Health reform financing ideas watered down, questions remain on premiums, taxes

Nov 25 2009

The New York Times reports that while the Senate health bill "includes nearly every big idea that health economists and medical researchers have for slowing cost growth — as well as for improving the patchwork quality of American health care, ... many of the ideas, like the rule on Medicare reimbursement, have been at least partly neutered. A provision to punish hospitals for infecting their patients, for example, would cut payments for the related treatments by a mere 1 percent. A provision meant to help people who don't like the insurance options offered by their employer would apply to only a tiny fraction of them. A provision to encourage more cooperation among doctors would not apply to the areas where it is needed the most: chronic diseases like diabetes and congestive heart failure." The Times cites other examples and reviews the political repercussions (Leonhardt, 11/24).

Taxes to pay for reform would be levied before changes to the system roll out, McClatchy Newspapers reports. "Some analysts said that's not necessarily bad. Delaying major health care changes until at least 2013, as the pending Senate and House of Representatives bills would do, would give the government sufficient money and time to get things right." The taxes include a surcharge on incomes over $1 million for couples starting in 2011, new taxes on "Cadillac" plans, a Medicare payroll tax increase on high earners and taxes on cosmetic surgery and medical devices that would start next year (Lightman, 11/24).

Kaiser Health News examines premiums and who might see an increase or decrease if health reform is enacted. "Republicans say premiums would go up, partly because of the possibility of new taxes on insurers. Democrats say they'll go down because of sweeping new regulations on insurers, as well as billions in federal subsidies to help individuals and small businesses." Both might be correct, KHN reports. "But, initially, many economists, insurers and health policy analysts agree, there would be a change of fortune for some people" (Appleby, 11/25).