Monday, September 21, 2009

Health Care Reform Summary and Updates

Summary of Possible Revisions to Obama’s Healthcare Reform (September 2009)
Nothing is completely certain at this point as there are several bills in the Senate and the House. At the end, they will have to be worked out, into one bill for the President to sign. Right now, it looks like Baucus' Bill will have a major influence, although Republicans as well as liberal Democrats are dissatisfied. More changes/compromises are bound to be made.

The Public Insurance Option
It looks unlikely at this point that the public option (the government-run insurance option) will stay. However, nothing can be completely certain at this point. There may still be a coop (non-profit) insurance option instead of a public option (obviously as a compromise with all those who’ve bought into the fear of “social medicine” with a public option.)

Raising Taxes
Obama promises not to raise taxes on families making under $250,000 per year. However, it is still uncertain whether he would raise taxes if he would raise taxes at income levels above $250,000

The cost if we go with the Baucus Plan will be under $800 billion over ten years. (My analysis: Although $800 billion over ten years seem like a huge cost, our current health care and health insurance system in this country is costing us more than that, and will cost us more than that as healthcare costs from our current system will continue to grow. As we in the 21st century compete globally (individuals for jobs as jobs are being shipped out abroad and corporations like GM competes with Japanese car makers, to name a few examples), the cost of not passing health care reform is much greater than $800 billion to U.S. citizens, U.S. corporations, and the entire United States of America.)

Other Provisions from Previous Summary
The other provisions from my summary (in my published article at the end of August) are likely to stay (when health care reform passes.) No one can be certain the exact form the final bill will look like, as many bills in the House and the Senate will have to be worked out (merged.) It’s a complicated process.

Summary of Obama’s Healthcare Reform as of August 2009 (from an article I've written for Bay Currents Newspaper)

Public Health Insurance
This government-run health insurance (funded by premiums) would be available to compete with existing private health insurance companies. Affordability credits will be available on a sliding scale system. (Affordability credits financially help those who can’t afford to pay for health insurance. The lower your income, the more affordability credits you would have.)
[As of September 2009, it seems that the public health option will likely be eliminated. It may possibly be replaced by a co-op option (non-profit organizations providing health insurance to compete with private health insurance companies.)]

Health Insurance Exchange
This would be a marketplace for individuals and small businesses to compare and shop for health insurance. There would be mechanisms here for consumer protection and fraud prevention. This is also where affordability credits would be administered.

Elimination of Discriminatory Practices Based on Health Condition
It would be illegal for insurance companies to exclude anyone from starting or renewing coverage because of a pre-existing condition.
[This apparently indisputable provision received applause from Republicans and Democrats. Therefore, it will likely stay. However, politicians (backed by special interests) who secretly want to exclude this item are trying to derail the whole health care reform (because they can't justifiably oppose this provision.)]

Prevention of Bankruptcy from Medical Expenses for Individuals
Insurers would no longer be allowed to put a cap on the amount of benefits received by an individual. However, there would be a cap on out-of-pocket medical expenses by an individual.
[This apparently indisputable provision received applause from Republicans and Democrats. Therefore, it will likely stay. However, politicians (backed by special interests) who secretly want to exclude this item are trying to derail the whole health care reform, using fear tactics as we've seen.]

Improving Medicaid and Medicare
Health care provider participation in Medicaid and Medicare would be increased, improving access to care for low-income families, the disabled, and the mentally ill. To do so, there would be increases in reimbursement rates for primary care services. The Medicare “donut hole” -- the coverage gap by which Medicare recipients have to pay for their medication for a brief period -- would be eliminated.

Investing in the Medical Workforce
To prevent a shortage of doctors and health care professionals due to an increased number of Americans being covered, more scholarships and loans would be made available for people entering various medical professions. There would also be an expansion and improvement of graduate medical education and medical training.

This has been mostly a factual summary, with my analysis/informed-opinion in brackets [] or parantheses (). More on my personal thoughts about health care reform at from my personal experiences with healthcare and having interviewed many others (for two published articles.)

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Shu Chan

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