Dr Jeff Terry has written another letter to the editor of the Mobile paper regarding the lack of attention that alternatives to the Democrats proposed health care reform (such as HR 3400) have received. Aside from the obvious (the Republicans had 6 years to do something and what they managed to accomplish was to give a $2,000,000,000 gift to Pharma) there’s the question of whether the alternative proposal has any merit.

As mentioned before, Kaiser Family Foundation has put together a nifty comparison of all of the Health Reform proposals. Dr Terry asks what the Democrats want to accomplish. I would say that President Obama lays it out quite specifically:

The President has indicated that comprehensive health reform should:
• Reduce long-term growth of health care costs for businesses and government.
• Protect families from bankruptcy or debt because of health care costs.
• Guarantee choice of doctors and health plans.
• Invest in prevention and wellness.
• Improve patient safety and quality care.
• Assure affordable, quality health coverage for all Americans.
• Maintain coverage when you change or lose your job.
• End barriers to coverage for people with pre-existing medical conditions.
• The plan must put the country on a clear path to cover all Americans.

HR 3400 Overview

Allow people who purchase coverage in the individual market to deduct the cost of premiums from their income taxes. Provide refundable tax credits to individuals and families with incomes below 300% FPL to purchase insurance in the individual market. Establish Association Health Plans and Individual Membership Associations through which employers and individuals can purchase coverage. Implement state high risk pools or reinsurance programs to provide coverage for people with pre-existing health conditions. Require states to provide coverage to 90% of children with family incomes below 200% FPL as a condition for expanding child eligibility to 300% FPL, and require states to provide vouchers to children eligible for Medicaid and CHIP, to be used to purchase private insurance.

Or, Kaiser has a tool that will generate a side-by-side comparison. By doing that, you can see that HR 3400 has no requirement for individuals to have coverage. Permit employers to automatically enroll individuals in the lowest cost group health plan as long as they can opt out of coverage (which will lead to high deductibles for low wage employess and lessen coverage). Barriers to pre-existing illnesses and injury are not reduced. Medicare fraud is the only example of wasteful healthcare spending covered and it prohibits comparative effectiveness research from being used to deny coverage of a health care service under a Federal health care program and require the Federal Coordinating Council for Comparative Effectiveness Research to present research findings to relevant specialty organizations before publicly releasing them (this will almost certainly increase costs).

Dr Terry feels that Representative Price has a proposal “which offers real reform measures that put patients back in control of their health care and their lives”. I would argue that what it offers is more subsidies for the wealthy, less accountability for physicians, and less coverage for Americans. I hope Dr Terry will take a look at the Kaiser website.

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