Some Optimistic Comments from the Peanut Gallery

Earlier this week, Stephen Ubl, chief executive of the Advanced Medical Technology Association, shared some optimistic comments about the direction of health care reform with Massachusetts medical device executives. Ubl believes that President Obama can successfully reform the current health care system if he addresses the problems and criticisms associated with fomer President Clinton's reform attempt. Ubl summarized the Obama administration's proposal, which includes:

"universal health coverage, subsidies to assure affordability, insurance reform, and meausres to encourage prevention and better managment of chronic diseases."

Most of the proposal reflects the current universal system implemented by former Massachusetts governor Mitt Romney in his state. Ubl predicts that President Obama will accomplish these objectives with "more transparency and bipartisanship" than the Clinton administration, which may drum up more support. However, Ubl warns the President against implementing the reforms to control health care costs at the expense of innovation and advancements.
Julian Zelizer, author and professor at Princeton University, recently commented on the direction of health care reform. Zelizer reflected on two major developments that occured over the past week. The first, mentioned in a previous blog, is that the President and Senate Democrats "included reconciliation instructions in the budget for health care." Second, the Democrats can successfully pass health care reforms without the threat of a Republican filibuster. However, Zelizer encourages the Obama administration to reflect on the challenges that faced President Clinton during his health care campaign. First, the Clinton administration's proposed legislation was very complex. The proposed reforms included employer mandated coverage, federal regulations and government sponsored health care for certain groups. Second, while working on the health care crisis, President Clinton simultaneously tackled other policy reforms, delaying the health care reform legislation. As a result, critics were able to "gather momentum and put together their attack." Third, the Clinton administration faced funding issues. Who should pay for the health care program? Zelizer believes that the current conditions are more favorable for health care reform today than during the Clinton adminstration. He predicts that President Obama will successfully implement health care reforms if he learns from past mistakes. However, Zelizer encourages the President to reach an agreement quickly on how to finance the reforms and to market health care reform so that it is impervious to most criticisms.

Today, the health care industry made another important concession regarding insurance premiums. Karen Ignagni, president of America's Health Insurance Plans, offered to end higher premiums for women. The rationale behind insurance companies charging higher premiums for women is that women are more likely to visit doctors, take prescribed medications and typically cost more during child-bearing years. Women were typically charged 25%-50% more than men for identical coverage plans. However, many politicians did not agree with the policy. This is the third major concession made by insurers. Late last year insurers agreed to accept all customers, "regardless of illness or disability." Earlier this year, insurers agreed to end higher premiums for sick customers. Ignagni, speaking on behalf of the health care industry, stated that "the industry would accept aggressive federal regulation, but would resist creation of a government-run insurance program," similar to that proposed by the Obama administration. So, while the industry is willing to make internal reforms, it is unwilling to support government sponsored health coverage. Hopefully, the government and the health care industry will reach an agreement that will benefit both sides.

What to Expect After the First 100 Days

This week the Senate confirmed President Obama's nomination for Secretary of Health and Human Services, Kathleen Sebelius. The Senate confirmed the Kansas governor, 65-31, despite Republican efforts to delay the vote based on her stance on abortion. However, the potential swine flu pandemic made the Senate confirmation more urgent. Although her primary focus will be on the current flu threat, Sebelius will eventually advocate for controlling health care costs, expanding coverage and increasing access.

A former president of the National Association of Insurance Commissioners, Ms. Sebelius is an expert on insurance regulation, which is sure to be a focus of the legislation that Congressional Democrats hope to pass this year.

Sebelius was sworn in on Tuesday, marking the beginning of many health care reforms to come.

Wednesday marked an important financial turning point in President Obama's health care strategy. Congress advanced a $3.4 trillion federal budget that "prevents Republicans from blocking his proposed trillion-dollar expansion of government-provided health care over the next decade." The funding sends a clear message to Republicans that the Democrats hold a majority. While Democrats will not move Obama's health care plan through Congress without bipartisan support, they do have the power to do so without the threat of a Republican filibuster. Republicans criticize advancing the federal budget and cite it as another example of excessive Democratic spending. The federal budget does not answer how President Obama will fund the adminstration's health care coverage plan, however, which may exceed $1 trillion over the next decade.

