The healthcare reform debate

The health care reform debate has continually heated up in the recent years among various interest groups, government officials, the House and the Senate and the media. This debate is of different interests to different interest groups as some look into the long term benefits where as others are profit-driven at the expense of the public.

HR 3962: The Affordable Health Care for Americans

This bill was crafted by the House of Representatives in November 2009 but later on December, 2009 the Senate passed a substitute bill, Patient Protection and Affordable Care Act which was later abandoned for the Healthcare Reconciliation Act of 2010.

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List of recommendations by interest groups

A group of health policy experts, health insurance executives, business leaders, economists, hospital administrators among other experts held several workshops to discuss health care reforms in a forum known as the Fresh-thinking Project and came up with the following recommendations;

Change the existing fee-for-service payment to a system that promotes and rewards improvement in the well-organized provision of quality care and put in the expansion of outcome, procedures to direct payment. Payments ought to be allied to improving patient products, reducing racial and further inequalities in outcomes, mounting effectiveness, and restraining the growth in the cost of care. Consequently connecting payment to outcomes will necessitate constant investment in the regular growth of outcomes measures (Terry, 1).
There is a need to pool a risk and therefore exchanges both regional and state to guarantee the Americans without access employer based insurance or any other type of insurance is enabled to obtain an average benefits package.
Employers are also supposed to also be permitted to play a part in these exchanges designed for their employees’ coverage.
Typically, underwriting individual and small group insurance firms do not perform well due to risk selection. Therefore in order to reduce poor selection there should be compulsory coverage for standard benefits and risk accustomed payments on the part of the exchanges. These mandates ought to be matched with mechanisms that ensure adequate participation of those qualified to avoid the buildup of just the high-risk people in the exchange. These mechanisms should include considerable subsidies, probably joint with enforceable directives. It is also important to recognize the efforts of the employers in their employees’ coverage.
According to the experts revenue source which includes a cap on the tax exemption which touches on employer-based insurance to support health care should be implemented to insure all Americans. There are tens of millions and budding numbers of Americans who are not insured and approximately 70% of these Americans cannot afford to pay for their insurance (Jost, 1).
Consequently, more savings should be mobilized to insure all Americans like passing on accessible health income or levying tax on tobacco.

President Obama’s new health care reform and the recommendations

The health care reforms recommended by Obama is meant to radically reform the insurance market by barring pre-existing stipulation, eradicating underwriting which is founded on gender, education, occupation or health status. It will also provide a guideline on the crucial benefits that the insurance plans must cover, to improve transparency and insurance disclosure.

Therefore his reforms to some extend will concur with their recommendations because it is going to create a national health insurance exchange where every new non-group policies will be put up for sale and make insurance accessible for employees of small and possibly even the large employers. The exchanges should raise competition and reduce the rising administrative costs so as to reduce overall costs and enhance accountability.

As a way of insuring all the Americans the Obama reforms if legislated would oblige employers with payrolls above $500,000 annually to grant health insurance to their insurers or forfeit a penalty (Jost, 1 and alternatively majority will be insured through House leadership.

It will as well recognize small businesses who have covered their staff by granting them tax credits. However, this idea has not been welcomed by many business owners. Similarly, many people look at it as a means of making those who are well off to pay taxes for the poor.

To raise money to cover such people, reforms are proposing taxation of medical device manufactures because this is likely to offer the government about $20 billion. The senate bill intents to reach or raise $40 billion from the device makers.

However, this may be difficult because national lobbyists for the industry on the other hand are favoring reconciliation to the lower amount and therefore this could increase lobbying.

The health care reforms proposed by president Obama’s administration have both losers and gainers and therefore everyone is pulling their side so that they will not be affected negatively (Terry,1).

The insurers feel that the reforms do not favour them whereas other stakeholders and interest groups feel that this will affect delivery system as well as ensure almost all Americans have access to healthcare.

Children’s hospitals on the other hand feel that they will have more to lose as a result of the reforms than full-service hospitals. I think in the long run all these reforms will work out to the advantage of all Americans if the end result actually moves America closer to sustainable healthcare system.

Works cited

Jost, Timothy. HR 3962: The Affordable Health Care for Americans; health affairs blog
Act. 2009 – July, 27, 2011


Terry, Ken. “Interest Groups Redouble Fight on Healthcare Reform” 2009 – July, 27, 2011