What health reform is and isn't....

Big developments this week with the national health reform legislation. The politics are getting fierce! But it ain't over yet and there's still good reasons to hope beyond hope that they get somewhere in Washington this year.

It's a good time to step back and analyze what this is and more importantly what it isn't.

This health care reform effort is NOT about instilling a Canadian-style, UK-style, German-style or any other nations' health care delivery system in the U.S. It IS about reforming the incredibly screwed up delivery system we already have by plugging the holes in the system where people fall through. The proposals in place include these basic elements:

* expand Medicaid to include more eligible people
* Stop private insurers from denying coverage to sick people (who can afford to pay their premiums) or "rescission" which is kicking people off their insurance roles after they become ill.
* offer high-risk insurance pools to people who are very ill who cannot afford insurance anywhere else.
* Incentivize large employers to offer health insurance to all employees and penalize those who don't
* Incentivize individuals to remain insured year-round and penalize those who don't
* Offer a public insurance pool to take care of most of the 48,000,000 people who are currently uninsured


We've tried to do this before in Oregon in the 1980s and 1990s and it was called the Oregon Health Plan. We passed legislation that expanded Medicaid (through a waiver) and offered a high-risk pool to folks with pre-existing conditions. We passed pay or play legislation for employers. But then, we repealed that legislation. We made the hard decisions in our communities about which care we would provide to people on Medicaid using our Prioritized List of health care options.

We had so-so help from the federal government with our health care experiment (some might remember that Hillary and Bill Clinton were no fans of the Oregon Health Plan)

What we learned in Oregon is that you can't reform some parts of the system without a plan for the entire system. And, in my opinion, a single state can't successfully reform health care within its borders without the federal government's help because so much of our health care system is tied up with federal laws that will either help or destroy any plans a single state makes.

So, as the Congress continues grappling with this issue I personally wish them all the best. It's been a long time coming. Oregon has been down this road. It's a tough yet necessary road. If we can't have Canadian-style health care then let's make our complex U.S. system the best it can be. God-speed lawmakers, don't weaken.

--Liz

Health Care Reform - Mid July Issue

There are two proposals on the table now, one from the Senate HELP committee and one from the House Tri-Committee. To see a really nice side-by-side evaluation of the two bills, please check out the Kaiser Family Foundation website here.

Click on Senate HELP and House Tri-Committee to see the differences.