So far, Republicans in Congress have mainly expressed opposition to the healthcare reform plans proposed by the Democrats. They haven’t offered many solutions of their own, but that’s about to change.  John Boehner, the most powerful member of the minority party in the House of Representatives, has promised that the GOP will present an alternative bill that doesn’t entail major government involvement or adding to the national debt. Obviously, there will be no public option in this version.

Boehner acknowledges that the current system isn’t ideal. How does he plan to give more Americans access to health insurance? These are several things Republican healthcare reform bill would do:

• Severely decreasing the number of medical malpractice lawsuits. This would lower health care costs through a reduction in the unnecessary tests given by overly cautious doctors. Malpractice insurance can also cost doctors millions of dollars per year. As a bonus, it doesn’t hurt that trial lawyers tend to support and contribute to Democratic politicians; this measure wouldn’t affect many GOP supporters.
• Creating a pool that allows small businesses and individuals to buy affordable health insurance in large groups. That proposal is similar to part of the Democrats’ healthcare plan. It’s pretty noncontroversial.
• Repealing the regulations that prevent people from going across state lines to buy health insurance plans. Some states, such as New York, regulate the industry more than others. These regulations include prohibitions on denying insurance to people with pre-existing conditions, for example. While these measures allow more people to be insured, they also result in higher health insurance premiums. Boehner believes that creating a nationwide free market will be more effective in lowering healthcare costs than a public option.

A Republican plan wouldn’t include a health insurance mandate, and would avoid tax increases. It sounds nice, but would it actually be successful? Even party leaders admit that their proposals wouldn’t come close to covering most of America’s uninsured.

The medical device industry, which manufactures and sells items such as heart stents and artificial hips, has kept a low profile during the healthcare reform debate. However, that doesn’t mean that they won’t be affected. Their products are very important to many patients, but help drive up the cost of your health insurance plan. That’s probably why the House of Representatives’ healthcare reform proposal includes $20 million in taxes–coming from a 2.5% sales tax. AdvaMed, the industry’s lobbying group, is obviously unhappy with this and believes that the tax will be detrimental to the American economy.

What would medical device makers consider a more acceptable bill? One that:

• Exempt small companies, defined at those making less than $100 million
• Would be tied to specific products, presumably with more profitable products being taxed a higher rate
• Was at least partly deductible as an expense and,
• Doesn’t take effect until 2013.

As it turns out, the medical device industry was lucky. An initial Senate proposal doubled the fee to $40 million, so AdvaMed has expressed its gratefulness for the reprieve. Such a break was probably going to happen anyway, in exchange for moderate Democratic Senator’s Evan Bayh’s support. Bayh represents Indiana, a state that is the headquarters to many medical device companies. Will the goal of affordable health insurance still be achieved with this corporate giveaway?

(Image: stevendamron under CC 2.0)

Following her Senate counterpart’s reveal of his healthcare reform plan earlier this week, Speaker of the House of Representatives Nancy Pelosi has now unveiled her chamber’s proposal for expanding affordable health insurance coverage. As expected, the House’s plan is farther-reaching than the Senate’s and more similar to the one outlined by President Obama during his campaign.  Here’s a quick Q&A on Pelosi’s plan:

Q: How much is this going to cost?

A: It’s projected to cost a whopping $894 billion over ten years.

Q: How is the government planning to pay for reform?

A: It will raise income taxes on couples making over $1 million and individuals making over $500,000 yearly. In addition, Medicare spending will be cut by an unknown amount.  Liberal representatives also floated the idea of having the government dictate the rates paid to health care providers by the public option, but moderates managed to strip out that provision. (The government, as well as private insurers, will instead negotiate payment rates with hospitals and doctors.)

Q: Is a public option included?

A: Yes. Unlike the Senate version, the House’s bill doesn’t allow states to opt out of it. So far, it doesn’t include a so-called “trigger” either.

Q: Will illegal immigrants be covered by the public option?

A: As of now, it’s unclear. That’s one of the main sticking points preventing the House bill from reaching a vote. However, remember that illegal immigrants are already receiving a form of public healthcare: hospital emergency rooms are required to serve everyone who comes in.

Q: What about abortion? Will it be covered?

A: That’s another controversial topic that will see much debate before the bill hits the House floor. A handful of pro-life Democrats will probably try to have abortion coverage removed from the public option in order for it to receive their votes. Meanwhile, some pro-choice representatives oppose a bill that doesn’t include abortion services. Either way, the Democrats have a solid majority in the House and can afford to lose some votes in either direction.

