Legislation will be needed for most of the health care plans currently being talked about in the United States. Insurers, doctors groups, and medical organizations have come together to propose voluntary cost-savings measures. However, this has not stopped President Barack Obama or legislators from moving forward on proposals that would substantially change the health care marketplace.
Primarily, it is Democrats that have taken the lead in drafting legislation. Senator Ted Kennedy has long been a proponent of major health care reform. His recent illness has removed him from day-to-day leadership, but his office is continuing to advance legislation for comprehensive reform including a public insurance entity to compete with private insurers. The other substantial Senate proposal will come from fellow Democrat Max Bacaus. Republican Senator Olympia Snowe is working on a proposal that would introduce public insurance only as a punishment to the private insurers if they fail to meet legislated goals for cost savings and good care.
President Obama campaigned aggressively for change in the health care system. He argued for continuation of employer-provided insurance and assistance to individuals who could not acquire health insurance because of pre-existing conditions or the high cost of premiums. Mr. Obama also recognized that rising costs across the U.S. health care system were doomed to bankrupt public financing of Medicare, damage American employers’ competitiveness in the global marketplace and increase the number of people unable to afford private insurance.
The president has continued to weigh in during his first months in office, although he has deferred tolegislative process for the development of detailed proposals. As a result of Mr. Obama’s direction, legislators have overlooked the option of nationalized health care, despite a vocal minority in the public who support adopting the Canadian or European-styled public model.
In the House, the Ways and Means, Energy and Commerce, and Education and Labor committees have come together to present their proposal as the Tri-committee Health Reform Draft. It contains a public insurance entity, requirements for continuation of employer-provided health insurance and aid to individuals seeking to purchase insurance.
Common themes in all proposals are to require at least major employers to provide health care insurance options. This will prevent the new reforms from encouraging employers to abandon heath insurance for their employees. This still may be a problem for employers below, a yet undetermined size. Individuals will be able to buy insurance without exclusions for pre-existing illnesses, although costs may differ based on some criteria, such as age. Public funds will be used to assist local income individuals in the purchase of insurance.
The President has also stated that health care reform must be paid for by cuts in other parts of the budget or efficiency within the health care system. This may be the harder part of the legislative accomplishment. It is not clear how the different proposals will deal with this issue.