Economist: The beginning of the end & Getting to 60

Things are getting a little clearer for me in terms of all the health bills that are currently being debated in Congress. So the House bill it seems has already been debated and passed. The Senate bill is currently being debated with the hope that the bill will be voted on before Christmas.

According to The Economist, The beginning of the end, the Senate bill is superior to the House bill because it's not keen as keen on the public option and proposes to pay for healthcare via excise taxes on expensive plans as opposed to the House bill's solution of taxing rich people. My understanding of the article is that the bill proposes to decrease government subsidies to employer-provided health insurance. But I'm not really sure if the government subsidizes employer-provided health insurance--need to find the answer to that. If they do subsidize, then I agree that a lot of cost savings could be achieved by eliminating those subsidies. But of course, then premiums on health insurance would go through the roof and then insurance would truly be unaffordable to all but the richest Americans, who wouldn't even need insurance in the first place.

The current Senate (and House) bill primarily focus on extending coverage to the 47 million people in America who don't have health insurance. But the bill really doesn't do much to address the issue of cost containment, which in my mind should be the biggest area of focus. Of course the government could be going for a phase approach: 1st phase extend coverage to all Americans, 2nd phase start containing cost. This is what Jeffrey Flier, the dean of Harvard Medical School, had to say for the bill:

“While the legislation would enhance access to insurance, the trade-off would be an accelerated crisis of health-care costs and perpetuation of the current dysfunctional system—now with many more participants. This will make an eventual solution even more difficult.”

Yikes.

As of earlier this week, I think that the public option was killed in the senate bill. A few alternatives have taken its place including a proposed expansion of Medicare to people ages 55-65. These individuals will be allowed to 'buy-in' to Medicare if they they have no other means of affordable health insurance. Another alternative is for the Office of Personnel Management, which currently manages the health plans of federal employees, to offer health insurance to the public through private not-for-profit insurance entities.

Another proposed mechanism for cost control proposed in the Senate bill is the concept of an Independent Medicare Advisory Board, which would be given a mandate to propose spending cuts and other reforms if health care spending exceeds targets. These proposals are presented to the president, who then submits them to Congress for approval.

It will be interesting to see if the Senate bill can be passed before Christmas...

The beginning of the end

Getting to 60