Q: What if I have a pre-existing condition and can’t get insurance?

A: These reforms are supposed to change that. Health insurers will no longer be allowed to deny coverage to people with pre-existing conditions. They won’t be able to charge those with pre-existing conditions significantly more, either.

Q: When will healthcare reform take effect?

A: It’s hard to believe, but the bill won’t fully kick in until 2013. By then, a mandate will require everyone who can afford it to buy health insurance. They can be insured via the newly created exchange (consisting of private insurers, in addition to the public option), by their employer, or an existing government program such as Medicare or Medicaid.

Q: But I need health insurance now! What can I do in the meantime?

A: The government is putting together a temporary program to insure individuals and families that have been rejected by private insurers. Otherwise, do you really want to wait for the government’s health insurance plan? Keep in mind that the House bill needs to be reconciled with the Senate bill before there’s a final vote, and that could take months.

(Image: U.S. House of Representatives Portrait)

Over the past week or so, the public option has been on a roll. Democratic leaders of Congress have insisted that some form of a public option be included in their healthcare reform bill, considering it an essential step in providing the nation with more affordable health insurance. It wasn’t going to be an easy battle. Senator Joe Lieberman has expressed his opposition to such a government-run plan. The independent senator–who used to be a Democrat and still caucuses with the party–cites budget concerns as his primary reason for rejecting it, and believes it isn’t the right time to go into even deeper debt. A less charitable view is that he wants to continue receiving funds for his re-election from major health insurance companies, many of which are headquartered in his home state of Connecticut. Only Lieberman himself knows his motivations for sure.

Lieberman has stated that he will vote with Harry Reid in the initial procedural vote that allows the bill on the full Senate floor for further debate, but vows to be part of the inevitable Republican filibuster against any final bill that includes the public option health insurance plan. Leaders should take him seriously, since he’s well-known for switching sides: he even campaigned for John McCain during last year’s presidential campaign. Nobody said getting 60 votes in the Senate would be easy; don’t be stuck without a health insurance plan in the meantime.

(Image: Official U.S. Senate Portrait)

Senate Majority Leader Harry Reid has joined the strong push for a public option in Congress’ healthcare reform bill, but its inclusion is not guaranteed. The provision’s fate is in the hands of moderate Democrats. Despite the ability for individual states to opt out of the government-run health insurance plan, centrist Democrats like Senators Ben Nelson and Max Baucus are still leery of voting for it. You should get a health insurance quote while you wait for the endless wrangling of votes to finish, since garnering 60 Senate votes to pass this bill will no doubt take awhile. The fact that several politicians in the party have received large campaign contributions from the health insurance industry doesn’t help.

Why the delay? The Senate and the House of Representatives have to debate exactly what form the public option will take, and moderates hold its fate in their hands. They need to compromise between comprehensive health coverage and cost. Gaining Republican votes is a lost cause at this point, so party leaders will be forced to exert their power. For example, Reid may try to convince a swing vote with a seat on a prestigious Senate committee–that a Senator will only get if he or she votes with him on healthcare reform. The more liberal House has a more comprehensive public option proposal included in its bill, and it must be combined with the bill in the generally more conservative Senate prior. Afterward, it’ll see even further amendments by the rest of Congress before a final vote. There is also the possibility, albeit less likely, that some liberal politicians will vote against the bill because it doesn’t do enough to reform our health insurance system. However, centrist politicians receive more attention from leaders because they are the wild card. Can you wait for Washington to decide, or would you prefer to be safe and get health insurance quotes from multiple insurers now? If, years from now, you like what the public option shaped up to be better than your existing health insurance plan, you’ll be able to switch–but if you’re caught uninsured before then, you’ll wish you hadn’t waited.

Medicare is one of the currently existing government-run health insurance plans (for individuals over the age of 65), and has been cited as a possible model for the public option proposed in healthcare reform bills. Medicare Advantage consists of supplement plans sold by private insurers, which provide extra coverage to certain consumers. Basically, think of Medicare as the basic model of a car and Medicare Advantage as the optional extras (sunroof, multi-CD changers). As of last year, over 10 million senior citizens who were eligible for Medicare also bought Medicare Advantage policies.

The health insurance industry is taking advantage of Medicare Advantage’s popularity with a new television spot. An ad by America’s Health Insurance Plans points out that healthcare reform will lead to cuts in the government’s support and subsidization of Medicare Advantage plans. One of the five healthcare bills floating around congressional committees (which must be reconciled into a unified bill for the entire Congress to vote on) calls for a $100 billion reduction in federal funding of Medicare Advantage. The program has its own issues that must be fixed, but older people are more vulnerable to scare tactics surrounding possible changes to their current long term health insurance. This may also be why the senior citizen demographic is least likely to support major healthcare reform.

