How Healthcare Reform Really Affects Us
by Greg Petty
May 2010
President Obama has signed the healthcare reform package and reconciliation bill into law. The reforms are a beginning, not the end, of our national effort to bring rational and improved health outcomes to our system of care and delivery.
I am sincerely dismayed at the vitriol and epithets directed by a few irresponsible citizens at some of the elected officials who voted to restructure the way healthcare is procured and delivered in this country. For an entire year there have been half-truths, misleading and downright false claims about what the reform bill would do. Our elected officials have acted to restructure a system that produced unsustainable national costs, left millions uncovered, is the most expensive per capita in the world and after all of that, is near the bottom of measured health outcomes for industrialized countries. The bill is not perfect but it is a good start. Our nation can continue to study broken and inefficient portions of delivery and provide subsequent improvements to the system.
There has been much political capital expended and action proposed by those who objected to the reforms in the elections this fall. It appears that non-partisan action for the betterment of our society is moribund. Not one single Republican voted to fix the existing costly and dysfunctional system. Sen. Hagan, Reps. Price, Miller and Etheridge joined other courageous members of Congress to vote their conscience and support these reform efforts. I believe most of us will find, upon closer examination, that America will have a better system of care once we understand the benefits the reforms provide us.
First of all let’s explode the myth. Reforms of the private system are not a government takeover of healthcare. All 160 million Americans covered by employer-sponsored plans will be able to keep them.
Reforms and Timelines
- Immediate insurance access for children with preexisting conditions. Establishes high-risk pools for coverage for all other persons denied coverage because of preexisting conditions.
- This year the denial of coverage because of illness and lifetime caps on coverage must cease. Children up to age 26 can remain on their parent’s insurance plan.
- Consumer cost protection. By 2011 all insurers have to prove that they are spending 80% of premiums (for individual and small group insurance) of premium dollars on medical services. 85% for large group plans.
- This year provides $250 rebate for those who enter the Part D prescription doughnut hole. Phases out the donut hole completely over a ten-year period and a 50% discount on brand-name drugs and 75% discount for generic drugs by 2020.
- By 2014 provide subsidies for families to help purchase insurance.
- Expand health coverage to an estimated additional 32 million people. This is critical to bringing down the cost of all medical services. We cannot truly impact existing system costs until most people can and do obtain preventative care.
- Establishes free preventative care screenings and immunizations. Free wellness visits for all Medicare beneficiaries.
- Provides 10% bonus to physicians providing primary care and scholarship funds for primary care physicians and nurses in training.
- Creates an independent Payment Advisory Board Commission for recommendations to Congress to reduce Medicare spending. Must be acted on by Congress on a fast track.
- Establishes a voluntary national long-term care insurance program to assist with these costs. Supports in-home care.
- Reforms are paid for and reduce the deficit by $119 billion over 10 years. The non-partisan Congressional Budget Office conservatively projects savings of $1 trillion to the national budget by 2020.
In the midst of all the heated debate that did occur, I heard very little about individual personal responsibility for our own health and the resulting costs we might incur. We need to stop taking for granted that a small co-payment is what the true cost for a visit to the doctor is. What we are seeing on a national scale is rates of obesity, and resulting Type II diabetes, increase alarmingly. The estimated annual cost for obesity care is over $200 billion. Cost estimates for those who smoke equal $190-200 billion per year. No matter what healthcare reforms are passed the system will be increasingly burdened by the escalating costs of care for these health issues. I am not certain what the exact percentages are but I believe it is close to the 80/20 rule. Experts tell us that 80% of the healthcare system cost is incurred by 20% of the patients. Put simply, we all have to do a better job of caring for ourselves through proper eating, exercise and reduction of harmful habits.
It is my hope that these explanations of the reforms have eased some of the anxiety that I know is out there. But don’t take my word; go read the bill for yourself. Do not let someone else make up your mind for you. To that end here are the links to both the full bill and the smaller reconciliation bill. Discover for yourself how you and your family are affected. We all have time to read them before we express our will in the elections this November.
Senate-House Reconciliation Amendments