The Doctor Is In: Senate health care reform bill is a step in the right direction

The Senate Finance Committee voted this week to pass its health care reform bill, paving the way for Congress to approve landmark legislation this fall.

While no one is saying the bill is perfect, it's clearly a step in the right direction. "Is this bill all that I would want?" asked Olympia Snowe, the lone Republican who voted for it. "Far from it. Is it all that it can be? No. But when history calls, history calls. And I happen to think that the consequences of inaction dictate the urgency of Congress to take every opportunity to demonstrate its capacity to solve the monumental issues of our time."

One of the many obstacles to bipartisan support of health care reform is the monumental price tag. Last week, the Congressional Budget Office estimated that the bill would cost $829 billion, and cut the deficit by $81 billion over the next decade -- while at the same time providing coverage to 29 million uninsured Americans and expanding Medicaid. While this seems impossible, proponents say the formula works because it will tax high-cost plans, cut Medicare spending and increase revenues from new taxes, which will offset the cost of covering more people.

Not so, claims America's Health Care Plans (AHIP), the lobbying organization for the health insurance industry. In a desperate attempt to block passage of the legislation, they hired PricewaterhouseCoopers to analyze four parts of the bill the insurance industry opposes. Lo and behold, the firm found that the bill would raise premiums for some people.

The front page of Wednesday's Washington Post read: "Health Insurers Emerge as Obama's Top Foe in Reform Effort." The article goes on to say that "Attacks on the leading Democratic reform plan this week by the insurance lobby left little doubt that two of the most powerful institutions involved in the debate -- the White House and the nation's insurance companies -- have abandoned any real hope of forging a compromise. What was a tenuous truce has turned quickly into an all-out battle, with both sides ratcheting up the hostilities."

This is news because the insurance industry has been acting -- and I use that word deliberately -- like it actually wants health care reform. But is anybody really surprised by the dirty tricks? After all, the insurance industry is such a big part of what's wrong with American health care -- the only reason insurers have a seat at the table, so to speak, is that their money flows into the coffers of our elected officials. They derailed reform in 1993 and clearly, they are at it again. It just took a little longer this time for the wolf to shed his red cape.

After making millions by short-changing sick people, insurance companies are unwilling to admit that many of the changes outlined in the Senate Finance Committee's bill -- and the four other versions produced by congressional committees -- will make our health care system stronger, more accessible and affordable. For example, the Finance Committee's bill will provide coverage to an additional 29 million Americans and it prohibits insurers from denying coverage to people with pre-existing conditions. The bill would also require businesses with more than fifty employees to help pay for health insurance coverage, and provides tax credits to employers with fewer than 25 workers.

In addition, the bill calls for the creation of non-profit insurance cooperatives and offers tax breaks to those who buy insurance this way. Although I am still hoping that a government-run public option will be included in the final version of the bill to ensure that there is an alternative to the for-profit insurance industry plans, I'm adopting a watch-and-wait approach on this one.

Meanwhile, PricewaterhouseCoopers has conceded that it analyzed only a small portion of the bill, "if other provisions in health care reform are successful in lowering costs over the long term, those improvements would offset some of the impacts we have estimated."

That's not going to stop the insurance lobby from running ads claiming that seniors enrolled in private Medicare plans could lose their benefits, as the Washington Post story mentions. I'm sure these ads fail to mention the disclaimer issued by PricewaterhouseCoopers. Like many other seniors, both my mother and mother-in-law have cut back on their spending habits because they are anxious and afraid that health care reform will burden them financially.

But seniors can rest assured that their basic Medicare coverage isn't at risk. Even if changes were made to the program, it's still possible for the elderly to receive quality care under Medicare because there's so much excess in how medicine is delivered. Millions of dollars could be saved in health care spending if doctors would simply stop ordering unnecessary, expensive tests. Legislation or guidelines protecting doctors from frivolous suits arising from competent care would be a good start and might go far in reducing unecessary tests and procedures.

My hope is that this is included in the final bill when Congress casts its votes. I also hope that seniors and others trying to sift through the spin will be guided by facts -- not fears -- in deciding whether to support our Congress and the president in their attempt to pass historic legislation. Misinformation derailed reform before, but this time around I think enough Americans are on to the insurance companies. In other words, they know a big bad wolf when they see one.

Russell Turk, M.D. is an obsetrician and gynecologist in Fairfield County, CT.


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