As the health reform debate heats up in summertime Washington, discussions center around how to make our current system more efficient, provide better value for the dollars spent, and extend coverage to those without it. The Senate Finance Committee options papers and the House tri-committee report devote whole sections to proposals to reduce health care costs. These proposals consider ways to find savings from working more efficiently, and slowing the growth curve — savings that could help pay the substantial cost of comprehensive health reform.
For reporters who normally cover topics other than health reform, today’s reform debates can mean playing catch-up. They may be facing a new vocabulary – public plan option, health insurance cooperative, employer mandate, individual mandate. Maybe they’re trying to figure out what all this means for readers, viewers or listeners.
Consumer Choice in Health Care: How Could Reform Affect Our Choices? How Could We Make Better Choices?
The idea of choice has long been a hallmark of the American health care system. We pride ourselves in believing that we – not government bureaucrats – choose our doctors, hospitals and health plans.
Various proposals to expand coverage to uninsured Americans and reform the health insurance market include the establishment of a health insurance exchange. The most widely discussed example of such an exchange is in Massachusetts, and it arrived recently with Massachusetts’ 2007 health reform efforts. Many are looking to the Connector, as the Massachusetts program is known, to inform their discussions of a national insurance exchange. But is that the only model?
One of the various proposals to expand coverage to the more than 45 million uninsured Americans is referred to as the “public plan option.” Though proposed only as part of a broader effort to expand coverage, the option is viewed in varying lights. Some see it as a tool for providing consumers affordable coverage by stimulating competition on the basis of quality and efficiency. Others see it as unfair competition for private insurers and, in the extreme, as a path to a single-payer system.
Forty-five million Americans were uninsured in 2007. They may have worked for an employer that didn’t offer coverage, or were eligible for coverage on the job but could not pay their share of the premiums. Perhaps they were denied coverage in the individual market. Whatever the reason for not having coverage, their lack of insurance limited their access to care, contributed to poorer health outcomes, and may have led to personal bankruptcy.
Now that we know the next occupants of the White House and the composition of the next Congress, many Americans expect to see an effort to enact significant reform of America’s health system. Congress isn’t waiting for the White House green light. Sens. Ron Wyden and Bob Bennett, as well as Sen. Max Baucus have already released health reform plans. Sen. Edward Kennedy is poised to do so.
The pre-election debate put health care reform ideas front and center. Now policymakers have to deal with translating theory into action under challenging economic conditions. Why completely reinvent the wheel when there are existing universal coverage systems that may have components the U.S. can learn from? This briefing, cosponsored by The Commonwealth Fund, provided an in-depth look at the very different approaches of Switzerland, Germany and Holland to providing near-universal coverage to their citizens.
The upcoming presidential election and the domestic economic scene have captured the top-of-mind attention of both voters and the media. But not far below the top is a profound concern about health care. Will I lose my job and with it my health insurance? Can I afford the ever-increasing costs of rising premiums, higher deductibles and copays? Which candidate’s health plan will best alleviate my concerns?
The Patient Protection and Affordable Care Act, signed into law in March 2010.