Health Care Reform reading list

Health care reform has gone from being a long and tedious argument to a reality, so I thought I would share some articles that bring the policy details. Hopefully it will have died down as an issue by the time all of you compete, but I imagine you'll get a resolution along the lines of, "This house believes Health-Care Reform will sink the Democrats."

So onward to knowledge! (If I was a superhero that would be my catch-phrase. I would be the lamest superhero ever.)

The Awful Status-quo

Before we get into the solutions, let's look at the harms:

The Uninsured and the Difference Health Insurance Makes - Kaiser Family Foundation (PDF)
This fact sheet describes the characteristics of the uninsured population, the difference health insurance makes, and why there is a large uninsured population.

Blue Cross praised employees who dropped sick policyholders, lawmaker says - Los Angeles Times
This article does a pretty good job of illustrating the insurance company practice known as rescission. Rescission is when an insurance company combs through the medical histories of their expensive (re: extremely ill) customers in order to retroactively drop their coverage.

“Pre-Existing Conditions” Affect Millions of Americans - Healthreform.gov (PDF)
A pre-existing condition is a medical condition that existed before someone applies for or enrolls in a new health insurance policy. Insurance companies frequently deny people coverage on the basis of pre-existing conditions.

General Reform Guides

At its core, health care reform is very simple to grasp. I'll let Paul Krugman explain:

Start with the proposition that we don’t want our fellow citizens denied coverage because of preexisting conditions — which is a very popular position, so much so that even conservatives generally share it, or at least pretend to.

So why not just impose community rating — no discrimination based on medical history?

Well, the answer, backed up by lots of real-world experience, is that this leads to an adverse-selection death spiral: healthy people choose to go uninsured until they get sick, leading to a poor risk pool, leading to high premiums, leading even more healthy people dropping out.

So you have to back community rating up with an individual mandate: people must be required to purchase insurance even if they don’t currently think they need it.

But what if they can’t afford insurance? Well, you have to have subsidies that cover part of premiums for lower-income Americans.

In short, you end up with the health care bill that’s about to get enacted. There’s hardly anything arbitrary about the structure: once the decision was made to rely on private insurers rather than a single-payer system — and look, single-payer wasn’t going to happen — it had to be more or less what we’re getting.

So the pieces of reform are interdependent. You can't ban discrimination by insurers on the basis of pre-existing conditions without an individual mandate. Otherwise you run the risk of driving up premiums for everyone and allowing people to free-ride on the new system. Having an individual mandate means creating a system of financial assistance for low and middle income citizens. Hence the subsidies. It is all of a piece.

Here are some articles and policy papers giving the big picture on health reform.

For Consumers, Clarity on Health Care Changes - New York Times
Nice little brief on how the law will affect most Americans.

Summary of Coverage Provisions in the White House/Congressional Leadership Reconciliation Act of 2010, Health Care and Education Reconciliation Act - Kaiser Family Foundation (PDF)
More details.

Health Reform Package Represents Historic Chance to Expand Coverage, Improve Insurance Markets, Slow Cost Growth, and Reduce Deficits - Center on Budget and Policy Priorities
Even more details.

Chart: How the bill affects you - Los Angeles Times
Visual aid!

Specifics

How big is the bill, really? - Ezra Klein
Examines the estimated costs of the law.

Who is left uninsured by the health-care reform bill? - Ezra Klein
The number frequently bandied about for the number of uninsured in the US is around 45 million. The new law expands access to 32 million people. Who's left out?

Key Provisions that take effect immediately - House.gov (PDF)
As you may have noticed, most of the major components of the law are going to be phased in over time, coming into full effect by 2014. This is a rundown of the more immediate changes.

Bad bill. Bad bill.

I think the new law is pretty fantastic when compared against the status-quo. Yet as Immanuel Kant once said, "Out of the crooked timber of humanity, no straight thing was ever made." Here are some articles emphasizing the negative.

In Health Care Overhaul, Boons for Hospitals and Drug Makers - New York Times
The special interests who profit from our wasteful system are mostly left untouched.

FDL Statement on the Passage of the Health Care Bill - Jane Hamsher
Hamsher and her cohorts at Firedoglake have been the leading opponents of the health care bill on the left.

Heritage Foundation Urges Repeal of "Intolerable" Health Bill - Heritage Foundation
From the right.

That's all for now. If you have any questions or comments, share them with me and the rest of the team.

Health Care Reform

I liked this:

But there’s another argument for health care reform, one that is at once more subtle and more sweeping. The disturbing part of our health care system is the financial and physical suffering it causes. But the unjust part of our health care system is the way it distributes that suffering. There are things all of us can do to stay healthy--we can eat right, we can exercise, we can avoid excessive risks. But even when we do the right things, we remain vulnerable.

You can have the perfect diet, jog three miles every day, and wake up one morning to discover you have cancer. So now you face mortal peril. And if, on top of everything else, you can’t pay your medical bills, you face financial ruin, as well.

Chance, of course, is part of life. Americans, in particular, seem to accept that. But every now and then, we have decided that need for such expansion--that there was, even now, the kind of common vulnerability to chance that required the sorts of initiatives we had enacted in the past. It happened with the New Deal, when we created the modern welfare state, and then again with the Great Society, when we expanded it.

The signature programs of these eras, Social Security and Medicare, work because they address a vulnerability we all share. Everybody is at risk of getting old; and everybody is at risk of misfortune, physical and financial, when that happens. To protect against that misfortune--to insure against that misfortune--all of us contribute. We all give, in the form of financial contributions; and we all get, in the form of financial security. Together, quite literally, we are stronger than when we are apart.

The conservatives protesting on the Capitol lawn Saturday see things differently. Health care reform isn't about contributing money for the sake of their own security; it's about having their money taken for the sake of somebody else's security. When they hear stories of people left bankrupt or sick because of uninsurance, they are more likely to see a lack of personal responsibility and virtue than a lack of good fortune. As my colleague Jonathan Chait has observed, theirs is an extreme version of a view common (although surely not universal) on the right: That individuals can fend for themselves, as long as they are responsible and as long as the government gets out of the way.

There's obviously a balance to be struck between these two world views. But, broadly speaking, conservative ideas about responsibility and vulnerability have dominated political discussion for most of the last four decades. That will change on Sunday, if health care reform passes. The bill before Congress may be flawed. And the process that produced it may be severely flawed. But it is, nevertheless, an expression of the idea that we--as as society--are not prepared to let people continue to suffer such dire consequences just because they’re unlucky.

What the Bill does.

Economists can tell stories

Mark Thoma tells a tale about job creation and social insurance that's pretty good.

Wal-Mart Hippies

In light of more conspiracists trying to single handedly take down the USFG, here's a NYT opinion piece comparing how tea-partiers of today have far more similarities than differences to the hippies of olde.

http://www.nytimes.com/2010/03/05/opinion/05brooks.html