By Debra Karplus
16 September 2009

While you were sleeping, a spider bit you near your eye; the bite instantly caused your face to become red, hot and puffy and your eye quickly was swollen shut.  You had the chills and felt shaky and feverish.  You phoned the clinic advisory nurse, who said that you needed immediate medical care.  So, your friend drove you to the hospital emergency room where you were given a shot and a prescription for a ten-day regimen of powerful antibiotics and steroids.  The bite may have stung, but at least the cost of the trip to ER didn’t, because you had adequate health care insurance on your parent’s policy or through your college or your job.  Lucky you!

But what if you are one of the 38% of Americans who have no health insurance?  Perhaps you are unemployed, in between jobs, employed by a small company that doesn’t offer health insurance benefits, self-employed, or have been denied insurance coverage because of a pre-existing condition.

Medical history

Creating a better health insurance system in this country has been on people’s minds for a very long time.  For the past few decades, a more comprehensive, accessible, and affordable American health care system has been on the prescription pad of several high profile politicians.  As First Lady in the 1990s, Hillary Clinton had great hopes, dreams, and plans for revamping health care coverage to be more inclusive.  Her efforts were not particularly well-received.  The late Senator Edward Kennedy had made health care reform his mission long before his diagnosis of brain cancer.   Filmmaker Michael Moore’s 2006 controversial documentary Sicko compared health care in American with the health care delivery systems in Canada and other countries.  Most recently, President Obama has brought health care to the forefront.

The heart of Obama’s plan

America’s Affordable Health Choice Act of 2009, HR Bill 3200, was introduced to Congress July 31, 2009, and is currently being reviewed as the remedy to provide health care for all Americans.  The bill is intended to continue what works, and fix what doesn’t. Comprehensive coverage and choice of physicians is one component of HR 3200.  If passed, insurance coverage would expand to the approximately forty million uninsured Americans.   Guaranteed coverage would provide essential benefits. The bill would prohibit the denial of coverage to persons with pre-existing conditions.  Also, the bill would allow people to keep their current health insurance plan.

Health care would become more affordable by offering sliding scale fees to low and moderate level income individuals and families, with caps on out-of-pocket expenses.  The proposed health care reform is designed to be a government managed plan which would compete with private companies; this kind of competition generally encourages serving the customer at the lowest possible price.

Individuals, large and small employers, and the government would share responsibility for health care.  Small businesses, despite their size, would not be penalized to provide employee coverage.  Health care delivery would be a collaborative effort.

The proposed health reform plan is designed to put heavy emphasis on preventative care and wellness, and assure high quality care to all Americans and help reduce costs. Community health care centers would be created to make health care programs more available at the local level.  Funds would be made available at the state and local levels to develop public health programs.

Cost control and reduction is another one of the goals of the passage of Obama’s bill; controlling rising health care costs would make health care delivery more efficient.  Waste and fraud would be monitored, and payment accuracy and elimination of over payments is expected to be the result of this legislation, also.

Who is footing the bill?

Proponents of the bill stress that it will be paid by surtax on households earning over $350,000 annually.  But, those who oppose Obama’s plan have serious concerns about its cost and suspect that ultimately, universal health care would be financed by increased taxes of middle class Americans.

Additionally, those who don’t support this bill are skeptical of the government’s ability to manage health care and question the quality of the care American’s would receive under this new plan.

Another big concern is the lack of details in this proposed bill.  The bill clearly defines what’s wrong with the current health care system and goals for fixing it, without specifics for making any of the suggested changes.  This may be left for Congress to fine tune.

The issue of reforming American’s current health care delivery system is certainly not a new idea.  It will be interesting to see how President Obama and this Congress move forward on HR Bill 3200. Health care reform may or may not be in our immediate future.