Both the Washington Post and the New York Times report that the Obama administration is signaling a new willingness to jettison the public plan element of healthcare reform legislation. Jonathan Cohn at The Treatment questions whether anything’s really changed, though, because Obama has consistently praised the public option as a good idea without insisting that it be included in the final bill.
As the summer has worn on and Congressional committees have come out with specific proposals, healthcare reform supporters are getting a better sense of what we can reasonably hope to get out of this round of reform and what will have to wait. Coverage expansion will probably happen, and subsidies will help more people afford health insurance. On the down side, I have yet to see anything that makes me think we’ll make any substantive progress towards slowing the growth in healthcare costs.
In other words, we’re not going to get the full-scale overhaul of the healthcare system that our country needs, but we can make substantial improvements. President Obama seems to be trying to give us more realistic expectations for the pending legislation, and one of the most visible changes he’s making is to refer to the current effort as “health insurance reform” rather than “healthcare reform.” With his list of “Health Insurance Consumer Protections,” he’s trying to end some of the worst abuses of the insurance industry, like refusing people coverage based on past medical history, dropping coverage for those who become ill, and placing annual or lifetime caps on the healthcare expenses they’ll cover. These changes won’t solve the problem of rising healthcare expenditures overall, but they can prevent a lot of health-related bankruptcies. Here’s the complete list:
- No Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
- No Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
- No Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
- No Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
- No Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
- No Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
- Extended Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.
- Guaranteed Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won’t be allowed to refuse renewal because someone became sick.
Of course, whether the legislation actually accomplishes these goals will depend on how it’s written. Trudy Lieberman at Columbia Journalism Review provides a helpful primer on provisions to watch (and watch out) for.
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August 17, 2009 at 7:20 pm
Health care -- how do we move forward
Do we need to spend over 1 Trillion dollars to make the much needed reforms that you mention? I think not, we can do much of what is proposed — but politicians are addicted to our money.
Follow the health care debate and see some of the facts about the health care delivery system at http://www.ilovebenefits.wordpress.com
August 18, 2009 at 9:40 am
Liz
What’s going to cost a lot of money up front is subsidizing insurance coverage for people who are currently uninsured. One of the main goals of this reform effort has always been to reduce the rate of uninsurance; the consumer protections listed above will help people who get insurance to keep it and get appropriate coverage from it.
August 19, 2009 at 4:47 am
Paul Kulpinski, LMT
It all boils down to our understanding of the definitions of “health care” and “health insurance”. They are two totally different things, but we keep using them to refer to the other. This is a big mistake.
I’ve illustrated my argument on my blog here: http://mwhealingartspaul.wordpress.com/2009/08/19/defining-health-care-reform/
August 19, 2009 at 12:05 pm
Sammy
All obama will do is outsource anyways. Just think about the all the lobbyists flocking to Washington DC because of obama’s reckless over-spending of $2 TRILLION in just 6 months, which alone is increasing the National Debt by 20%.
Politicians take people’s money and reward the large corporations, in this case companies in the health care industry, since they have the money to more effectively lobby politicians. In the end smaller businesses will be hurt.
Politicians will only reward companies that will be in their best political interest. Honestly, when can you really trust politicians since they are basically professional liars, and being president just means you are the best liar of the time. Why not just give the money directly from the people to the companies and take politicians in government out of the equation?
obama is going to recklessly spend TRILLIONS of tax payers’ money just to give insurance to about 25% of those who do not have it. Over 50% of people’s income go towards taxes, just imagine how many more people will afford health care insurance if their income is almost doubled because of dramatic tax cuts.
Competition is what is needed. It lowers prices of products and services, along with developing new innovations. All of which will benefit consumers. You need to remember that monopolistic tendencies can also apply to government.
The reason why the cost of insurance is high is because politicians in government mandate insurance companies to increase their premiums to pay for ridiculous things. In addition, politicians put up regulations so that Americans are not allowed to get insurance from another state and use the coverage in their own state. This reduces competition making it more expensive for people to get insurance. On top of that medical professionals are not allowed to freely practice their profession in any US state without taking a long and tedious licensing process. This again increases the cost of medical insurance.
In the end, the problem with most economic issues is too much government intervention of the economy by politicians, who will only tend to do things for political self interest. Just like how obama nationalized GM to pander to its unions. Politicians can barely run government, yet people think they can run a multi-national auto manufacturing company?
The solution is SMALLER government, LESS spending, and LOWER taxes.
August 19, 2009 at 4:56 pm
Liz
Other developed countries spend a lot less than we do on healthcare and have similar health outcomes – and they ensure that no one goes without healthcare. The extent of government involvement varies from country to country, but none of them leaves it entirely in the hands of the market. That’s because the market doesn’t work for healthcare.
If we let the healthcare market run without government intervention, we would indeed get competition – but the poor and the sick wouldn’t be able to get the care they need. Yes, our government’s involvement in healthcare results in rules that make health insurance more expensive, and it leaves taxpayers with less money to spend. I think it’s a worthwhile tradeoff to make in order to avoid a society where only the rich can get healthcare. I’d gladly pay more taxes if it meant covering everyone and feeling more confident that I’d always be able to get adequate healthcare, even if I lose my job or develop a chronic illness.
August 20, 2009 at 4:51 pm
Dick Clapp
I admire your tolerant rationality, Liz. You respond clearly to some of the more absurd claims of the “live free or die” set that reacted to your initial post. I just watched Barney Frank respond to some similar comments in a town meeting in Dartmouth, Massachusetts earlier this week. I continue to wonder who’s behind this stuff? How did Sammy, for example, find your post on TPH? Does he belong to a service that scours the web for places to inject the lies he puts forward? (I’m referring, for example, to his quote that “over 50% of people’s income go (sic) toward taxes”) Clearly, some of this is orchestrated, as the Barney Frank clip illustrates.
In any case, keep up the good, patient work. Jon Stewart, Barney Frank, Physicians for a National Health Program and others will keep up their part of the battle as well. You may have noticed that there was a call for a national “anti-Obama” rally in DC on Sept. 12, and a call for a “pro-public option” rally the next day, Grandparents’ Day. The beat goes on. . .
August 24, 2009 at 1:05 am
Anonymous
Unfortunately, what Liz proposes in the post entry is NOT what is being proposed by Obama / Pelosi / Reid. So… wishful thinking about as Pelosi said, a bill will not come out of the House which does not include a government-run debacle program.
Liz, your proposals listed in itemized fashion is fine… BUT… tort reform, purchasing across state lines would have to be added to make it a “real” proposal.
August 24, 2009 at 1:11 am
Anonymous
Response to Dick Clapp’s post. Please go back and carefully look at the video objectively. You will see that it was only Barney Fwank would kept raising his voice and screaming. Look it up on YouTube. Frankly, I am shocked at the “left’s” perspective of the debate. The arrogance is unbelievable! Those expressing their views at the townhalls are seniors (democratic base), many moms (again, dem base), and independents.
Look at the spiraling out of control decline of Obama’s numbers. It’s obviously NOT republicans, “live free or die crowds”, etc that is causing that decline. It’s the indies and dems that are bailing!
August 24, 2009 at 1:24 am
Anonymous
Liz, your claim about the USA spending for more on healthcare than other countries for similar outcomes is misguided. Be careful not to compare apples to organges in the numbers.
What about… what is the life expectancy of someone diagnosed with cancer and other fatal diseases vs other countries? As one who has lived in a number of countries and traveled to well over 60, I can tell you that I would not want to get sick anywhere but in the USA!
Just look at Canada, UK, and other countries with universal h/c. Not exactly a system I or my family would want to depend on….