Whether it is to ensure access to affordable healthcare or protect consumers from unforeseen health costs, a serious look at the problems of our current system should be at the top of any committee’s agenda. The time to act has arrived. Large numbers of people have come to believe that our current path is unsustainable and dysfunctional, with a growing sense that there is a lot of money being invested in things that are not improving patients’ health and quality of life.
The two current proposals for reform offer some promising steps forward. Both would end many of the egregious practices of private insurance companies (denying coverage to people with pre-existing conditions or dropping policies when they become sick), and they both call for creation of new regulated marketplaces where insurers compete to offer a variety of affordable health care plans to individuals and small businesses. They also include a public option to compete against private insurance and a requirement that medical providers treat everyone with equal respect, regardless of ability to pay.
However, both bills have serious shortcomings. Most importantly, a strong and broad insurance exchange is essential to a successful reform. Both the HELP and Finance bills propose creating such an exchange, but basic economics tell us that their models will not achieve this goal. The more insurers there are in an insurance pool, the lower premiums will be and the better negotiating power will be between insurers and doctors and hospitals.