Florida Health Insurance News
"Health Insurance Advice"

WHAT'S THE PROBLEM?

Americans spend more on healthcare than any other country, yet some 46 million lack health insurance. The cost of care and insurance has been rising rapidly, hurting businesses that provide health coverage to their workers. Most workers get healthcare coverage through their employers. When workers lose their jobs, many also lose health insurance. Government programs for the elderly and poor fill in some of the gaps, but not all.

WHO IS FOR THE OVERHAUL?

Business, consumer and health industry groups and lawmakers agree the current system is not working for many Americans and needs to be fixed. They agree costs are too high and too many people are left with inadequate or no coverage. But beyond that basic agreement lie some deep differences that Obama will have to bridge if he is to succeed where others have failed.

WHAT DO BUSINESSES WANT?

Most large employers and many small businesses offer healthcare coverage to their workers. For workers, this is the most cost-effective way to receive coverage even if they have to pay some or all of the cost, because insurance is cheaper when the risk is shared among a pool of people. Self-employed people and others seeking insurance in the individual market pay the highest costs because they are not part of a risk-sharing pool. Reducing cost is businesses' primary goal.

WHAT DO CONSUMERS WANT?

Affordable, effective healthcare that does not disappear when one becomes seriously ill or loses a job. Medical bills can pile up fast and lead to bankruptcy.

WHAT'S IN IT FOR INSURERS?

A consensus is emerging on requiring everyone to obtain health insurance, a mandate that would bring insurers millions of new clients. But how such a mandate would work remains to be settled - whether it would be through an individual mandate, a requirement of employers to provide workers coverage or, more likely, a mixture of both. Such a mandate would involve government subsidies to help low-income people afford insurance. The insurance industry has offered to end the practice of charging higher premiums for the sick and excluding pre-existing conditions from coverage in exchange for the mandate.

Insurers also oppose creating a new a government-run plan that would compete with them for business. Republicans also oppose a government plan, arguing it would drive private insurers out of business. Democrats back the idea, arguing it would ensure competition in the health insurance market.

WHAT ABOUT HOSPITALS AND DOCTORS

Hospitals want an overhaul that results in fewer uninsured people arriving at their doors and also promotes health and wellness programs instead of just treating sickness.

A shortage of primary care doctors is a major concern and they are seeking more money for training. Primary care doctors could benefit from proposals that would improve their compensation for overseeing the care of patients. The goal is to reward doctors for good outcomes, rather than pay for individual procedures and treatments that can lead to repeated hospitalizations and higher costs.

The American Medical Association also wants insurers to be more open about how they set reimbursement rates for treatments, arguing that some payments are artificially low.

WHAT'S IN IT FOR DRUG AND MEDICAL DEVICE INDUSTRIES

Covering every American means more people can afford prescription drugs and treatments and thus increase demand. But the overhaul will aim to lower the cost of those drugs and treatments. Measures promoting the use of generic drugs and requiring more information about the effectiveness of various treatments could affect these industries.

WHERE ARE THE BIGGEST BATTLE GROUNDS?

Obama has called for a bipartisan effort on the healthcare overhaul, but he is keeping open an option of fast-tracking the legislation through a budget process called reconciliation. Such a move would enrage Republicans who would be limited in their ability to insist on changes to any legislation.

Big partisan battles can be expected over how much government programs will be involved. Democrats and their liberal allies want a government plan to be part of the mix of insurance options available to consumers to lower the cost of coverage.

Insurers, Republicans and conservatives oppose the idea, arguing it would be the first step toward a complete government takeover of the health industry.

A number of Republicans also oppose gathering and providing more information on the effectiveness of treatments. They argue it would eventually lead to rationing of care.

Considering Government Healthcare Reform

There is a need of an urgent and comprehensive health care reform in the United States of America and a number of organizations like the National Small Business Association (NSBA) have been vibrant proponents of this concept. Now it’s the turn of a panel of experts which is also giving voice to the same demand. What is the consideration of this group therefore?

According to the group, it’s high time for the government to initiate precise efforts to overhaul the U.S. healthcare system and only that can lead to the inclusion of essential maneuvers that provide better access to good food and recreation. It has also been concluded by the panelists in the report commissioned by the nonprofit Robert Wood Johnson Foundation that there is the need of innovative thoughts. Take for instance, the concept of providing requisite medicines and food to the sick people is normal and this also leads to the calculation of costs. But the panelists consider that it is more important to give people in schools and cities better access to nutritious food and places to exercise.

Speaking on this, Jim Marks, head of the foundation’s health group, which funds projects and research aimed at improving healthcare made it clear, “It’s clear that as a nation we have tried to spend our way to better health through medical care, and it hasn’t succeeded.”

What has been the government’s response? Well, both of Congress and White House, according to latest information, are taking stock of the reality and are therefore gearing up to refurbish healthcare delivery and insurance coverage. It is to be noted that the US President Barack Obama has made providing health insurance to the 46 million Americans without it a cornerstone of his plan, seeking a 10-year, $634 billion reserve fund as a “down payment” for the effort.

It has also been learnt that Congress is planning related legislation and has adopted steps to insure some children and boost electronic medical records.