American Diary: Debate on healthcare reform

Debate on healthcare reform*

by Dr. Uttam Kumar Das writes from New York


“Pace of health care reform bogs down under weight of questions and costs” -- the front-page headline of The Buffalo News on July 26, 2009 portrays the present scenario of President Barrack Obama’s proposed healthcare reform initiative. It has generated a great debate throughout the country.

The draft legislation has been under review by a six-member Senate Committee in the office of the Senate Finance Committee chairman since June 17.

It is very unlikely that the US$ 1 trillion overhauling-plan will get an approval before the August recess of the Congress, a dateline set by the President earlier.

It is likely that the President has placed the healthcare reform at the top of his legislative priority. He is pushing for a measure that aims to rein in healthcare costs, improve care and expand coverage to most of the 46 million uninsured Americans.

As the Buffalo News reports, some 14,000 Americans are reportedly losing their health care every day. The majority of them are bankruptcies—62 percent— result from health care costs, along with 50 percent of mortgage foreclosures.

Some observer opines that the present healthcare system has become a “cancer” on US economy.

In 1970, the healthcare costs took up 7.2 percent of the economy, which is now 16 percent.

Americans spent an average of about US$ 6,500 per person on health care in 2006. It is by far the most in the world, and more than twice what Japanese and Germans spent.

However, as of July 28, the reform-agenda has been stalled in the Senate and House of Representatives. Both the houses are controlled by President’s fellow Democrats.

It has been hit by a deluge of criticism over the cost, scope and funding of the measure proposed.

The opposition Republicans are critical of the proposed plan, terming it as an expensive first step toward a government takeover of healthcare.

Some commentators see the struggle in the U.S. Congress over the healthcare reform as Democrats' "honeymoon" with Democratic President Obama coming to an end. Mr. Obama took the office of the President only six months back.

It is also commentated that if the Democratic-controlled Congress and the President could manage to iron out differences and enact healthcare reform by this year, Obama will be able to have fulfilled the most important promises of his 2008 election campaigns.

The proposed healthcare reform is termed as an essential to long-term viability for the US economy.

It is expected to reduce regional disparities in Medicare payments. Now, the Federal Medical Program insures around 44 million elderly and disabled Americans at an annual cost of US$ 450 billion. This is the one-fifth of the US healthcare spending.

As proposed in the reform legislation, the Institute of Medicine will have a year to complete a study on the regional variegations in costs and quality of care and make recommendations to the health and human services Secretary.

The Secretary will then implement new payment rates taking into account the study’s recommendations. Some US$ 8 billion will be set aside by the legislation to implement those payment adjustments.

Some legislators observe that the proposal could help to reduce costs throughout the healthcare system because Medicare is such a huge part of medical coverage in the US. They also observe that private insurance will also be influenced by this overhauling if implemented.

The proposal also calls for a second study by the Institute of Medicine to address ways to reward value and quality care over quantity. Medicare now bases payments on the number of medical procedures. The second report is due by September 2011.

The proposed law also proposes way for “high quality, evidence-based, and patient centered care.” The health and human services Secretary has to report the recommendations of the studies to the Congress, which then will have to act by the end of 2010 to stop them from automatically going into effect.

However, there are other concerns on the proposed healthcare-overhauling.

Some observers see that there will be strong lobby against certain provisions of the reform bill. For example, the proposed reform is to hit the profits by big pharmaceutical companies what they get from the so called patented drugs. They do monopoly business which increase the price of a given ‘patented drug.” The reform aims to limit the protection for the patented drugs.

Also the reform may affect people’s right to privacy as it proposes maintaining of ‘electronic medical records’ of the people undergoing medical care.

How those records will be processed and maintained and who are to have access to those records that is a concern, as Dr. Lynn M. Mather, a Professor of Law and Political Science at the State University of New York at Buffalo observes while responding to a query from this writer. However, she is hopeful about the reform and supports it.

Another concern is that the development concerning the reform may impact on the upcoming mid-term Congressional election-just 15 months ahead.

However, President Obama seems to be optimistic with the reform, and now urges the lawmakers to finalize the healthcare by the end of this year.

The writer, a Dhaka-based human rights lawyer and researcher, is currently in the USA as a Humphrey Fellow. E-mail contact: udas1971@yahoo.com

*Published in the PROBE News Magazine (Dhaka, Bangladesh), July 31-August 06, 2009; link: http://www.probenewsmagazine.com/index.php?index=2&contentId=5403.