Health Reform – Getting over the finish line

It’s looking more and more like Congress may actually act on health reform in the few weeks. The first vote in the House will be the hardest. If the House passes the Senate bill, what remains will be a simple up or down vote in the Senate on a series of amendments that would give more Medicaid money to the states, get rid of any special treatment for any state (read Nebraska), improve subsidies for families to buy coverage, and toughen regulations on the insurance industry. With the President making the case for quick action again yesterday, a look at just a few of the things reform will actually do for North Carolinians is worthwhile:

1. It will give people the security and peace of mind to know that they won’t lose their health insurance just because they lose or change their job.

2. Insurers will be prohibited from denying health coverage or charging more for pre-existing conditions – immediately for children and over time for adults as the health insurance exchanges get up and running.

3. Many small businesses will immediately get substantial tax credits – for up to half the cost – to enable them to start providing health coverage to their workers.

4. The so-called “doughnut hole” gap in Medicare drug coverage will be eliminated.

5. Parents will be able to immediately keep their kids on their own family insurance plan up until age 26.

Just as important, reform will start the changes we need to bring costs under control. In addition to reducing the federal deficit by over $100 billion over the next ten years according to the Congressional Budget Office, reform contains the critical changes we need to lower health costs. First, as this article in the New England Journal of Medicine this week explains, the reform bill sets up series of pilot projects in Medicare to assess how different ways of paying providers can save billions of dollars. The authors cite one method tested already by Medicare of paying doctors and hospitals a global fee for taking care of a heart patient – this project showed immediate savings and is the kind of change that, once tested, can be implemented across our health system to save substantial amounts of money and improve care.

In addition, Medicare is made much more efficient by reducing overpayments to private insurers and streamlining the way Medicare pays for care. The savings from these efficiencies are half plowed back into Medicare itself, reducing costs for preventive services and helping close the drug “doughnut hole” gap. In addition, reform bills set up a center to compare treatments and figure out which ones work and are worth paying for, encourage state innovation in malpractice reform changes, and put a new emphasis on prevention and coordination of care.

Special interests can’t be allowed to get in the way of the care and cost savings so many North Carolinians need. I’m very optimistic that we are finally on the reform home stretch.


  1. pino

    March 9, 2010 at 3:19 pm

    reducing the federal deficit by over $100 billion over the next ten years according to the Congressional Budget Office

    They achieve that by taxing us for 10 years while providing service for only 8. It’s a nice trick, but a trick non-the-less.

  2. Adam Searing

    March 9, 2010 at 3:44 pm

    Since the bill taxes only cadillac health plans of top execs and people making over $200,000 a year, I guess by “us” you mean a pretty select group…

  3. pino

    March 9, 2010 at 6:51 pm

    I guess by “us” you mean a pretty select group…

    Hi Adam, that would be an interestinig debate if we were discussing how to tax folks; but we’re not. Who ever the “us” is doesn’t matter. “Us” or “them” The oint you are making is that this bill reduces the deficit by $100 billion over 10 years. My counter to that claim is that the only way it can do that is to bring in revenue [doesn’t matter how] for 10 years while supplying a product for only 2.

    When viewed this way, you begin to see that beginning in year 11 or 12, this whole house of cards will fall apart and begin to hemorrhage money just like every other social program we have passed.

    So, your claim may be technically accurate, it is only achieved by a trick of legislation.

  4. IBXer

    March 11, 2010 at 10:38 am

    Adam, you should be ashamed of printing these kind of outrageous lies that have been totally discredited.

    This bill will:

    1) Cause higher unemployment due to the added cost of doing business.

    2) Increase premiums for 25% of Americans according to CBO because of the no pre-existing condition rules.

    3) This bill will cripple small business who rely heavily on part-time employees because it “will require businesses to count part-time workers when calculating penalties for failing to provide coverage.”

    4) The Director of the CBO, Doug Elmendorf, told the Senate Budget Committee that none of the bills he has seen would reduce health care costs: “In the legislation that has been [analyzed so far] we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of … health care spending by a significant amount…. On the contrary, the legislation significantly expands the federal responsibility for health care costs.”

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