To PO it is

This past week has been a very busy week for our Senators and our Representatives as they come closer to introducing their health care reform bills to the floor. The topic of the week was of course the Public Option, which seems to be the most debated policy in congress and throughout America. But before you form an opinion on it, I will explain some background of this policy and explain its importance in the health care debate. Also I want to introduce the policies that each house is developing for the public option since it is important to understand what they are going to be fighting for.

The idea was first created before the 2008 elections when some health care experts started to promote this new idea of a public insurance pool that would be modeled after Medicare. It was seen as a better way to attract congress and constituents on a plan other than the single payer system that could provide for real progression in the health industry. Soon these experts started to meet with presidential candidates to introduce them to this new compromise that could convince and unite both single payer supporters and other more conservative liberals. Therefore when Obama became president and introduced his plans to pass health care reform this year, he decided to fully support the pubic option and strongly suggested it be included in the health care reform bill.

Now this brings us to the present…

After the heated debates this summer, the public option came out with some serious wounds. Yet the events of this summer did not completely destroy it and now we have assurance from both the Senate (as posted earlier this week) and now the House of Representatives that the public option will be present in their bills. In the Senate, Harry Reid officially announced on Monday that he will included the public option in the Senate bill with a clause allowing states to opt out of it. The reason for the opt out/opt in clause is to gain more support from moderate Democrats to support a health care bill with public option. Interesting….

On the other side of the capital, the House was motivated by the Senate’s decision and what a surprise they also added a public option to their health care bill. The House was first divided on what type of public option they preferred and decided on a less robust one. Instead of a program providing reimbursements to doctors based on the lower rates paid by Medicare (which is the more robust plan), the house announced that they had settled on a option that would negotiate rates with providers. Democrat leadership was pushing for a more robust plan but many rural representatives feared that their hospital and doctors would suffer from the plan.

Now since both the Senate and the House have officially announced their bills, the public option will be the center of the debate since many congressmen/women have pledged to not pass a bill with a public option. So stick around and enjoy as we see our congressmen/women go head to head on the congressional floor.

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To PO or to not PO that is the question

The public option has had quite a ride in this health care reform roller coaster. The public option has been a preferred policy by both Democrats and the President. The President has strongly suggested it to be included in the health care reform bill but it has experienced some serious opposition mainly the GOP (of course) and some conservative Democrats. But just when you thought it was gone for good, there are some new developments on the public option coming from the Senate. Senate Majority Leader, Harry Reid, has recently proposed that the public option should be included in the bill but it will allow states to opt out of it if they wish to. That is an interesting twist to the health care reform debate. Currently the bill voted by the Senate Finance Committee does not include a public option but may be added once it reaches the Senate floor for debate. Why this sudden change to attempt to added it to the health care reform bill?? I would possibly blame it on the turn in public opinion which has increased from 55% to 61% in favor of the option. This turn of events has encouraged both House Representatives and Senators to bring up the issue again. In both houses, they are seeking to add a public option but what type of option? It is too early to tell but one thing most politicians are sure of, or at least those supporting the public option, that without a public option little reform will occur only time and further research will tell.

Lessons Learned

Last week I analyzed the National Health Service of the United Kingdom and both identified the pros and the cons of the system. As our government comes closer and closer to forming a bill, what can they learn from the pros and cons of the NHS and maybe adopt? Well some would argue that the NHS has really nothing good to offer the United States (cough …cough the GOP) but is that really true?? Based on reports from the World Health Organization (click here for full report) the United Kingdom per capita spending on health is three times less that the per capita of the United States. Even though they pay less, they provide the same amount of doctors, nurses and services. Therefore what can the US learn and possibly benefit from the UK system?
One lesson the US can learn from the NHS is the system’s ability to pay much less per person than the American system while still guaranteeing coverage to all its citizens. By being able to provide insurance to the entire population (either with a single payer or public option) cost per capita can decrease. The United States is known for having large gaps in its health insurance coverage which contributes to the high per capital cost. An additional ability that the United States (and its people) can benefit from is having no limit on the amount of health care treatment provided. In the United States, time and time again we heard the stories of terminally ill people being denied coverage or dropped by their insurers since they reached their coverage limit. This is one of the major concerns that people have with the health care system in America and one major pro about the UK that should be included in the reform.

Although I do see some ways in which we can learn and benefit from the pros of the NHS, we can also learn from its problems. It is clear that this country is not ready or willing to have a single-payer system as the UK since they believe it will cause long waiting times for medical assistance and inadequate care and treatment. Although these cons are subjective, the US can adopt some aspects of the single-payer system and add them to the current system and meet half way. What I mean by meeting half way is that the US should consider something like a public option meaning an option offered to citizens that is government controlled. By having an option to citizens that is low in cost and coverage, we may be able to keep all the good aspects that work in the NHS and apply them to our health care system. Therefore if a citizen is worried about having to wait sometime for a general surgery they may chose to have private insurance. If a citizen does not have the adequate funds to have private insurance or just lost their coverage as a result of losing their job then they will be able to be covered under the public option. So by having some citizens in the private sector and others in the public both systems will be balanced and waiting lines can be less of a problem since the population will be divided between the two.

The NHS provides citizens with great care at a low price and the US should consider attaining some of these great aspects by adopting something like a public option, which provides the good aspects while not adopting the entire single-payer system.