Stuart Altman, a health care expert from Brandeis University, commends the President on creating health care policy objectives and principles that will help guide the health care reform strategy. According to Altman, the true test is imminent: how will President Obama fund a health care overhaul? Thus far, the Obama has successfully expanded health care coverage to more children and provided funding and resources to various health care initiatives in the economic stimulus package. President Obama has also called on health care representatives and members of both political parties to create multi-group support. Unfortunately, not all of the players support the proposed agenda. For example, whereas most of health care representatives support requiring employers to cover employees and do not support a government run coverage plan, politicians favor the opposite.

As the first one hundred days draw to a close, only time will tell what direction health care reform will take.

This week I found three articles that address health care reform. The first author shares her personal story as an eample of why the current health care system does not work for average Americans. The second author opposes a public coverage plan and critiques many of the proposed health care reforms. The third article is a compilation of different ideas that health care reform supporters suggest based on President Obama's health care address. Author Kate Michelman of The Nation, experienced two major crises within a short period of time. Soon after they occured, the medical crises became financial burdens, even though Michelman and her husband has excellent health care coverage. Based on her experiences, Michelman now advocates for health care reform. She argues that millionsof Americans share her predicament and many more are only one crisis away from medical and financial failure. According to Michelman, this can happen to people in any social or economic bracket and will force all citizens into a similar plight no matter what socio-economic status one initially falls under. Michelman also argues that the health care crisis is not a "series of isolated problems," that only require individual attention. Those that suffer should not suffer alone and would benefit from uniting forces. Finally, she places responsibility on the health care industry for "nominally cover[ing] long-term care but [failing] to cover its actual cost." She believes that the public is mislead in assuming how much they are truly covered.
Sally Pipes of the Washington Examiner opposes President Obama's public coverage plan. The reporter predicts that the plan will be a disaster that will ruin America's health care system. Pipes fears that the proposal will lead to a "single-payer, government-run health care system." She argues that the Obama administration will impose restrictions on private insurers, which puts them at a disadvantage. As a result, private companies will have to drive up costs to break even or make a profit. I disagree with Pipes' arugment. If a public plan supplements the private industry, it will most likely cover citizens who cannot afford the current coverage plans. The plans will operate in different spheres. Pipes claims that insurance premiums will have to charge the same price to all members of a particulr demographic group regardless of illness. While this may be a problem for states that have low insurance rates per person, many states pay a substantial amount for health coverage per person. Therefore, it might actually reduce how much money is allocated per person for health care coverage. Pipes fears that when private insurance companies raise premiums they will become less competitive with the public sphere. While this may occur, perhaps eliminating some of the private sector will not have many significant negative consequences.
Finally, the "Room for Debate" section of The New York Times hosted several health care officials and experts and published their views. Professor Elliot Fisher of Dartmouth Medical School suggests that the reforms target the "fragmented care system, lack of accountability for the overall costs and quality of care, and a payment system that rewards growth and unnecesary care" present in the current system. Karen Ignagni, president and chief executive of America's Health Insurance Plans agrees that the reforms should focus on cost, access and quality of care. Doctor Kevin Pho proposes that universal coverage go hand in hand with training more primary care medical professionals. He argues that a universal coverage plan would fail because there would not be enough primary care medical professionals to see the influx of patients. It is evident that there is some consensus as to what flaws need to be addressed in the current health care system. While plans and proposals vary, the problem definition phase is becoming more clear: The current health care system is wasteful, not available to many, inconsistent and ill-equipped to service Americans. Although I have become slightly more moderate in wanting universal health care, I agree with these authors. Something must be done soon to address these issues.

