Debate Grows as Health Bills Get Closer

Congress and Lobbyists Are Scrutinizing Option for Public Health Care

From the WebMD Archives

June 11, 2009 -- The debate over health reform is heating up in Washington, with lawmakers, interest groups, political parties, and the president all weighing in on how to cut costs and spread insurance to all Americans.

Congressional committees are expected to unveil final versions of their health reform bills over the next two weeks. Those bills will likely deal with the toughest details yet to be worked out: whether to create a government-run or government-sponsored insurance alternative, what form that option should take, and how much it will all cost.

Meanwhile, a new report concludes comprehensive health reform could directly help as many as 185 million Americans, either by lowering the cost of coverage they get through their employer, or expanding coverage for the estimated 46 million uninsured.

"If coupled with broad health system reforms, the average family would save $2,314 a year by 2020," states the report by The Commonwealth Fund. It estimated a total national savings of $3 trillion by 2010 if Congress enacts sweeping health reform that includes robust preventive care and universal access to coverage.

"An estimated 100,000 lives per year would be saved, 68 million more adults would receive recommended preventive care, and 37 million more adults and 10 million more children would receive care from physician practices," the report states.

Public Health Care Option

How -- or if -- Congress will achieve universal coverage is still very much an open question. Democrats have announced their intention to propose some form of government-run or government-funded insurance entity. The entity would help pool large numbers of people together, in theory cutting insurance costs and giving people more access to coverage.

Speaking at a town hall-style event for his health reform plans in Green Bay, Wis., President Barack Obama made a strong pitch for a "public insurance option" to be part of any health reform package.

"And the reason is not because we want a government takeover of health care. I've already said if you've got a private plan that works for you, that's great. But we want some competition. If the private insurance companies have to compete with a public option, it'll keep them honest and it'll help keep their prices down," the president said.


The president is scheduled to address the American Medical Association (AMA) Monday in Chicago. Despite support for White House reform plans just last month, the AMA, the strongest lobbying group for physicians, made clear it's concerns about public or government health plans.

"The AMA opposes any public plan that forces physicians to participate, expands the fiscally-challenged Medicare program, or pays Medicare rates," Nancy H. Nielsen, MD, the AMA's president, said in a statement.

But Nielsen also says the group is open to other forms of a public plan, including a possible nonprofit cooperative that merges taxpayers and private insurance companies. That proposal floated yesterday in Congress and is now under serious consideration.

"I'm opposed to a government option, period," said Rep. John Boehner, R-Ohio, the House Minority Leader. Still, Boehner called the idea of a co-op "interesting."

Congress is soon to make final decisions on how to try and pay for broad reforms that spread health coverage to tens of millions of people.

That could cost anywhere from $600 billion to $1 trillion, Sen. Charles Schumer, D-N.Y., a member of the Finance Committee, said Thursday.

Leading Democrats say they're considering a plan to raise money by eliminating part of the exclusion that shields workers' health benefits from taxes. The plan would likely set a cap on the value of insurance plans -- possibly around $14,000 or $15,000 for a family of four -- and then apply income taxes to any value above that.

The average annual premium for a family of four is now just under $13,000.

WebMD Health News Reviewed by Louise Chang, MD on June 11, 2009



The Commonwealth Fund: "Front and Center: Ensuring that Health Reform Puts People First."

President Barack Obama.

Rep. John Boehner, R-Ohio, House minority leader.

Sen. Charles Schumer, D-N.Y.

Nancy Nielsen, president, American Medical Association.

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