The various health reform bills will most likely head to the Senate floor for debate this week.  The outcome remains in doubt, but passage of some type of bill seems likely in both the Senate and  House.  Despite pledges regarding budget neutrality, deficit neutrality, not covering illegal aliens, minimizing taxes and impact on Medicare, it would seem, reviewing the CBO’s recent comments (see links below) that accomplishing those items is improbable – at least if the current formats of the proposed bills emerge in some coherent form.

With our economy continuing to sink, job losses mounting and no real economic upturn likely (despite the White House spin), especially in view of the current massive deficits and debt, the majority of current health reform proposals will only further aggravate the problem.  We, through “the plan” have offered a variety of solutions that focus on expansion of coverage, control of health insurance premiums and regulatory reform.  There are some components of the current proposals that we agree with, but the massive cost outlay and tax increases (fees, surtaxes, penalties and the like are tax increases by anther name) make the current construct of reform a negative.

It remains a item of fascination as to why Democrats and Republicans have steadfastly avoiding looking to meaningful health insurance oversight and regulation as the easiest, least costly means to accomplish what most agree on – expansion of coverage for the legal citizens who are uninsured.  No doubt the health insurance lobby (and insurance lobby in general) is quite powerful, well heeled and well positioned to prevent this type of regulatory oversight. Nevertheless, it would be the best option both for accomplishment of legitimate health reform goals and for preservation long term of a vibrant private health insurance market.  While we remain hopeful, we must be very concerned that Real Health Reform will not be accomplished by the current legislative proposals, only drastic reform labeled as health reform. . . obi jo

With the Senate Finance Committee set to approve its health care bill this week, Democrats are tantalizingly close to bringing legislation that would make sweeping changes in the nation’s health care system to the floor of both houses of Congress.

Party leaders still face immense political and policy challenges as they combine rival proposals — two bills in the Senate and three in the House. But the broad contours of the legislation are in place: millions of uninsured Americans would get subsidized health benefits, and the government would move to slow the growth of health spending.

The policy challenges are also daunting. In the space of one year, the Democrats are trying to restructure one-sixth of the economy, writing a bill that will affect almost every American, every business and every doctor and hospital in the country.

• The major House and Senate bills would require most Americans to carry insurance. This individual mandate could touch off an angry public reaction, especially if the penalties for violations are taxes collected by the Internal Revenue Service. Many lawmakers want to minimize the penalties.
• Whether the government should require employers to provide health benefits to their employees, or pay a penalty, is still an open question. Liberal Democrats say yes. Moderate Democrats are unsure. Republicans are generally opposed.
• Lawmakers have not decided how to pay for the legislation, expected to cost about $900 billion over 10 years, though they insist that it will not add to the deficit. The House has proposed a surtax on high-income people, while the Senate proposed an excise tax on high-cost insurance plans.
• Democrats are divided over whether to create a government insurance company to compete with private insurers. The more liberal House will probably not pass a health care bill without such a public insurance option, while the Senate appears unlikely to pass one with it.
• Lawmakers are looking for ways to provide more generous subsidies to help low- and middle-income people buy insurance. Many Democrats and some Republicans, like Senator Olympia J. Snowe of Maine, insist that insurance must be affordable if people are required to buy it.
• While Congressional leaders say they want to curb the explosive growth of health costs, it is unclear whether the final bill will make a serious effort to do so. Every proposal meets resistance from health care providers who fear a loss of income, even as they stand to gain millions of paying customers if nearly everyone has insurance.

Health Overhaul Is Drawing Close to Floor Debate – http://www.nytimes.com/2009/10/04/health/policy/04health.html?_r=1&emc=tnt&tntemail0=y

An Analysis of Premiums Under the Chairman’s Mark of the America’s Healthy Future Act – http://www.cbo.gov/ftpdocs/106xx/doc10618/09-22-Analysis_of_Premiums.pdf

The Effects of Two Specified Policy Options for Health Care on the Federal Budget Deficit – http://www.cbo.gov/ftpdocs/105xx/doc10563/09-21-RyanLtr.pdf

Additional Information on Insurance Coverage for Unauthorized Immigrants Under Proposed Health Care Legislation – http://www.cbo.gov/ftpdocs/106xx/doc10619/09-22-GrassleyLtr.pdf

Preliminary Analysis of Specifications for the Chairman’s Mark of the America’s Healthy Future Act – http://www.cbo.gov/ftpdocs/105xx/doc10572/09-16-Proposal_SFC_Chairman.pdf

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