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