A good segment of the population have hoped that the health care reform process would do something about the three major problems of health care, spiraling out of control costs, lack of availability of insurance to much of the population, and a bureaucratic indifference that seems to have permeated the health care field.

There was a good deal of hope originally for ordinary people who needed health care at a fair price. The hope was that health reforms would expand the availability of health insurance to some of the uninsured  and do something to control price increases and some growing issues like a shortage of primary care providers.

But, then we looked at a bill that was the product of dozens of compromises and actually ends up spinning its wheels in place.  The bill is being touted as increasing insurance availability to 30
million uninsured, but experts say we are actually likely to see an increase in the number of uninsured fashion forcing many Americans to drop their present coverage. Premiums, deductibles, and co-payments will continue to soar, even though we initially believed that these controls were the purpose of the reform. Ther are no guarantees that the uninsured will be able to afford new private coverage even with the promised subsidies, which will be more than three years down the road. as the expansion of Medicaid will not take place until 2013 and many states are already pushing back with concerns that the their recession-strained budgets will not allow them to pay their share in adding to their Medicaid programs, potentially leaving millions of the poorest Americans uninsured.

The bill has no cost containment mechanisms for the costs of health insurance or for health care itself. In fact the insurance industy is warning that sharp premium increases will result, and these are likely to come quickly.

The bill will set up a Health Benefits Advisory Committee to recommend a minimal essential benefits package that includes four tiers, insurance industry lobbyists will argue for the most minimal levels of coverage, and we can anticipate an huge number of people who are underinsured.

The public option has been debated a great deal in the news, but as presently constituted it will have a minimal and a negligible role in health care reform. The Congressional Budget Office concluded it would cover only about 6 million people, which will be a very small segment of the population. By 2013, the public option will cost more than private programs, mostly due to covering sicker individuals and its inability to set reimbursement rates for physicians and hospitals as is done by Medicare. Moreover, middle-income families may be required to spend 15 to 18 percent of their income on insurance premiums and co-payments.

The mega 1 trillon dollar health care bill is a potential disaster that all Americans should fear. It appearrs likely to escalate costs, limit availability of care, and do essentially all the things the political leaders promised to protect us from.

More cost, less coverage, higher taxes, and a bigger burden on employers appear to be in the works.

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