchase private insurance – is more likely. Also, U.S. Sen. Olympia Snowe, R-Maine, and a critical swing vote, has proposed establishing  a ‘trigger’ for the public option that would take effect in markets with insufficient competition, thehill.com reported Monday.

If Snowe’s ‘trigger’ option holds, it may represent a suitable compromise between liberal Democrats, who want a public option, and nearly all Republicans and centrist ‘Blue Dog’ Democrats, who are dead set opposed to it.

Meanwhile, a tax on ‘Cadillac’ insurance plans probably will not be included in the bill, due to opposition by organized labor, The New York Times reported.

With, the 'Cadillac' tax out, the other major savings area in health care reform is likely be more efficient Medicare and Medicaid systems. On Medicaid, any poor person(s) who accesses care via the proposed, subsidized premium system will represent a net cost reduction for the U.S. government. On Medicare, most health care analysts agree that cuts to reimbursement rates and a shift to payment for health outcomes will help cut costs.

Further, businesses would be required to offer insurance or pay a percent of their payroll cost to the federal government to help offset the U.S. government’s cost for subsidizing health insurance for the poor/working poor. (Some small business may be accessed a lower fee for non-insurance of employees.)

Finally, the net cost of the above, if passed into law? The proposed changes still would reduce the deficit by at least $40 billion over 10 years, but the key point there is that health care reform not increase the deficit. President Obama has repeatedly said he will not sign a health care reform bill that increases the deficit, and so far, Congressional lawmakers are on-track to produce a deficit-neutral bill, according to an analysis by the Congressional Budget Office.

Hence, if the health care reform bill as currently comprised passed and were signed into law by President Obama, it would insure some of the uninsured immediately, and the remainder over time; and re-structure the health care system and move the nation away the unsustainable emergency room treatment pattern. It would also decrease health care costs, including Medicare and Medicaid cost containment. The bill would not insure everyone immediately, as liberals Democrats want, nor would it leave every health care decision for the uninsured up to the private sector, as conservative Republicans want. In sum, the bill would incrementally move the United States toward a health care system where everyone is insured. That doesn’t sound like much, but given Congress’ polarized, partisan politics-dominated condition – one where deep philosophical differences exist between the Democratic and Republican parties - that’s about the best the nation can hope for at the current time.