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.