Most people don't know what is in the House bill to reform health care, yet it is, I think, close to what the Obama administration originally envisioned. When the House and Senate bills are reconciled, how close will the final product be to the House bill? Hard to tell, but I see it as a benchmark for progressive reform. While it’s not perfect, it represents a very good start. Over the next three years, as it’s fleshed out, details are filled in, and Medicare is reformed in ways that enhances the quality of care, eliminates hazardous waste and reins in costs, it could become an excellent plan. But you can’t root for it if you don’t know what’s in it.
As I mentioned yesterday, the House Committee on Education and Labor has put together an interactive graphic to help people figure out how “America’s Affordable Health Choices Act,” HR3200 would affect them. Again here’s the link. Click on it, and you can find out what the legislation would mean for you, whether you’re self-employed, uninsured, on Medicare, or have employer-based insurance. It also tells you how the bill would affect both large and small employers.
This bill addresses many of the problems that I wrote about in Money-Driven Medicine—and that you see in the film; waste, profiteering, a shortage of primary care doctors, and a system that rewards doctors for doing something—but not for listening to and talking to the patient.
HR 3200 aims to change the financial incentives in our system. Rather than paying physicians more if they see more patients, and order more tests and procedures, it offers bonuses for better outcomes. The bill also addresses the high cost of care, protects patients from medical bankruptcy, makes primary care more accessible, and guarantees that no one will be denied insurance, or charged exorbitant premiums because of a pre-existing condition. Here’s a quick overview.
Few realize that "America's Affordable Health Choices Act" promises:
No more co-pays or deductibles for preventive care
No more rate increases for pre-existing conditions, gender, or occupation
No more coverage denials for pre-existing conditions
An annual cap on your out-of-pocket expenses that should prevent medical bankruptcies. (The cap will be based on your income, but no matter how much you earn, no one will be asked to pay more than $5,000 a year in out-of-pocket expenses –$10,000 a year for a family. This includes all co-pays and deductibles.)
Guaranteed, affordable oral, hearing, and vision care for your kids
Mental health care coverage for everyone
More family doctors and nurses will enter the workforce, helping guarantee access
More family doctors and nurses entering the workforce, helping to guarantee access.The bill raises fees for primary care, offers bonuses to those who provide primary care as well as loan-forgiveness for medical students who choose primary care. It also raises pay for nursing school instructors. At present many qualified candidates would like to enter nursing school, but there are not enough teachers.
No more lifetime limits on how much insurance companies will pay
No reason to ever make a job or life decision again based on health care coverage
Under the bill you can:
Keep your doctor, and your current plan, if you like them
If you don’t have employer-based insurance and buy your own plan, you’ll be able to enjoy lower group rates because you’ll be part of a national pool
The Public Insurance Plan
The bill also offers a high quality public health insurance option that would compete with private insurers. Yesterday, the New England Journal of Medicine published a new poll online showing that nearly three-quarters of all doctors support some form of a public insurance plan.
But no doctor would be forced to participate in the public insurance plan. And no patient would be forced to choose it.
The pollsters explain that doctors like the idea of a public plan because they like Medicare. Many observers expect that the public sector plan would be modeled on a new, improved Medicare. The House bill calls for Medicare reforms that would simultaneously reduce costs and lead to better care by rewarding health care providers for the quality, rather than the quantity of the care they provide.
In order to work out any wrinkles in the public insurance plan, the House bill proposes phasing it in. In the first year of health care reform the public option would available to the uninsured, the self-employed and small employers with less than 11 employees. In the second year, it will be open to those with 20 or fewer employees and over time, to larger employers.
For a more detailed, very clear, user-friendly look at the House bill, go to this website where you can click on specific topics such as: “Myths vs. Facts,” “The Health Insurance Exchange,” “Employers and Health Reform” and “Strengthening Medicare.”