We’ve all heard about the healthcare debate, but have we actually been listening? With so many confusing concepts and rumors circulating, it’s easy to zone out. But frankly, if we still don’t know the basics, now is the time to learn.
Two of the big names in this debate, Medicare and Medicaid, are easily confused. Medicare, established in 1965, is a federally funded medical plan for American seniors aged 65 and older. The program covers expenses like doctors visits, hospital stays, drugs and treatments. However, Medicare is estimated to run out of money in 8-10 years, and is already struggling with a large gap in drug benefits, referred to as the “donut-hole.”
Medicaid, established in 1964, operates under both federal and state funding, and provides healthcare to Americans who cannot pay for medical care. Medicaid services parallel those offered under Medicare however, services under both programs are subject to complex rules, limitations and exceptions.
The public option and single-payer plan are both potential provisions in the healthcare bill.
The public option is the crux of the healthcare reform package. It is a proposal for a government run insurance plan called “the Exchange.” The Exchange will be available to all Americans, and not subject to bias towards “pre-existing conditions,” or medical conditions that have been diagnosed 24 months prior to the issuance of an insurance policy.
Because the public option will be run by government, the policymakers’ theory is that it won’t require profit, forcing premiums and insurance costs lower. The public option will influence private insurance companies to either compete or risk the loss of customers.
A large concern in regards to the public option is coercion, but President Obama has reiterated many times that nobody will be forced into the public option. Even so, many Americans who opt out of the public-option believe that they will lose their current health insurance due to adjustments in private companies and with some people choosing the public option, the loss of customer base will increase insurance premiums for those who choose to remain with private insurance corporations.
Another concern with the public option is competition.
As one audience member in a healthcare town hall meeting asked the President, how can private companies expect to compete with the government? To this Obama compared FedEx and UPS to the United States Postal Service, saying that the private companies are doing fine while the USPS is failing. His statement, meant to reassure citizens that a public option would not jeopardize the possibility of competition from the private sector, stirred up its own controversial issues and lent credence to fears of ineffective ‘big government.’
Because of the aforementioned worries, President Obama declared in his address to joint Congress that he would approve a bill without a public-option, but many dispute this claim, saying that a healthcare bill without the public option would not amount to reform.
Another possible option of the healthcare plan is the single-payer plan. The single-payer plan would have the government act as administrator, collecting healthcare fees and allocating costs. Currently, there are tens of thousands of organizations acting as “administrator,” meaning that the billing system is complicated to an extreme. Under the single-payer plan, Americans would not have a choice between public or private options, and everyone would be under the umbrella of the public option.
The single-payer plan is predicted to reduce administrative waste, but its opponents declare the plan is a government takeover, and thus, socialism. Socialism by definition is a political theory advocating state ownership of industry. Despite intense fears of socialism in the United States, proponents of Obama’s plan say Americans must realize that in some respects our country already is socialized (public schools, highways etc.)
So why do we need healthcare reform anyway? As of 2007, roughly eighteen percent of the United States population under 65 years old was uninsured. In the last three years, 12 million Americans were denied healthcare coverage through high costs as a result of pre-existing medical conditions.
Besides the staggering statistics, currently private insurance companies are dictating who receives coverage and at what price. Furthermore, private companies are known for dropping coverage when a customer becomes sick, leaving Americans in a vulnerable position: ailing and lacking sufficient funds to get better.
When the insurance companies begin to profit more from healthcare than do our citizens, we know it is time for reform.
So what will the bill do? President Obama’s proposed bill will require private insurance companies to cover all customers, regardless of pre-existing conditions. It will also be illegal for companies to drop coverage when a customer falls ill. Furthermore, the bill will “cap out of pocket expenses,” so that Americans do not become insolvent because of medical costs.
Moreover, President Obama has recognized that often, many Americans skip preventative measures and doctors check-ups as a result of high costs, so the reform bill will eliminate extra costs on items like flu shots and mammograms. The bill will also add funds to the Medicare Trust so that the future generation of seniors is guaranteed healthcare.
Given the current economic crisis, many worry how the healthcare reform plan will be paid for.
Obama has claimed that the plan “will not add a dime to the deficit,” however it is predicted that the plan will cost $100 billion per year for ten years. Proposed ideas to subsidize the cost include raising taxes on those making at or above $250,000 dollars per year and, as always, cutting the administrative waste created by private insurance companies.
President Obama, while acknowledging the cost situation, brought healthcare reform into perspective.
“Now I know that at this moment, when we stand in the midst of a serious economic crisis, some might ask how we can afford to focus on health care… the question isn’t how we can afford to focus on health care – but how we can afford not to. In order to fix our economic crisis, and rebuild our middle class, we need to fix our health care system too.So it’s clear that the time has come – right now – to solve this problem: to cut health care costs for families and businesses, and provide affordable, accessible health insurance for every American.”
Speech, Portsmouth High School, August 2009
Commonwealth Fund Biennial Health Insurance Survey 2007
Healthcare For America NOW