If you just look at H.R. 3962's rock-solid provisions, health insurance reform has to top the list. Eliminating underwriting and cancellation when the policy holder becomes sick (makes a claim) would be a major step forward. Providing subsidies for the poor seems like a necessary part of insurance reform but it creates another set of marginal tax rates that differ from the marginal tax rates on income. When you think about the interest groups that support H.R. 3962 (AARP, AMA, AHA, AJA, PhRMA, etc.), any proposed reform beyond health insurance will have a difficult time in the Senate.
Comprehensive health care reform would have to provide universal coverage and deal with controlling why health care costs so much in the US. A study by the International Federation of Health Plans and other research shows that prices of hospital visits, physician visits, routine procedures, and laboratory tests are all much higher in the US than in other countries. To this list, we might as well add tort reform to keep Republicans on board. Notice that the list of cost drivers pretty much matches the list of interest groups that support H.R. 3962 (the America Hospital Association, the American Medical Association, the Pharmaceutical Manufacturers Association, the American Justice Association, etc.). The bill doesn't address these cost drivers.
The major problem with comprehensive health reform is taking on all the interest groups at once as was attempted in 1993 during the Clinton administration. A divide-and-conquer strategy would make a lot more sense. There seems to be wide-spread support for taking on the Health Insurance Industry. Let's make sure that health insurance reform gets passed. Then, lets take on the remaining interest groups one at a time. It will be slower but it's probably the only realistic approach to comprehensive health care reform.
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