No health care reform would bring more problems

Washington ? What could be worse than health care overhaul? No health care overhaul.

It’s anybody’s guess whether President Barack Obama’s health remake will survive in Congress.

But there’s no doubting the consequences if lawmakers fail to address the problems of costs, coverage and quality: surging insurance premiums, more working families without coverage, bigger out-of-pocket bills, a Medicare prescription gap that grows wider and deeper, and government programs that pay when people get sick but do little to keep them healthy.

“They complained, ‘If you pass this bill, prices will go up,”‘ said Sen. Maria Cantwell, D-Wash., who helped shape the Senate Democrats’ bill. “Well, you don’t pass it, and prices will still go up.”

For economist Douglas Holtz-Eakin, a top adviser to 2008 GOP presidential nominee John McCain, “no one has the luxury of saying we’re not going to worry about this.” While he’s no fan of the Democrats’ approach, he said Republicans “are going to have to deliver something at some point. The question is whether they do it with this president leading or wait for a Republican president.”

Health care spending hit $2.5 trillion last year, growing faster as a share of the economy than at any time in a half century, yet with results that compare poorly with other advanced countries spending less. Government programs — mainly Medicare and Medicaid — will soon cover more than half the nation’s health care tab, a staggering burden for federal and state budgets.

A look at how some major groups would fare if the health care overhaul collapses and present trends continue unchecked:

Older people

Both Democratic bills would begin experiments aimed at providing quality care at lower cost for Medicare recipients, particularly those with chronic conditions such as heart failure and diabetes. Copayments for preventive care would be eliminated. The House bill gradually would close the “doughnut hole” prescription coverage gap, now growing wider and deeper because of inflation. Those improvements would be lost.

On the plus side, private insurance plans in the Medicare Advantage program, serving about one-fourth of seniors, would be spared cuts proposed by Democrats. Still, insurers and other service providers won’t get a free pass. With Congress looking to cut the federal deficit, Medicare will be on the chopping block again.

“The irony is that major interest groups — hospitals and drug makers — had agreed to take reductions this time,” said John Rother, top political strategist for AARP, which supports the Democratic bills.

Workers

The divide between those who have health insurance and those who don’t will get deeper. Many more will find themselves with inadequate coverage that leaves them with hefty bills if they get seriously ill.

By 2019, the number of uninsured would rise to 54 million, most of them low-income workers paying federal and state taxes to support health care programs for older people and the poor. The Democratic bills would expand Medicaid to pick up more people near the poverty line, while providing subsidies for many middle-class households to buy private coverage.

Those with health problems

Insurers would be able to continue denying coverage to people with medical problems, or charge them higher premiums. People who get sick could face cancellation of their coverage in certain circumstances.

People in their 50s and 60s, when many medical conditions emerge, would face premiums up to six times or seven times higher than what those in their 20s pay.

Employers

Big employers were hoping that the Medicare experiments would provide a template for their own efforts to try to control costs and maintain quality. Small employers were leery of the Democratic bills, although some would have received subsidies to help them provide coverage.

If nothing gets done, large employers will be the front line in efforts to rein in health care spending. They will keep passing on costs to employees through higher premiums and copayments. But they’re also expected to be aggressive to get workers to shape up by quitting smoking, losing weight and making other lifestyle changes.

No health care reform would bring more problems

Washington ? What could be worse than health care overhaul? No health care overhaul.

It’s anybody’s guess whether President Barack Obama’s health remake will survive in Congress.

But there’s no doubting the consequences if lawmakers fail to address the problems of costs, coverage and quality: surging insurance premiums, more working families without coverage, bigger out-of-pocket bills, a Medicare prescription gap that grows wider and deeper, and government programs that pay when people get sick but do little to keep them healthy.

“They complained, ‘If you pass this bill, prices will go up,”‘ said Sen. Maria Cantwell, D-Wash., who helped shape the Senate Democrats’ bill. “Well, you don’t pass it, and prices will still go up.”

For economist Douglas Holtz-Eakin, a top adviser to 2008 GOP presidential nominee John McCain, “no one has the luxury of saying we’re not going to worry about this.” While he’s no fan of the Democrats’ approach, he said Republicans “are going to have to deliver something at some point. The question is whether they do it with this president leading or wait for a Republican president.”

Health care spending hit $2.5 trillion last year, growing faster as a share of the economy than at any time in a half century, yet with results that compare poorly with other advanced countries spending less. Government programs — mainly Medicare and Medicaid — will soon cover more than half the nation’s health care tab, a staggering burden for federal and state budgets.

A look at how some major groups would fare if the health care overhaul collapses and present trends continue unchecked:

Older people

Both Democratic bills would begin experiments aimed at providing quality care at lower cost for Medicare recipients, particularly those with chronic conditions such as heart failure and diabetes. Copayments for preventive care would be eliminated. The House bill gradually would close the “doughnut hole” prescription coverage gap, now growing wider and deeper because of inflation. Those improvements would be lost.

On the plus side, private insurance plans in the Medicare Advantage program, serving about one-fourth of seniors, would be spared cuts proposed by Democrats. Still, insurers and other service providers won’t get a free pass. With Congress looking to cut the federal deficit, Medicare will be on the chopping block again.

“The irony is that major interest groups — hospitals and drug makers — had agreed to take reductions this time,” said John Rother, top political strategist for AARP, which supports the Democratic bills.

Workers

The divide between those who have health insurance and those who don’t will get deeper. Many more will find themselves with inadequate coverage that leaves them with hefty bills if they get seriously ill.

By 2019, the number of uninsured would rise to 54 million, most of them low-income workers paying federal and state taxes to support health care programs for older people and the poor. The Democratic bills would expand Medicaid to pick up more people near the poverty line, while providing subsidies for many middle-class households to buy private coverage.

Those with health problems

Insurers would be able to continue denying coverage to people with medical problems, or charge them higher premiums. People who get sick could face cancellation of their coverage in certain circumstances.

People in their 50s and 60s, when many medical conditions emerge, would face premiums up to six times or seven times higher than what those in their 20s pay.

Employers

Big employers were hoping that the Medicare experiments would provide a template for their own efforts to try to control costs and maintain quality. Small employers were leery of the Democratic bills, although some would have received subsidies to help them provide coverage.

If nothing gets done, large employers will be the front line in efforts to rein in health care spending. They will keep passing on costs to employees through higher premiums and copayments. But they’re also expected to be aggressive to get workers to shape up by quitting smoking, losing weight and making other lifestyle changes.