MARCH 3, 2009
Tough Questions Dog Health-Care Overhaul
By LAURA MECKLER
WSJ
WASHINGTON -- President Barack Obama launches his ambitious health-care effort with considerable agreement among diverse interests about the need for fundamental changes. But behind that broad consensus lie several tough questions that won't easily be resolved. The White House is declining to stake out a position on most of these questions, though Mr. Obama took stands on them during the campaign. He hopes to work with Congress to find consensus -- a tall order, given that several of his predecessors failed in their efforts to overhaul the health-care system.
(snip)
On Thursday, Mr. Obama will host a summit on health-care issues where a variety of stakeholders will come together with members of Congress. Business, labor and consumer groups, as well as much of the health industry, have all said they want to see changes to the country's health-care system, both to reduce costs and to extend coverage to the 45 million people in the U.S. without health insurance. But big differences exist between Republicans and Democrats over the approach, with Democrats favoring more government involvement and Republicans preferring market-oriented solutions. During his presidential campaign, Mr. Obama proposed a system in which people could buy insurance through a government-organized marketplace, where private plans and a new government-run plan would compete. Subsidies would be available to many based on income.
But his vision prompts many tricky questions, among them:
(snip)
If the government were to require businesses to offer insurance, it would have to set a standard for what counts as insurance. Would a bare-bones plan with limited coverage qualify? Businesses and others would likely wince at the idea of government setting standards for the benefits they must offer. During his campaign, Mr. Obama proposed that large businesses be required to offer coverage or pay into a fund, while small businesses that offer coverage would get a tax credit.
Should individuals be required to buy insurance?
Many experts believe that in order to cover all Americans, there must be a mandate that people obtain insurance. Otherwise, some -- for instance, young, healthy people -- wouldn't bother. During the presidential campaign, Mr. Obama rejected that notion, saying people would buy insurance on their own if the cost came down. At the same time, Mr. Obama and many Democrats want new rules that prohibit insurance companies from rejecting people who are already sick, or from charging them more. The industry argues that it can't be expected to accept many expensive new customers without also getting the business offered by new healthy, cheap-to-insure customers. If the government were to require individuals to purchase insurance, it would have to make sure there is money to pay for subsidies for those who can't afford to pay the full cost on their own.
Should a public plan be created to compete with private insurers?
Many Democrats insist that there be a public option. Some say it would provide a test for whether Americans prefer a government-run system similar to what exists in Canada. But opponents say it would skew the playing field because government will always be able to undercut private insurers' prices.
How to pay for it all?
Mr. Obama has been vague about how the country's future health-care system should be structured, but he was detailed last week about how to pay for it. He proposed raising $634 billion over 10 years through tax increases on the wealthy and cuts to existing government health-care spending. Each of those provisions is likely to be controversial, and more funding will be needed if the government is to provide subsidies to all Americans who need them. Estimates put the full cost of Mr. Obama's health plan at more than $1 trillion over 10 years.
http://online.wsj.com/article/SB123600860805510401.html (subscription)
Printed in The Wall Street Journal, page A5
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As I was reading this, I had two comments:
First, I really wish that Dr. Howard Dean were invited to this Health Care Summit. The other day he was on PBS and pointed the difference between health care and health insurance. About how businesses, especially small one that have created most jobs in recent years, should be free from the burden of providing insurance, also the auto industry.
Another - I don't know why we question funding of it. All of us, who currently pay premiums, should continue to do so, except it will be tax that go to the general funds. I don't think that anyone would want a universal health care for free. This is what the rest of the civilized world does - offer health care supported by our taxes.
My Blue Cross is raising my premium by 20%, again.
:banghead:
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