On to Congress

As I posted a few days back that it was time for the Senate Finance Committee to vote on a health care reform proposal, well they have and the verdict is… it passed!! It was even passed with the support of Republican Olympia Snowe, do I see the end of the partisan divide in congress…that may be too optimistic. Since they have passed the bill it is now heading to the congressional floor where there will be more challenges to face and it’s not going to be pretty. Since the future is unclear for the bill, what needs to occur for its success?

One major factor contributing to its future is based on the actions of its main supporter, President Obama. Since he first introduced his motives and plans to congress and the American people, he has made a great effort to clarify and further his goals for health care reform. Now is the time, more than ever, to motivate not only the representatives and the senators but the entire nation. It is necessary for him to prove the necessity of this bill at this time and declare it essential to leave partisanship and self-interest behind. He must advocate unity by working with the two parities but should not be too lenient to a specific party's demands. Most importantly he must know specifically what he is seeking to accomplish in order to properly lead congress and the people. The time has come, as Chris Matthews would say, for the president to play hardball.

The United Kingdom and the National Health Service

One of the main goals that I wish to accomplish from this blog is to explore other health care systems from different countries. Since the UK system, National Health Service, has been used as an example of a failing single-payer system by the opposition in the health care debate, I am intrigued to discover the reasons behind these allegations. Is it a failing system displaying “what goes wrong when government interferes” or is it a fable?

In the US health care debate lately, the GOP is leading a “Be frightened of England” campaign in order to stir some fear in the already heated debate. Some statements included

“Go on the government’s dime for medicine, and you’ll die waiting for that easy surgery treatment.”

Their messages can be seen everywhere both on the web and on the congressional floor. Yet is there truth to their argument. From researching several sources on the UK, I have compiled a list of pros and cons of the single payer system.

Let’s first present some of the pros. In the UK, all residences are insured by the state and medical attention is largely free at the point of use. In order for all citizens to be covered, there is a general tax paid (about 3% yeah I know that’s a lot!) by the UK residence. With this type of health care system, UK residence are able to receive good health care and pay less for it (in the end that 3% does come back to you). One major pro about the system is that it is able to provide great medical assistance with worthy doctors and nurses at a low flat rate for the entire UK population (this also includes a flat rate for prescriptions). Some last major pros about the system are insurance prices which stay the same year after year and all residence are guaranteed medical attention.

Although this system seems perfect…well to be honest it’s not perfect. Some of the problems with the National Health Service (NHS) include poor waiting times for general surgeries, hospitals being overcrowded and with outdated medical equipment, and many more fueled by scandals and politics. Many of the complaints about the effectiveness of the system are caused by the long waiting list for general surgery that ranges from waiting to 30 days to 18 weeks (if lucky enough). The NHS gives high priority to important surgeries but for minor surgeries people are forced to wait longer. Other problems have to deal with inadequately supplied hospitals affecting their abilities to properly assist the patients. Several more arguments are presented mainly drawn from individual incidents that have led to residence questioning the effectiveness of the system.

Although it seems as the people from across the pond may not be too happy with the NHS, on the contrary polls have shown they are satisfied and feel that they are getting “good health care”. Therefore is it a system to “be frightened” as the GOP state? Seeing from the poll results it seems that the people of the United Kingdom don’t see their health care as a system to cause fright. Therefore the GOP is exaggerating quite a bit about the single payer system to possibly sway the debate in their favor. But partisanship aside, what can we learn and benefit from the NHS?? That will require more research and will be discussed in next week’s posting. See you next time =)

The time has come to…

This past week the Senate Finance Committee has completed debate on the health care reform proposal. So it is time for the Committee to vote (amen to that!). The vote will take place next week and the Committee is the last of the five panels to consider the health care legislation before it is presented to Congress (and where the real action begins). The proposed plan will cost $829 billion over the next 10 years allowing for several reforms in the health care system including:

§ Creating a health plan exchange in an effort to standardize premiums and coverage
forcing insurance companies to compete for business.
§ Would increase coverage from 83% to 94% of Americans
§ Will reduce $81 billion of federal deficits
§ Medicaid would be standardized for everyone with an income up to 133 percent of the
federal poverty level.

For these reasons, and especially since it is below a trillion dollars, it is a bill that is being seriously considered. One missing piece of this bill is, of course, the much debated public option. Therefore there has been much speculation about the effectiveness of the competitive market in the health care sector with the absence of a government offered alternative. As a result, it may not even lower premiums and be helpful to consumers. With all these speculation the view of its effectiveness is slowing receding in the eyes of legislators. Yet nothing is set in stone until it gets to the congressional floor and amendments may be added or retracted but at the moment the time has come for the committee to decide.

Working on some research

Ever since I started this blog, I have been able to see countless videos, letters and posts by both angry and passionate Americans on health care reform. I wondered why so many of these citizens felt so strongly about the health care reform. I decided to do some research on the sociological aspects that motivate people to feel so passionate about reform but much of my research came up empty. Most of what I found dealt with explaining why the health care system is failing and what can be done to reform the system. Although that is very useful information, it does not address why it is so hard to pass a reform bill. Across the nation, senators and representative faced angry mob crowds demanding that they leave their health care alone yet when we look at some studies done other years it shows that a large majority want reform. There are very few articles that explain why Americans want reform yet when it comes down to passing a bill it either does little in reform or it completely fails in congress. Therefore I will venture in to the world of academia and seek to answer the question of why the public opposes reform when they are clearly demanding for it. As seen in the past couple of months, public opinion, if loud enough, has the power to change the course of policy in government. If we do find explanations to these questions, we may be able to finally understand the concerns of the voters and discover a better plan of attack to make reform more appealing.