(Image: Kaiser Family Foundation)

Forget the Invasion of the Body Snatchers. Right now in Washington D.C.,  it’s more like the invasion of the health insurance industry’s lobbyists. The final reconciled healthcare reform bill is set to hit Congress in a few weeks’ time, and over the past few days it’s become clear that it will more likely than not include some version of a public option. Groups such as America’s Health Insurance Plans have registered over 3,000 lobbyists on the subject, at a cost of $263 million this year alone. Leading Congressional Democrats, like Harry Reid and Nancy Pelosi, have reaffirmed their support of the public option while turning against the insurance companies. Both sides of the issue seem to have rejected further attempts at compromise.

Meanwhile, thousands of lobbyists are currently courting representatives and senators–their targets run across the political spectrum, but they’re mostly focusing on Democrats perceived to be weak on health care reform.  The days of infamous lobbyist Jack Abramoff taking congresspersons on all-expenses-paid exotic vacations in exchange for voting in his client’s favor are supposed to be over, but some may still be swayed on the public option by their schmoozing. On the bright side, it seems as though their actions this time around could be obviously sleazy enough that even most politicians may turn against them. Even though Americans disagree on the best route for reform of our nation’s various health insurance plans, we all hope that our representatives in Congress will do what’s best for America as a whole.

(Image: Fovea Centralis under CC 2.0)

While making the rounds of the Sunday morning talk shows, Republican Senator (and 2008 Presidential candidate) John McCain stated that he believes that some form of a public health insurance plan will be included in the healthcare reform bill. McCain is a staunch opponent of government involvement in health care, but is certain that the Democrats have enough votes to pass some form of a public option in both chambers of Congress. While it’s looked for awhile as if the House of Representatives’ bill would include that government health insurance plan, prospects for such a provision in the Senate appeared doubtful. However, other legislators shared McCain’s confidence that it would gain the 60 votes required to pass; as well as his doubts that Republicans would filibuster the health reform bill.

Still, the plan that ends up in the final bill may not be the comprehensive Canadian or European-style public program that has been receiving all the attention. It’s very likely that the public option included might be subject to a trigger. Such a trigger option would only take effect if the private market fails to perform to certain specifications, as a sort of safety net. These conditions include the failure to insure a certain percentage of states’ populations over a certain time period, or not achieving enough success in reducing costs. That type of coverage from the federal government isn’t as far reaching as what Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi desire, but is a health insurance plan that has a better change of passing both houses. McCain speculates that the triggered public option is what will probably be included in the bill, as Democrats were burned from their last attempt to pass sweeping health reform during the Clinton administration.

(Image: marcn under CC 2.0)

Even though news has broken that a Public Option bill has passed, it is really still stalled. It only passed out of the Senate Finance Committee but has yet to pass any other sectors of congress. It can still be shot down or filibustered. The problem is no one wants to vote on this issue. They want it to stay the same. The effects of this bill are vast and sweeping. They effect both the economy and workplace as well as every American.

A public option, however, doesn’t meant free universal healthcare. It could mean tax credits for those making under a certain amount. It could mean annual credits for checkups at any doctor or it could mean simply another plan to choose from to compete with current plans, driving down prices. In fact, it could even increase the value of private healthcare because if government run healthcare works anything like the VA or medicare, then people are going to want an alternative even if it is a bit more costly.

How many doctors are going to want to deal with government health insurance? What will the limits be? will they be just as ruthless on cost of operations, will they deny you what you need because it is too expensive to the US government?

There are still so many questions and without a clear bill to really look at (since its always changing) things are still up in the air and people are still stalling.

Don’t go without health insurance too long hoping for the public option, Obama may be out of office by the time it passes and gets established as a viable option.

When did we get the idea that we are entitled to certain things as human beings, as Americans? Perhaps the constitution which grants so many rights such as free speech and the right to bear arms, is the source by which we have made our mistake.

The constitution has granted us rights to abstract concepts that can be utlilized for form action and physical results for ourselves and our fellow men and women. However, no where did it claim that physical things, such as food, shelter or healthcare are given rights. There is no precedent to this. The idea that these are given rights creates a different America, a lazy America.

As Americans we motivate ourselves by the promise of what is to be. If we have everything that we want and need, then we have nothing to strive for, to fight for or to evolve ourselves and those around us for.