• Reader Response: Health Reform Baby Steps

    Andrew asked how current health reform legislation are steps toward the ideas I expressed in a prior post. The answers are that the Senate bill includes provisions for:

    • Establishing a more uniform Medicaid program by extending eligibility to all individuals with incomes below 133% of the poverty level,
    • Increasing federal investment of Medicaid by increasing federal funding of state Medicaid programs,
    • Undoing some of the effects of preferred tax treatment of employer-sponsored insurance by imposing an excise tax on expensive plans (Cadillac tax),
    • Beginning to sever the link between employment and health insurance by permitting access to exchanges,
    • Supporting comparative effectiveness research, which should identify treatments with greater efficacy and safety,
    • Taking some of the politics out of Medicare pricing by establishing an Independent Payment Advisory Board, which should increase the chances of more efficient pricing and payment,
    • Promoting accountable care organizations (ACOs) for which Medicare payment will be based in part on quality, not exclusively quantity, of services.

    These are just a few of the ways in which current legislation would promote the ideas I listed earlier. That health reform is complicated tells you nothing about what’s in it. In fact it is full provisions that take steps toward a more sensible health care system (see for yourself). After all, that’s the point.