An Alternative Direction

This week, former congressman and 2004 presidential candidate Richard Gephardt shared some advice with the Obama administration regarding health care reform. The universal health care advocate who vehemently campaigned for universal coverage during the 2004 presidential race is now cautioning the Obama administration from making vast and extensive changes to the system. Gephardt predicts that any health care reforms will not pass this year and "is urging the White House to defer that goal until it enacts cost-saving reforms in health care delivery." He believes that President Obama is facing several looming obstacles, most notably how to finance universal coverage or simply health care reforms. As seen during former President Clinton's administration, the health care system comes down cost savings. This may seem ironic given that the United States pays much more in health care coverage than comparable industrialized countries with universal health care coverage. Unfortunately, the current economic situation places an even greater burden on the burning question: How does the president plan on financing health care reforms? Thus far, it appears as though President Obama is incorporating reforms into the economic recovery plan by casting it as "controlling the 'crushing cost of health care'" for those most affected by the poor economic situation. Even if the Obama administration can provide a convincing financial plan, Gephardt fears that universal coverage will meet opposition from both political parties. Despite Democratic majorities in Congress, Gephardt predicts that Republicans and moderate Democrats will not be receptive to a universal coverage plan. Health care reform will require strong leadership, patience and perseverance. Gephardt also advises that the President take incremental steps, such as implementing universal coverage for low-income workers. These small victories could pave the way for more sweeping reforms in the future.
Until a more efficient health care system is implemented, there are some steps that the health care industry could take that would improve the quality of care and reduce service costs. For example, many medical offices are switching to electronic medical records. One family doctor found that the electronic medical records made her office more productive and enabled her staff to spend less time searching for records and more time meeting the needs of the patients. She can also better monitor specific patient conditions. Another doctor reported that the electronic medical records system forced costs down by as much as 75%. Electronic medical records also make it easier to share patient information across medical offices. Unfortunately, some medical professionals are unwilling to make the switch because they cannot afford the start-up costs. Others have had negative experiences with the new technology and favor the traditional record keeping method. President Obama is encouraging the switch to electronic medical records as seen in the stimulus package, which allocates some money to transferring medical records to an electronic system. Most of the money will benefit "undeserved and rural areas." Despite its many advantages, the electronic system does not eliminate unwilling insurance companies that "use delaying tactics to avoid paying for care," a common frustration felt by many medical professionals. Still, it is evident that the electronic medical records system may be one incremental step on the way to cheaper health insurance that does not compromise the quality of service.
Successful health care reform will require more than material changes. According to a Yahoo News article, the uninsured population have not shown "collective power" or organized a united front against universal coverage opponents. If the constituency does not vocalize their opinions, lawmakers will be dissuaded by the cost of universal health care without factoring in the need for it. Not only do uninsured citizens not mobilize or lobby, most of the uninsured population is not represented in elections. "In the last election, only 10 percent of registered voters said they were uninsured." Historically, politicians respond to the needs of constituents that will help them secure reelection. If the uninsured population does not exercise the right to vote, politicians will be less receptive to their plight. There are several reasons why the uninsured do not show "collective power." First, many believe that being uninsured is a personal problem. Those with the misfortune of losing health coverage "often struggle alone instead of turning their frustration into political action." Second, many uninsured individuals are too busy trying to stay afloat and do not have the time or resources to mobilize politically. Third, research suggests that most uninsured middle class Americans will eventually find some medical coverage within several months. Therefore, the uninsured population does not have time to politically mobilize. Until all uninsured citizens become active in the political sphere, some grass-roots groups are lobbying in Washington for guaranteed coverage. However, those represented are typically insured and do not share the same plight as uninsured citizens.
Based on readings from the book, I understand that most citizens are not active in politics, particularly those that cannot afford to. If any progress is to made towards universal coverage, the uninsured population will have to vocalize their plight. I also agree with Gephardt regarding incremental steps. At this point, universal health care will only come to fruition if the idea is introduced gradually. I am hopeful that some of these changes will occur under the Obama administration.

Switching Topics...

