(Excerpted from the New York Times Aug.10, 2009)

With the debate over the future of health care now shifted from Capitol Hill to town halls, supporters and critics of the Democrats’ legislative proposals are polishing their sound bites and sharpening their attack lines.

Increasingly, the battle looks like a presidential contest, with expensive advertising campaigns and Internet-driven efforts to mobilize local support. It can be difficult to sort fact from fiction, as angry protesters denounce the legislation at raucous public forums.

President Obama and his Democratic allies in Congress have made the health care overhaul their top priority, putting their political futures on the line. Democrats had hoped to spend the month whipping up support for the legislation, but instead find themselves on the defensive, responding to what Mr. Obama describes as “outlandish rumors” spread by critics.

Many Republicans view fighting the president as a smart political strategy, turning a potentially wonkish debate over Medicare reimbursement rates and subsidies for the uninsured into an ideological battle over the government’s role in health care.

Each side hopes to win ground by boiling down one of the most complex policy discussions in history into digestible nuggets. For beachside viewers who might be more interested in iced-tea service than fee-for-service, here is a guide to the main fight points.

KEEP IT OR LOSE IT?

Mr. Obama has said repeatedly, as he told the American Medical Association in June: “If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.”

These assurances reflect an aspiration, but may not be literally true or enforceable.

The legislation does not require insurers or employers to continue offering the health benefits they now provide. The House bill sets detailed standards for “acceptable health care coverage,” which would define “essential benefits” and permissible co-payments. Employers that already offer insurance would have five years to bring their plans into compliance with the new federal standards.

The Senate health committee bill goes somewhat further by offering an “option to retain current insurance coverage.”

The legislation could have significant implications for individuals who have bought coverage on their own. Their policies might be exempted from the new standards, but the coverage might not be viable for long because insurers could not add benefits or enroll additional people in noncompliant policies.

Dallas L. Salisbury, president of the Employee Benefit Research Institute, a private nonpartisan group, said: “The president and Democrats in Congress are saying what they would like. Their promises may not be literally true because your health plan may change, and your doctor may no longer accept your insurance.”

SOCIALIZED MEDICINE

Or Uniquely American?

Republicans harshly criticize Democratic proposals to create a government-run insurance plan, or public option, to compete with private insurers. Republicans say the public plan would drive insurers out of business and lead to “socialized medicine” or a government takeover of health care. Democrats say they want a “uniquely American” system with public and private elements.

For now, the Republican criticism seems overblown. Major versions of the legislation all rely heavily on a continuation of private health plans, offered by employers and by insurance companies, subject to sweeping new federal regulations.

Whether a public plan would crowd out private insurers depends on details yet to be decided, including its premiums and its payment rates for health care providers.

The public plan is not even a certainty. To win bipartisan support for the overhaul, some Democrats have proposed private nonprofit health care cooperatives, instead of a public plan, to compete with private insurers.

The Congressional Budget Office has estimated that, under the House bill, the number of people with employer-sponsored insurance would climb to 162 million in 2016, which is 3 million more than expected under current law. Further, it said, enrollment in the proposed public plan might total 11 million, far lower than estimates cited by Republicans.

An additional 10 million people, most of them now uninsured, would enroll in Medicaid, the budget office said.

At any rate, the federal government already holds sway over the health care system through Medicare, Medicaid and various insurance programs for children, veterans, military personnel and other federal employees. The federal government will account for 35 percent of the expected $2.5 trillion in health spending this year, and that does not include subsidies built into the tax code.

To read the entire article, visit the New York TImes

Written by :

Michael Alan Bissett

 

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