Is the Health Care Bill Good or Bad

Is the health care bill good or bad? This is an issue which has been debated most strongly amongst the Americans. The $900 billion health care bill is to be funded by a combination of tax hikes on the wealthy and cuts in the existing medicare. The bill plans to expand cover to more than 35 million Americans. With this health care bill, every legal citizen of the United States of America will get a health insurance policy. Thus, this health care bill seeks to enable the citizens to cope with the high costs involved in health care. If the question regarding the efficacy of the health care reform is lurking in your mind, go through the information on the pros and cons of health care reform to decide for yourself.

Is this Bill Good or Bad for the Citizens?

Let's look at the various aspects of this bill in order to find out if it is good for people.

• Qualified plans would be offered via medical exchanges which Americans would purchase. An issue is that these plans can't really compete with other on what to offer. There would be a list of benefits that plans may offer. A good point is that it would mandate health insurance coverage for prescription drugs, mental health benefits and substance abuse services. It also requires insurers to insure children till the age of 26.
• Community ratings would now be given federal sanction. Several states have these ratings where all patients pay the same coverage irrespective of their health and illnesses. A positive aspect is that it would prevent companies from charging different premiums based on their health.
• The bill dampens the trend toward consumer driven care. It mandates certain minimum packages and hence, you may not be able to opt for a stripped down health insurance plan that covers only the major health related expenses. Many argue that Health Savings Account is more cost conscious than those who get reimbursed.
• The plan bifurcates Americans into two categories, the ERISA and non-ERISA. The former have a slew of benefits. Under ERISA, employers are exempt from standard minimum packages, community ratings, etc., but the same benefits are capped. They would have only a 5 year life span. Non-ERISA employees have to opt for minimum standard packages. Ultimately everyone would get clumped into the medical exchange and hence, a level playing field for all.
• Access to specialist doctors would be controlled via a primary doctor. They will decide which tests are good for you. They will also decide the specialists you get to meet. The bill does not rule out fee for service plans which could benefit the sick and the elderly.

Is this Bill Good or Bad for the Doctors?

Again this question depends on which medical doctors group is answering these questions. Again let us look at the pros and cons as advocated by doctors in their answer to this question.

• Doctors argue that the objective is to give health care more efficiently and bringing an additional 35 million additional Americans or so under coverage. However, the government would fund a substantial part of this by cutting down on the reimbursement available to doctors under the Medicaid and Medicare Plans. This could be to the detriment of doctors.
• Medical doctors state that the screening system in place via the primary health care physicians would reduce the pressure on the specialists as certain ailments may not require advanced treatment. But again one wonders whether the primary health care physicians are qualified to make decisions about the specialists their patient should see or not.
• The additional surge of 35 million odd people would according to medical profession see a surge in demand for health services and that too at a time when many struggling hospitals have been handing the pink slip to employees. But then the lowered reimbursements to doctors as discussed earlier may lead to a number of doctors quitting the profession itself.
• To the detriment of doctors, there is no SGR cap, no liability reform and no proper way to fund the same. The initiatives to tackle obesity, tobacco abuse and preventable injuries and death too are missing according to specialists. Also there seems to be very little relief from the bureaucratic mess created by insurance companies. Many doctors argue that insurance, tort and tax reforms should precede the health care reform initiative.
• The emphasis is on primary health care givers so as to make medical care more expansive and less expensive with additional pay outs to this category of health care givers. But then again these primary physicians would also have to go in for plenty of computerization and pricey electronic prescribing tools which are not adequately covered by the subsidies leading to added pressure on their incomes.

This was some information on the pros and cons of the health care bill. Like any complex piece of legislation it will have its teething problems but let us hope that the good far outweighs the bad in the long run here.