This week, I am deviating from my normal blog topic to talk about President Obama’s recent trip to Iraq. On Tuesday, Anderson Cooper spoke at Elon about his experiences abroad, specifically, reporting from the front lines of various wars. Over the course of several years, Anderson Cooper has visited Iraq several times and on Tuesday, he shared some anecdotes. I was very interested to hear his commentary on how the country has changed and its current state of affairs. As a result, I decided to read articles about President Obama’s impromptu visit to Iraq and find out more about the presidents’ position on the subject. According to White House Correspondent, Jennifer Loven, the President ended his European tour in Iraq, where he addressed an audience at Camp Victory, the U.S. military base in Baghdad. He acknowledged the sacrifices that American soldiers have made thus far and spoke about his diplomatic efforts. Shortly before landing in Baghdad, bombs exploded in a nearby neighborhood, suggesting that violence continues despite democratic achievements. Although, President Obama encouraged the Iraqi Prime Minister to “make quicker strides in reconciling the country’s still-divided factions,” he stated that his role during this tour was to listen, rather than dictate. President Obama suggested embracing the ethnic divisions and incorporating them within government and security spheres.
One subject that the President has made very clear is that the United States will withdraw all American troops by August 2010 to focus on the war in Afghanistan. More specifically, a New York Times article states that, “Mr. Obama’s plan to begin withdrawing the roughly 140,000 American troops in Iraq on strict timetable [will] leave 35,000 to 50,000 by August 2010.” This declaration has drawn sharp criticism from American politicians and officials who believe it is too early to abandon a country with such a fragile infrastructure, as evidenced by the recent surge in violence. However, President Obama is confident that his strategy and fortified diplomatic relations will help maintain security and stability in the area. Before leaving Iraq, the President met with the Prime Minister and other Iraqi officials to establish better relations with the region and begin a more diplomatic approach. Prime Minister Maliki seemed receptive to President Obama’s comments stating, “dialogue should be the only way to resolve any issue, whether if was between Iraqi security components, or in the region.”
According to an NPR article, President Obama called upon the continued support and hard work of American soldiers during the imminent transition period. He acknowledged that this time is critical because of upcoming national elections, which may indicate Iraq’s political stability. And, while the President is not supportive of a war that he inherited from former President Bush, he is unwilling to abandon the cause immediately. Nor is the President looking to prolong American involvement stating that it is time for the Iraqis to “take responsibility for their own country.” In order to prevent collapse and nullify past efforts, the withdrawal procedure must be carefully facilitated.
From what I have read about President Obama’s policy on Iraq and his first visit to Iraq, I think that he is headed in the right direction. It will be interesting to see the results of a complete withdrawal of US troops so quickly. The next Iraqi election will be a great example of whether or not Iraq can function successfully as a democracy. Unfortunately, I think that Obama is not considering the deep ethnic divisions that are plaguing the country. Incorporating the different ethnic groups into the same government and expecting it to work immediately is idealistic and naïve. I hope that the results will be successful and that the War in Iraq will end completely in the near future.

Progress

On Thursday, a New York Times article reported that President Obama's secretary of health nominee, Kathleen Sebelius, will not achieve a quick approval. The Kansas governor fielded a series of questions from the Senate Finance Committee, who will continue to review her responses. Based on the hearing, it appears that Sebelius receives more support from the Democrats than the Republican party, who question her stance on abortion. Another point of contention during the hearing was tax irregularities. Gov. Sebelius also established her stance on a public coverage plan that would compete with private insurers. She supports creating more options for consumers, especially those that only have access to a few options.
According to a New York Times article, "efforts to overhaul the health care system have moved ahead rapidly." The chairmen of five Congressional committees, all Democrats, and the health care industry have made several important decisions regarding potential legislation. The two parties have met consistently to discuss pressing matters. First, the chairmen determined that all citizens should have health insurance, financed partly by employers. Second, the congressmen suggest that the federal government provide a public health insurance option to supplement private insurance plans. Third, the Democrats established an early deadline, the end of July, for the House of Representatives and the Senate to vote on the legislation. Fourth, the health care industry promised to accept all citizens, regardless of their illness, if the government required that Americans have health insurance. The industry also offered to stop charging higher premiums based on level of sickness. However, the chairmen face considerable obstacles, particularly from the Republic party. The Republican camp argues that "a government plan would have unfair advantages and could drive private insurers from the market." And, the chairmen have yet to discuss financing such a coverage plan. One fact is that both political parties and the health care industry will have to make concessions in order to create a successful health care reform. Without the support of each group, a public coverage plan could become a costly failure.
Finally, a third New York Times article outlines some of President Obama's plans for health care reform. According to this article, "Mr. Obama’s strategy is to sell the expansion of access — largely through public insurance programs — as inseparable from serious efforts at innovation and restraint." The article references the incremental health care reform that took place in Massachusetts. One of the main elements of success was the idea of gradual change. Another important element is rewarding those who encourage preventative medicine. Finally, the state of Massachusetts is working toward requiring that all residents be covered by insurance. While the case does provide strong evidence to support a public health care coverage plan, I believe it will be difficult to implement this plan and expect the same results. In my opinion, expanding coverage is a necessity, but there are so many other factors to consider at the federal level.

