Jen Cannistra from the White House Office of Health reform has a post up at the White House Blog that takes an interesting approach to assessing the current health care reform effort. She reminds us of something the Obama Team did during the transition.
…in December 2008, we invited Americans across the country to host and participate in Health Care Community Discussions to talk about the problems they faced with the health care system and proposed solutions. Over 9,000 Americans in all 50 states and the District of Columbia signed up during the holiday season to host a Health Care Community Discussion, coming from every walk of life – patients, doctors, nurses, religious leaders, first responders, and small business owners.
She then breaks down what they learned into discreet categories and says what the current bills do to address the problems.
Lacking Insurance Security
Health Insurance Reform Solution: Reform will ensure that Americans always have guaranteed choices of quality, affordable health insurance whether you lose your job, switch jobs, move, or get sick. With the new health insurance exchange, Americans can easily compare insurance plans, prices, and performance to decide which quality affordable insurance option is the right one.
Problems with Insurance Companies
Health Insurance Reform Solution: Reform will end insurer abuses, lower premiums, and hold insurance companies accountable. Insurance market reforms will prohibit abuses such as denying coverage for pre-existing conditions; charging exorbitant premiums based on gender, age, or health status; dropping coverage when people are sick; and imposing annual or lifetime limits on benefits. Insurers will be held accountable for excessive overhead costs fueled by unreasonable executive compensation and profits. And consumer rights will be enhanced by requiring all insurers to provide effective appeals procedures including outside, independent review of appeals.
Denied Coverage because of a Pre-Existing Condition
Health Insurance Reform Solution: Insurance companies will no longer be able to deny or water down coverage because of a pre-existing condition. Affordable insurance coverage options will also be made immediately available through a high-risk pool for Americans who are uninsured and have a pre-existing condition. In the Senate bill, insurers will be prohibited from denying coverage to kids with pre-existing conditions six months after enactment.
Charged More Because of Illness
Health Insurance Reform Solution: Reform will end insurance discrimination that charges individuals more if they currently face or previously had any illness.
Overwhelmed by Out-of-Pocket Expenses
Health Insurance Reform Solution: Reform will save families from financial ruin by placing a cap on what insurance companies can force individuals to pay in out-of-pocket expenses. As well, Americans will no longer face annual or lifetime benefit limits so that Americans can have the peace of mind that treatments they need will be provided.
Lacking Access to Health Care
Health Insurance Reform Solution:Reform will give insurance coverage to over 30 million previously uninsured Americans and will provide refundable tax credits to make sure Americans can afford quality coverage. For those receiving this premium assistance, the Congressional Budget Office estimates that average premiums under reform will be significantly less than what they would have paid without reform.
Caught by the “Donut Hole”
Health Insurance Reform Solution: Reform will close the coverage gap, or “donut hole,” in the Medicare Prescription Drug Program, dramatically lowering the cost of drugs for millions of seniors.
Expensive Early Retiree Premiums
Health Insurance Reform Solution: Employers and their retirees between 55 and 64 years of age will have lower premiums from new financial assistance to employer health plans that cover early retirees, bringing down premiums by as much as $1,200 per family per year for some plans.
Small Business Burdens
Health Insurance Reform Solution: Small businesses pay three times the administrative costs of large businesses for health insurance. Health reform will create a health insurance exchange that will reduce administrative costs, enabling small businesses to easily and simply compare the prices, benefits, and performance of health plans. Reform will also provide tax credits to help small businesses provide health insurance for their employees, making health care significantly more affordable for small businesses and their workers.
Struggling with Rising Health Care Costs
Health Insurance Reform Solution: There are numerous ways that reform will lower costs for Americans. Reform will create an “exchange” or marketplace for insurance competition that will lower administrative costs. The Congressional Budget Office estimates that such reforms will lower premiums of a comparable plan in the individual market by 7 to 10 percent – which means more money in the pockets of Americans, and the security of having high quality coverage. Reform will also lower health care costs by streamlining the health care system through reforms such as improving care coordination, reducing medical errors, and encouraging more efficient health plans. A recent Council of Economic Advisers report (pdf) estimates that these provisions could reduce the growth of health care costs by one percent, generating 320,000 jobs nationwide and raising median family income by $6,800 by 2030. And a recent Business Roundtable study found that with reform, health care costs could be reduced by as much as $3,000 per employee by 2019.
Concerns about Fragmentation in the Health Care System
Health Insurance Reform Solution: Health insurance reform will invest in innovative models of care such as “patient-centered medical homes” and “accountable care organizations” that rely on teams of primary care doctors, specialists, and nurses working together to coordinate and monitor a patient’s care more effectively. These models are intended to encourage health care providers to better coordinate a patient’s care, track prescriptions, avoid duplication of treatments or tests, and follow a patient’s health progress. This will help improve quality of care, prevent medical complications, and reduce costs by keeping people healthier and out of the hospital, especially important for those with chronic medical conditions.
Concerns about Medical Malpractice
Health Insurance Reform Solution: In September, President Obama issued a Presidential Memorandum directing the Secretary of HHS to move forward with an initiative to give states and health systems the opportunity to apply for medical liability demonstration grants that put patient safety first and work to reduce preventable injuries; foster better communication between doctors and their patients; ensure that patients are compensated in a fair and timely manner for medical injuries, while also reducing the incidence of frivolous lawsuits; and reduce liability premiums. To encourage states to develop alternatives to traditional malpractice litigation, the House bill includes a voluntary state incentive grants program and the Senate bill includes state demonstration grants.
Inadequate Emphasis on Prevention
Health Insurance Reform Solution: Reform will require insurance plans to provide free preventive services and will create a system that manages illness and disease instead of just treating it when it’s too late.
Primary Care Physician Shortages
Health Insurance Reform Solution: Reform will increase funding for grants, scholarships and loan repayments for physicians, nurses, dentists, mental health providers, and others. Reform will also provide loan repayment programs to encourage more nurse faculty to address the educational bottleneck in nursing, support programs to increase diversity in our workforce, invest in better workforce analysis so we know where more resources and providers are necessary, and provide payment bonuses to primary care providers practicing in underserved areas.
You can drill down and get more detail as well as read real-world testimonies at the original link.
How do these concerns line up with your experiences? What do you think of the “reform solutions”?
