Health Care Reform for the Less-Informed

As I looked back over the few posts I have, I realized I had unintentionally been shying away from the nitty-gritty aspects of the health care reform for one reason: I didn't get it. I really didn't get it, and unfortunately I was too lazy to go way back into the archive of articles to see how it all started. Luckily, my father has worked in the health care field for most of his life, so I sat him down to explain it to me. For those who are as woefully ignorant about health care as I am, here is what he said.

There are three main concerns with any health insurance system: cost, access, and quality. The current United States health insurance system stands as follows:
1. Cost. We spent $2.5 trillion on health care last year. That number is projected to go up to $5 trillion by 2020. This amount is also two times more per person than any other country.
2. Access. There are on average 47 million people without health insurance at sometime during the year. This is 16% of the population.
3. Quality. In rankings of health insurance systems based on various quality indicators among developed countries, the United States ranks below the middle.

It seems to me that everyone would agree these are problems. If you are not convinced, my father also pointed out the ways in which health insurance is starting to affect the country (the people and the government alike).

Obviously, the rising costs of health care put the government in a deficit and put pressure on government budgets. Also, since most people qualify for health insurance through their jobs, there is a lot of pressure on businesses (especially in this economy) and they spend so much on employees' health care that they can't compete with foreign companies. GM and Starbucks, for example, spend more on health care than they do on cars and coffee beans, respectively. Lastly, this puts pressure on families, particularly if they lose their jobs, becuase they have to spend more on health care themselves or get lesser quality health care becuase it's all their employers can afford.

So clearly, this is a downward spiral that needs a change of direction.

Obama's Plan

1. Health insurance exchange/Connector program: This would connect those seeking health insurance with those selling health insurance through a market-type setting. The sellers would have to meet certain standards such as avoiding the experience rating, which prevents people with previous conditions from getting health insurance.
2. Individual mandate: The Connector would be accompanied by an individual mandate, meaning everyone has to get health insurance. To make that possible, the government would provide subsidies for people with low incomes.
3. Public option: To keep health care costs low in private insurance companies, the government would provide a public plan to compete with the private plans and prevent a few companies from monopolizing the profits.
4. Comparative effectiveness: In order to determine what are reasonable expenses for doctors and hospitals, the government will provide studies on comparative effectiveness, which determine what the best course of action (i.e. medication or surgery) is for a given condition/illness, regardless of cost, so that money is not spent unnecessarily.

So that, briefly, is what's going on in health care reform. I tried to present these facts without bias, but now let me state my opinion: I AM ALL FOR IT!!! There is no way to insure an entire country without problems, but attempting to provide health insurance to an entire country: let me tell you, that sounds like an awfully good prospect to me.