So we'll finally have (almost) universal health insurance in the USA after they merge the bills in congress and Obama signs it into law. Most parts won't take effect for several more years and it will probably be a decade before the new system is fully in place. The reforms will be budget-neutral and will pay for themselves with new taxes, cuts to existing programs, and reforms to the existing Medicare program. The reforms are largely based on what was done in the state of Massachusetts from 2006-present. They now have almost universal coverage in the state (like 98%) through a combination of expanded public programs, subsidies, mandates, and regulation.
Basically, here's what the reformed health care system will look like:
<ul><li>Most people (60%+) will continue to get their health insurance through their employer.</li>
<li>People 65 and older will continue to get Medicare (which is like Candadian Medicare, but stingier, and only for the elderly)</li>
<li>Medicaid (the state-run program for the poor) will be expanded to cover far more people including all adults in poverty for the first time.
<li>There will also be health care "Exchanges" set up in the states which will sell a variety of private health insurance (a "public option" probably won't be available) including the same insurance that federal employees (congressmen, postal workers, etc) get. The idea is that everyone else will buy insurance from these exchanges. Premiums will be heavily subsidized on a sliding scale to make them affordable.
<li>You will be required to have health insurance through your employer, Medicare, Medicaid, or one of the Exchanges, or pay a tax penaltly (This is how it is done in Switzerland and several other European countries).</li>
<li>There are numerous other provisions that will make insurance fair: now they won't be able to deny you for a pre-existing condition, or charge you more for one, or drop you once you have coverage (unless you don't pay)</li>
<li>There are also numerous provisions to try to reign in costs in Medicare--a program which is quickly running out of money.</li></ul>
In the end, 95-98% of American citizens will have health coverage in 5-10 years--up from 85% now--with many of the most egregious practices of the health insurance industry ended. Most people won't notice much difference at all since most are already insured. The uninsured, unless they're poor or old, will be required to purchase private insurance (at subsidized rates in a fair market).
Thoughts? Comments?
I personally think that this is a logical step to make given our existing system. However, the existing system is pretty crappy. We will still spend more per person on health care than any other nation and we still won't have 100% universal coverage. Also, they stripped the provision that allows people under 65 to buy into a single-payer, government-run program like Medicare. I believe that this would have made the market much fairer. The political will to make more substantial changes just wasn't there. We have far too many lobbyists for large corporate health interests and far too many conservative politicians who believe health care is a privelege reserved for the higher classes.
Basically, here's what the reformed health care system will look like:
<ul><li>Most people (60%+) will continue to get their health insurance through their employer.</li>
<li>People 65 and older will continue to get Medicare (which is like Candadian Medicare, but stingier, and only for the elderly)</li>
<li>Medicaid (the state-run program for the poor) will be expanded to cover far more people including all adults in poverty for the first time.
<li>There will also be health care "Exchanges" set up in the states which will sell a variety of private health insurance (a "public option" probably won't be available) including the same insurance that federal employees (congressmen, postal workers, etc) get. The idea is that everyone else will buy insurance from these exchanges. Premiums will be heavily subsidized on a sliding scale to make them affordable.
<li>You will be required to have health insurance through your employer, Medicare, Medicaid, or one of the Exchanges, or pay a tax penaltly (This is how it is done in Switzerland and several other European countries).</li>
<li>There are numerous other provisions that will make insurance fair: now they won't be able to deny you for a pre-existing condition, or charge you more for one, or drop you once you have coverage (unless you don't pay)</li>
<li>There are also numerous provisions to try to reign in costs in Medicare--a program which is quickly running out of money.</li></ul>
In the end, 95-98% of American citizens will have health coverage in 5-10 years--up from 85% now--with many of the most egregious practices of the health insurance industry ended. Most people won't notice much difference at all since most are already insured. The uninsured, unless they're poor or old, will be required to purchase private insurance (at subsidized rates in a fair market).
Thoughts? Comments?
I personally think that this is a logical step to make given our existing system. However, the existing system is pretty crappy. We will still spend more per person on health care than any other nation and we still won't have 100% universal coverage. Also, they stripped the provision that allows people under 65 to buy into a single-payer, government-run program like Medicare. I believe that this would have made the market much fairer. The political will to make more substantial changes just wasn't there. We have far too many lobbyists for large corporate health interests and far too many conservative politicians who believe health care is a privelege reserved for the higher classes.
