Health Care Reform: House vs. Senate

Wednesday, December 16, 2009

While the House passed its version (HR 3962) of national health care reform earlier this month, the Senate continues to debate its own bill (HR 3590). It now appears that a number of changes are being considered, including the so-called “public option”. Regardless of the contents of the Senate’s final version, the two separate laws must eventually be reconciled to eliminate any differences between the House and Senate versions before the “law” can be implemented. The task of reconciling almost 4,000 pages contained in the combined documents is no mean undertaking (the devil is in the details). Although, the reconciled version will most assuredly not contain 4,000 pages, it can be expected that the final version will still be a significantly sized document. What’s more, you can expect that the final law will be amended over time, as is the case for virtually all major legislative acts, i.e., ERISA.

Whether you are a supporter or not of a public health care option, you must acknowledge that today we have a number of such options funded in part by local, State, and/or Federal taxpayer monies in the form of Medicare, Medicaid, Children's Health Insurance Program (CHIP), State high-risk pool programs, VA, TriCare, FEP, … et al. In addition, many health care providers write-off indigent care and care provided to others who fail to pay. In the case of indigent care, these write-offs may be fully or partially reimbursed by local, State, and/or Federal entities. And in the cases of taxable organizations, such write-offs (bad debt) may be deductible against earnings. In any case, the cost of such care eventually becomes the financial burden of the taxpaying public either directly through taxation or higher health care costs, i.e., increased insurance premiums.

Based on the findings of a USA Today/Gallup poll released yesterday, December 16, 2009, 48% of those polled would advise their Senators to vote against healthcare and 46% to vote in favor of healthcare, with 6% offering no opinion. The poll was based on phone interviews with 1,025 adults, 18 and older taken between 12/11 and 12/13, 2009. The poll had a 95% confidence level with a margin of error of ±4 percentage points. See the complete poll at:
http://www.gallup.com/poll/124715/Majority-Americans-Not-Backing-Healthcare-Bill.aspx

While 48% is not an absolute majority, there are a number of individuals who are unable to put their full support behind the current health care legislation. On the other hand, 46% (no small number) of those polled felt that legislative action was needed and they are willing to support their elected officials in national health care reform. It is safe to say, that Americans are almost equally divided between what course of action to take relative to this debate. Whatever is the final outcome, half of Americans are going to be dissatisfied with the results, at best. At worst, no one will be pleased with the final product and it will be a source of discontent for both supporters and non-supporters.

There is much at stake with health care reform. It is suggested that as a nation, we are at a competitive disadvantage relative to other nations due to the added cost the American health care system places on our manufactured goods. We are told that Americans spend more on health care per capta than others and receive less value than those who spend less, i.e., Britain, France, Germany. It is reported that a significant portion (47m +/-) of the US population is uninsured and thus represents a loss of productivity for those Americans and an avoidable and unnecessary economic burden on the country.

As someone who has witnessed the growth in health care expenses and the difficult decisions individuals, employees, and employers have been forced to make, the outcome of the current national health care reform will have a far reaching impact.