HOUSE REFORM BILL SHORT $500 BILLION

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HEALTH REFORM BILL SHORT 500 BILLION DOLLARS

Congress is determined to pass very significant health reform this year. The problem is that the one trillion dollar package can only be 50% financed by taxation. The reaming 500 billion dollars needed are difficult to find.

We must look at the defensive medicine doctors are practicing to protect themselves from lawsuits. Huge sums are spent in unnecessary testing. Another large sum is spent on trial lawyers and the present judicial system that gobbles up over 60% of settlement claims.

House Democrats, in a 1000+ page report, are ready to pass a new public health insurance plan aimed at individuals and small businesses that can't afford insurance.

This plan would bar insurance companies from denying coverage to people who are sick, while also requiring most Americans to carry health insurance or else pay a penalty of about 2.5% of their gross income. If you earned less than $88,000 a year the government would give you generous subsidies to help you buy this health insurance coverage.

The Senate Democratic proposed legislation includes mandates that insurance companies provide coverage and that we individuals must carry. The differences occur on how to finance these charges.

The senate finance committee is pushing for a bipartisan measure to finance the bill through a combination of modest tax increases rather than taxing upper employee health benefits. They want to put a fee on pharmaceuticals and other healthcare industries, and make corporations report each year, so that the government could get a greater share of corporate taxes. Drug makers and insurance companies would be charged an assessment, and individual companies fees would be based on their market share.

The White House is pushing hard for action before the legislature recess, so the two versions of House and Senate vcould reconcile their differences and send the president a final bill by September.

COMMENTARY

It seems the process of health reform is moving extremely quickly. Artificial time frames are not realistic, given the magnitude of the job the government is assigned to do. Talk is that the Senate chamber may stay in session an extra week, which would delay senators’ vacation plans, congressional trips, and hometown activities. If there is no action this summer, Congress may hesitate voting for such a contentious issue as raising taxes for something that may never become law.

In the present system every incentive in medicine is to do more and get paid more. Doctors get paid more and hospitals get bigger. Doctors protect themselves from lawsuits, by ordering every test available. Defensive medicine wastes billions of dollars and these resources are diverted from patient care to medical compliance, all to prevent lawsuits.

There seems to be no discussion of overhauling the old ways. Congress is proposing new programs with new taxes to pay for ever rising health care costs. Yet, hard choices are not being made. Only half of the billion dollars necessary for this reform package will come from taxation. Another $500 billion must be found somewhere else.

TORT REFORM takes over 60% of each dollar spent, most of it going to trial lawyers and the jury system. The injured only received 40% of each dollar spent. Much of this money could be used to subsidize the health reform package. The president reform package offers little to contain costs, but it certainly offends the least number of special interests.

The AMA, and AARP have favored creating projects for special health courts. One important interest group hates the idea. You got it. The trial lawyers who contribute heavily to congressional campaign coffers are Sacred Cows, not to be sacrificed.

in the Senate, Sen. Eniz, proposed creating a health court pilot project. The Senators quickly killed the idea, declaring constitutions require juries to be the decider is in civil law suits. They were concerned it would result in broad scale tort reform.

There have always been special courts for bankruptcy tax disputes and Worker’s Compensation, where experts apply consistency of justice. The Senators, however, are not willing to discuss the merits of an expert court. Trial lawyers say: "Our protection against tyranny of the majority would be injured, and we take enormous risks as a country if we interfere with the institution of trial by jury. “

What do you think? Your comments are always appreciated. Visit www.drneedles.com for more blogging on controversial medical subjects.