Sunday's vote on U.S. health care reform was one of the heated and argued pieces of legislation in recent history. Did the government create socialized medicine? Is the government taking over health care? Is the path of the government going to bankrupt the country? Those questions and more were asked.
After watching 6 plus hours of C-SPAN rhetoric, platitudes and opinions on what health care reform was going to do if passed, it came down to three votes that ultimately allowed the health care reform bill to pass. The legislation doesn't even come close to socialized medicine like Canada's. If anything, HR 3590 is of regulations similar to that of the United Kingdom, in which private (insurance premiums) and public operated programs are available side by side. The U.S. already offers such assistance such as Medicare / Medicaid. Canada does have some private health care insurance programs for non-essential services.
Government run - the only government components of the legislation is expanding the existing Medicare / Medicaid programs, U.S. military health care, Co-Pay (COBRA) assistance and simply ensuring that insurance policies can be purchased regardless of the health of a patient. In Canada, health care is 100% operated and managed by the provincial and federal government departments responsible for health care services, including the facilities (hospitals and most specialized needs such as MRI's, CT scans, etc.), payments to all healthcare employees- then you have government run health care. Under Canadian law, every citizen is covered and nobody can be refused treatment or services. Premium costs vary from province to province and your status, i.e.: single, student, married, senior, etc.
A key area of savings is stopping waste, fraud and abuse of existing programs. Electronic health records and prescription drug records will go a long way to finding these savings. This assumes that the Health care IT industry can agree to a single set of standards. If HIPPA is any example, that could prove difficult to solve all the demands required. There are signs that the framework within HIPPA can be done. IT systems can and do cross reference records through several SOA architectures that can interoperate with a variety of systems. It is a significant set of steps. Abuse and fraud detection is a responsibility that the insurance industry also has to wake up to and take partial accountability for. In fact I think the CBO numbers underestimate the amount of fraud and over payments that Medicaid / Medicare payout to insurance carriers. It would not surprise me if they find more than $500 billion in waste and fraud.
The biggest change in healthcare that U.S. citizens will see is the insurance industry becoming very conservative how they invest health care premiums they collect to make money. With the HR 3590 legislation, insurance carriers will no longer be able to drop its customers because of pre-existing health care related risks. That of course means higher payouts when a benefit claim has to be paid out. The insurance industry can still make money, it simply won't be as a high rate of return that allows short term risks in how they invest and make bets with premium revenues collected. This behavior alone may create the large pools of insurance clients that create large revenue opportunities. The insurance industry lost billions investing is poorly regulated sectors, AIG being exhibit A. This legislation alone will change how insurance carrier executives invest premiums.
Change will happen, but it won't be as drastic or dramatic as some think it will be. President Obama suggested that Health Care Reform is like Bill of Rights on Steroids. It's probably not that powerful since the President originally did propose a public option, but it certainly goes a long way creating equality in health care solutions for its citizens. The White House has one final hurdle to overcome in the Senate with the reconciliation bill requiring a vote Monday. Sorry, there's no way I'm going to watch yet another 6 hours of C-Span coverage, you can do that yourself. C-SPAN's coverage is scheduled to start live coverage at 2 ET.