The Effects of Health Care Reform

On Monday, President Obama officially nominated Kansas Governor Kathleen Sebelius and Nancy-Ann DeParle as secretary of the Department of Health and Human Services and director of the new White House Office for Health Reform, respectively. If approved, both nominees will bring considerable experience to the Health Care positions. Sebelius has encouraged a bipartisan approach to her health care expansion in Kansas. DeParle “was commissioner of the Department of Human Services in Tennessee from 1987 to 1989 and managed Medicare and Medicaid in the Clinton administration.

“ The nominees will work closely with President Obama to achieve the goals set forth by the Obama administration. Some of these tasks include, “cutting costs, expanding access and improving the quality of health care.”

President Obama, Sebelius and DeParle agree that reforming the health care system is a huge fiscal undertaking, but necessary to help the general public and America’s economic health. To initiate health care reform, Obama recently allocated $155 million of the federal stimulus package to 126 new health clinics. The money will benefit roughly 750,000 insured and uninsured Americans. President Obama will elaborate on his health care strategy at a summit today.
It is evident what health care reform will mean for Americans but what impact will it have on patient and doctor mentality? What will it mean for current health care insurers? New York Times columnist Tara Parker-Pope recently explored the effects that health care reform will have on doctor and patient mentality. According to Parker-Pope, patients will have to learn to accept that while it is important demand the best possible care, the “best” does not necessarily mean the newest or most technological treatment. Dr. David Newman, a physician at St. Luke’s-Roosevelt Hospital Center argues that even if health care reform is implemented, patients and doctors must change the way they view medicine. Perhaps the $1 billion set aside in the federal stimulus package to review the efficiency and effectiveness of current procedures will help change the patient perspective on medical procedures and treatments. However, based on historical precedent, Parker-Pope is not hopeful that the general public will be receptive to the medical comparisons. Given new drug “propaganda,” the number of different medications for any ailment, and the increase in technology, public opinion towards health care may be difficult to change. Even if there is a health care reform, how effective will it really be?
Finally, what kind of affect will health care reform have on health insurers? Reporter Reed Abelson suggests that the current economic situation and the imminent health reform are serious threats to the health insurance companies. Although plans have not been finalized, if implemented, several of the proposed plans may have serious consequences for health insurers. Representatives of some health care companies, such as Ronald Williams, chief executive of Aetna, realize that given the current situation, now is the opportunity to make significant changes in the health care system. However, many more representatives do not support the proposals. Expansion of Medicare program poses one major threat to private insurers, but this may have negative externalities. In response to these threats, private insurance companies are implementing innovative measures, including breaking into new markets. No matter what the future holds for America’s health care system, change is inevitable and private insurers should be ready for reform without compromising quality of care.

