Status Update: U.S. Health Care Reform

It is complicated. Listening to a singular pundit or TV channel for news about health care reform may only provide talking points, and attempting to put together the entire debate and its current status leaves most people confused and frustrated. The ins and outs of health care reform are undoubtedly complicated, especially as hundreds of pages of legislation filled with political-speak will likely dictate the future of health care in America. But the issues at stake are rather simple, and though the debates rage on, a basic understanding of the core of health care reform is necessary for the public to stay aware and involved in the process.

Health care reform became an issue partially because the public demanded it. Not only are there more than 46 million Americans currently without any type of health insurance, another 25 million people are underinsured. And recent economic woes have sent hundreds of thousands more into the category of uninsured as unemployment numbers rise. Another contributing factor to the underinsured and uninsured is medical costs that continue to rise; Health Affairs reported that $2.4 trillion was spent in 2007, which is 52 percent more than any other nation in the world. Add to those numbers the fact that of the 1.5 million Americans that are likely to declare bankruptcy in 2009, more than 60 percent of them result from medical bills, per a 2009 study by the American Journal of Medicine. Thus, the need for action increases by leaps and bounds.

When President Barack Obama campaigned for the office he currently holds, he spoke of the need for health care reform on a consistent basis. And just over one month after taking the oath of office, he reiterated his focus on the health care crisis that “cannot wait.” By June of 2009, he brought the issue to Congress as a must-do item on the agenda, and he urged the idea of a government-sponsored health insurance plan, similar to Medicare and now known as the “public option,” to compete with the private insurance companies now dominating the market, along with the mandatory removal of preexisting conditions as a reason for refusal of any health care.

While some Democrats in Congress embraced the plan, others were skeptical of implementing a public option, and Republicans blatantly rejected the idea, fearing low quality care and the strain that might cause private insurance companies to be put out of business. The debates then began in the hall of Congress but quickly disintegrated to divisive jabs when erroneous information spread that illegal immigrants would be covered under the public option, that death panels would be instituted to rid society of some of its sick or elderly members, and that people would not be able to keep their current insurance coverage if they chose to do so. Some of the public became fearful that the public option would create a socialist form of medical care in the United States, and many in Congress fell in line with those fears, standing back from support of any drastic changes to the current system.

Another stumbling block for potential agreement on the issue of reform is the ability of the government to find ways to pay for it. Numerous ideas have been introduced, including cutting excess from Medicare, and while those continue to be debated, the general consensus remains that any health care reform package should provide a viable alternative to increasing the U.S. government’s current deficit.

It should also be noted that a great majority of the members of Congress have or continue to accept large campaign donations from private insurance companies and their executives, making it more difficult to stand for changes that those companies staunchly oppose. Senators and Representatives who have chosen to support drastic health care reform have likely done so at the risk of losing campaign contributions and possibly future elections, if they accepted said monies in the first place.

The latest development in the ongoing saga of Congress’ attempt to address health care reform involves a bill introduced to the Senate on September 16, 2009, by Senator Max Baucus (D-MT). America’s Healthy Future Act proposes a 10-year overhaul of the health care system that would cost roughly $829 billion, though the Congressional Budget Office’s study revealed it would not only be paid for by taxes on expensive and comprehensive health plans and reductions in Medicare Advantage spending, but it would reduce the deficit by $81 billion over the next decade.

The meat of the bill proposes the creation of health insurance cooperatives (co-ops), which are non-for-profit insurance groups controlled by consumers to compete with private insurance companies. However, this is different from the aforementioned public option in that it would not be regulated by the government (after its initial launch and sponsorship by federal funding). Along with the co-op initiative, the Baucus bill proposes an individual mandate that will require every American to buy some form of insurance or pay a penalty, with those living three times below the poverty level eligible to receive subsidies to aid in their purchases.

Baucus prepared his bill to come before the Senate Finance Committee on October 13 for a vote, but on October 12, a lobby representing a group of insurance companies released a previously-commissioned study by PricewaterhouseCoopers that warned of insurance premiums rising drastically should the Baucus bill eventually be passed into law. It was speculated that the news was released to deter members of the committee from passing the bill, though it seemed to effect none of the votes either way.

The October 13 hearing was held as scheduled, and the Baucus bill passed by a vote of 14 to 9, split directly down the line with Democrats voting for it and Republicans voting against it with one sole exception when Olympia Snowe (R-ME) crossed party lines to cast her vote in favor of the bill.

Where does that leave health care reform?

Many steps remain in the process. Changes to the Baucus bill are inevitable, as it must be combined with the previously-passed Health Committee bill that provided for a public option. Ultimately, the bill that comes before the Senate must win at least 60 votes to pass and avoid the possibility of a Republican filibuster, and Congressional aides estimate that the meetings to merge the bills and finding consensus between House and Senate proposals will require a minimum of several weeks, according to CNN.

Therefore, Americans must wait. While constituents can contact their representatives in Congress to express their opinions, they must then wait as the fate of their health care coverage is debated on Capitol Hill. The goal is to pass some form of health care before the end of the 2009 calendar year, but what kind of reform eventually passes remains to be seen.