Am I happy?
I have been asked by many if I am satisfied with the various components of the healthcare reform drafts that have been presented by the various committees in the House and Senate. I think I have been fairly consistent in my beliefs that in reforming the current US healthcare system, to start out, less is more. There is no change in my beliefs. The problem now is figuring what constitutes less vs. more. To do that, we need to see how the Senate and House will ultimately reconcile all their various bills into something the American public and all of the various and numerous interested parties accept (or try to accept). Our previous failures in reforming the healthcare system date back longer than Bill Clinton and the early 1990s. We have allowed our healthcare system to evolve into its current form over many decades. As I have been saying all along, it is going to take many more years to unravel and rebuild the current system into something that works for many more Americans than what we have today. Believe me, what we have today needs work.
The primary reason the bulk of my focus has been on the Baucus/Finance bill is because I believe the content is the most reasonable approach to starting to reform the system, i.e. less is more. Certainly there are problems with the bill for everyone. But if you understand healthcare and take a truly objective view, this bill makes some sense. It really does start slowly. Let me highlight the big concepts:
- There is not government plan – a less expensive and less bureaucratic way to start;
- Eliminates preexisting conditions as a reason for an insurance company to deny you coverage – any reform must have this component;
- It creates an independent body to review whether various healthcare treatments are effective so we can fund programs that make sense and benefit the public (hopefully removing wasteful spending);
- Creates an exchange system so consumers can find polices that work — increasing consumer choice and competition (to lower prices);
- Creates a mandate so everyone pays into the system – spreads the risk and puts everyone on the hook for their healthcare (we all pay for it now anyway);
- Creates subsidies for those who can not afford insurance so they can buy insurance – clearly a must have in all bills; and,
- Taxes groups that can be taxed (insurance companies, pharma, device makers, etc) – we need to raise money – period (see some of my previous blogs on this topic).
This is a good and reasonable start. There are clearly other provisions in the finance bill but I believe these are the big ones. Each one of these is political and creates a series of complicated discussions. There is never going to be an easy way to reform the system perfectly. Nor is there any one way to do it correctly. So we can squabble forever over who is right and who is wrong – what a total waste. Or, we just start somewhere (here) and work it through. With unemployment where it currently is in this country and healthcare expenditures rising for everyone, individuals, employers, and the government – we are out of time. What we have in the Baucus/Finance committee plan is taking it slowly. I cannot say that about the House Bills. I have to hope the final bill to the President looks like what has been done in the Senate Finance Committee. If not, we could be in trouble. Real trouble.