Premliminary Steps Toward Health Care Reform

In the wake of the economic crisis and the enactment of the federal government stimulus package, President Barack Obama will release specific details regarding his agenda later this week. On Tuesday, President Obama formally addressed the Congress and elaborated on some of his major policy initiatives, including health care reform. "The president said he'll address the burgeoning costs of entitlement benefits for health care" and focus on expanding access to insurance services. In making these statements, President Obama did not ignore the challenges that he will face. He acknowledges that he devised many policies during his presidential campaign that appear overly ambitious given the current political environment. Despite the current situation, according to President Obama,"health care reform cannot wait, it must not wait, and will not wait another year." However, if the President takes this opportunity to implement health care reform, he will face unique challenges.
According to an Associated Press reporter, the President is calling for $634 billion over 10 years to reform the current health care system. To finance the reform, President Obama plans to"[trim] Medicare spending and [limit] tax deductions for upper-income earners." However, President Obama is facing a staggering number of uninsured American (about 48 million) and the number continues to rise due to companies laying off employees. The unemployment rate is directly related to the rate of insured Americans. Therefore, as the number of Americans are layed off, they lose employee health care benefits and become a part of the uninsured population. President Obama also faces financial constraints. According the reporter Ricardo Alonso-Zaldivar, of the Associated Press, "the cost of guaranteeing coverage for all could easily exceed $1 trillion over 10 years." This following his very pricey economic stimulus plan. Members of both political parties fear the hefty cost of health care reform and without their support, there is no hope for a better health care system in the near future.
As previously mentioned, the economy is impeding the health care initiative proposed by the Obama administration. A report from the Department of Health and Human Services stated that

"as the recession cuts into tax receipts, Medicare's giant hospital trust fund is running out of cash more rapidly, and could become insolvent as early as 2016."

To compensate for Medicare's lacking coverage, other programs, including Medicaid are covering more people who lose employee health coverage. Another trend that is placing more pressure on the current health care system is retiring baby boomers, who are now reaching age 65 and will start taking advantage of Medicare coverage.Due to these factors, the report estimates that "taxpayers will be responsible for for more than half of the nation's health care bill by 2016." This does not include added coverage for children and low income income working parents. The report also caluculated that "health care costs ill average $8,160 this year for every man, woman and child," and that value could increase to $13, 100 in 2018 if nothing is done. The Obama administration is confident that these statistics, coupled with costly procedures and medical technology, will help the health care reform initiative gain momentum.
In my opinion, health care reform is necessary. However, given the current economic situation, perhaps the Obama administration will have to curb the health care initiative or prolong action. To win over public opinion, President Obama will have to take gradual steps that do not threaten the economy and steps that attack the issue with biparisan support.

The Direction of Health Care Reform

The Obama administration achieved a victory this week. After much negotiation, the President signed the $787 billion economic stimulus package, a portion of which is dedicated to health care services and the medical industry. Last week, I focused on the impact that the stimulus bill will have on Medicaid in particular. This week, I will approach the issue from a different perspective. According to a New York Times article, 1.1 billion of the economic recovery package will be allocated to the Department of Health and Human Services to compare different medical treatments and services. “The program responds to a growing concern that doctors have little or no solid evidence of the value of many treatments.” Researchers are hopeful that the funding will allow them to eliminate ineffective and costly treatments. Supporters of the funding also claim that the medical assessment will help reduce the cost of health care in the long run. Rather than focusing on new drugs and treatments, the study will emphasize alternative services that may substitute procedures deemed ineffective. Proponents of the plan agree that the research will supplement the existing health care system and help to improve the quality and efficiency of care.
With the economic stimulus package settled, the Obama administration is focusing on cabinet appointments and health care reform. After several nomination failures, including Daschle, President Obama is considering Kansas Governor Kathleen Sebelius for secretary of health and human services. Her record indicates that she is committed to a bipartisan approach, particularly regarding health coverage expansion. Gov. Sebelius has considerable experience “navigating partisan politics as a Democrat in one of the country’s most Republican states.” According to New York Times reporters Peter Baker and Robert Bear, Sebelius will probably not play as significant of a role as previous nominee Daschle would have regarding setting health care policy. However, health care reform activists are pleased with her candidacy and hope that she will help expand the health care system and guide it in a new direction.
One major issue that the incoming secretary of health and human services will face is a growing number of uninsured young adults. As of 2007, 29% of people in their 20’s did not have health coverage due to several factors. First, many young adults cannot afford health insurance. This is especially prevalent in major cities, where the cost of living is high and young adults face competing financial burdens. Second, there is a group mentality that twenty somethings are invincible. Many young adults to not opt for health coverage and seek alternative health services. For example, reporter Cara Buckley reveals different sources that the uninsured populations will use to avoid paying for coverage. Methods include resources like WebMD to self-diagnose, borrowing medications from friends, or using free clinics for most health services. The real problem is that most family health plans stop covering young adults at 19, but most of this population does not qualify for Medicaid. There is a gap between the very poor citizens, who receive government assistance, and those making minimum wage, who cannot afford private insurance premiums. Some politicians and interest groups suggest increasing the age that families can claim their children as dependents. Some states have already enacted this policy. Easing these requirements will alleviate some of the issues, but a more extensive health care reform is necessary. Hopefully under the Obama administration, with the recently enacted stimulus bill and a new secretary of health and human services, the the health care system will address some of the major problems affecting our country and head in the right direction.

