Editorial: Senate can do better than House on health reform

Staff Writer
Mount Shasta Herald

The health reform bill passed out of the U.S. House on Nov. 7 is better than no reform at all. But the U.S. Senate, which is finalizing its version, has the opportunity now to pass something much better.

The House bill does little to control costs. The version that emerged from the Senate Finance Committee, which is being combined with other proposals from that chamber, does more to bend the cost curve by taxing gold-plated health plans.

Health economists believe such a provision is a major tool that would slow the nation’s annual, above-inflation health care cost increases. Americans are shielded from the cost of their health care choices because they never see the premiums taken out of their paychecks. Gold-plated plans exacerbate this trait by not requiring co-payments.

It may sound counterintuitive that subjecting health care plans to taxation will reduce costs. But health economists believe it will result in less-expensive plans on the front end without hurting the level of care offered.

The House bill requires employers to provide health insurance while the Senate Finance bill imposes fines for those who do not. The nation ought to move away from basing health insurance on whether or not you have a job, but that is too radical a change to implement today. At a time when businesses are struggling, the Senate Finance bill has a less costly employer mandate.

The House bill perpetuates the nation’s employer-provided system. The Senate Finance bill leaves room for future changes.

The House bill also leaves the current fee-for-service system mostly intact. Any new law needs to provide more financial incentive for quality and collaborative care instead of paying health providers based on how many tests and procedures they order.

For example, 80,000 people die annually from hospital infections that could be prevented. Over 100 Michigan hospitals nearly got rid of most such infections by implementing five-step checklists in the intensive-care unit.

One way to ensure every hospital in America follows such procedures would be to slash Medicare payments for treatment of preventable infections. But the House bill only requires hospitals to report those rates publicly. The Senate Finance bill contains a modest 1 percent reduction in payments to hospitals with high infection rates.

House Republicans have offered an alternative that, according to the CBO, would leave the same percentage of Americans uninsured in 2019 as today and would reduce the federal budget deficit by less than the House Democrats’ bill. That’s neither reform nor a serious alternative.

Doing what needs to be done to fix our health care system won’t happen in a single bill; the issue is too complex with too many interest groups involved. Everyone should understand that Congress will need to make adjustments and build upon its work after this year.

Springfield (Ill.) State Journal-Register