The Stimulus Package and Medicaid

The debate over the stimulus package dominated new sources this week. Although the President has shown consistent support of the almost $800 billion dollar economic recovery plan, Congress has stalled its passage. Over the past few weeks, the stimulus package bounced between the legislative houses and Americans saw many different figures and proposed allocations of money. Finally, a compromise is in sight. According to a recent report on the NPR website, Congressional negotiators reached a deal with the White House. The solution: a $789 billion dollar economic recovery plan that provides tax cuts for the middle class, allots funding for school construction, and divides money to the individual states. Legislators are hopeful that the bill will alleviate the unemployment rate by creating more opportunities in the job market. Not only is the bill a compromise of the House and Senate, but the Democrats and Republicans, too. This proposal received more Republican support than earlier versions, despite some lingering disagreements regarding money allocation.
One point of contention is Medicaid. Medicaid, a federally funded program, “provides health insurance to an average of 58 million low-income Americans,” according to reporter Julie Rovner. The federal government distributes Medicaid funding to individual states for implementation. The current economic crisis has had negative consequences on the government sponsored health program. There is a direct relationship between the unemployment rate and the demand for Medicaid. As the unemployment rate increases, people lose their income and health care coverage, and the demand for Medicaid soars. Unfortunately, “because most states must by law balance their budgets each year, a number of them have no choice except to cut their Medicaid programs, which for many states represents the largest or second-largest budget item” (“Medicaid”). Since access to Medicaid programs is limited, Americans are seeking health care services in the private sector. However, patients are unable to pay for the services, placing a significant financial burden on private health care companies. Without some Medicaid funding, it is likely that the private sector will continue to suffer. To alleviate some of the issues, Congress proposes allocating $87 billion towards the Medicaid program over the next two years. Legislators are confident that increased funding will allow states to shift current Medicaid funding to other areas of need. Some supporters believe that the Medicaid funding will create more job opportunities in the health care field, an added bonus.
Critics of the proposed Medicaid funding argue that the economic recovery plan is not the proper means of addressing the health care problem. One editorial in the Chicago Tribune suggests that due to the complexity of the health care system, a more extensive reform is required. Throwing money at the Medicaid system may have negative consequences, such as reducing competition in the private sector. The stimulus package would extend health care benefits to the unemployed, specifically those who do not qualify yet for Medicare, and provide funding for technological advancements in the field. However, according to one editorialist, “once benefits are extended, it will be politically difficult if not impossible to scale them back to pre-crisis levels” (“Mission”). So, a separate debate continues. Should the government boost federal funding of its health care program and improve the current conditions? Or, should it wait until all branches can agree on a more extensive reform of our problematic health care system?


Articles in order used:
Tedford, Deborah. "Negotiators Reach Stimulus Deal." NPR.org

Rovner, Julie. "Medicaid A Prickly Issue in Stimulus Package." NPR.org

"Mission Creep." ChicagoTribune.com