Imagine a scenario: You’re fresh out of college and you take some time off to travel to an exotic land. While there, you find yourself infected with an exotic disease. Where do you turn? Now, imagine that during a graduation present ski trip you fall and break a leg. Where do you turn? Even if you just come down with the flu, where do you turn? Who pays for the astronomical medical bills?
The answer to those questions could dramatically change within the next few months.
The key defining political objective of President Obama’s term is shaping up to be the health care reform.
The issue of health care has long been an issue of debate, going back to the early nineties when former President Clinton drafted his own version of health care reform and attempted to force the square peg bill through the round hole of Congress.
Obama has decided to take on the supreme task of health care reform and, as a result, the health care landscape could potentially be looking quite different when many current college students graduate.
Here is a look inside of what the key issues of the great debate are and what it all means according to SMU political science professor Matthew Wilson.
The current system and the issues plaguing itAs it currently stands, health insurance is predominantly provided through the employer. An employee will pay partly into the health care system, with the employer picking up most of the tab on the insurance. This leaves obvious gaps of uninsured Americans if their employer elected not to provide a health insurance program. The poor and elderly are a separate group, covered by government-financed services called Medicare and Medicaid.
“Buying health insurance individually, not through an employer can be very expensive,” Wilson said. “Currently, our system has no guarantees that all Americans will be covered; there is no safety net.”
Among many other issues with the current system is the fact that private insurance companies often lock out individuals with a pre-existing medical condition, neglecting that these problems are often the crux of the matter.
According to Wilson, it is not a matter of debate whether or not reform is needed, but rather the extent and shape the reform will take.
Solutions being debatedWilson said part of the problem with the current debate is Obama has very broadly described the objectives he wants to see in a reform, but has left it up to Congress to work out the exact details.
Obama has stated he wants health care for every American, and has made it widely known that he favors a public option in which the government would provide insurance for the uninsured.
Wilson said this is part of the core objection that many conservative Democrats and Republicans have with the idea, holding up any reform for debate.
Wilson also said that by letting Congress work out the details of the bill you have different bills moving through both houses of Congress, further complicating the matter and adding to debate.
Who’s whoAccording to Wilson, it is Obama and the liberal Democrats that favor the public option. The problem the more conservative members of Congress have with this idea is primarily focused around cost, what it will do to the budget deficit and how it will be paid for.
In the Obama administration’s first year in the White House alone will rack up more than one trillion dollars in the federal budget deficit, or money the government spends past the tax dollars it receives. This can be a large problem if the deficit gets out of control, and an expensive publicly funded health care system many conservatives feel will push the deficit even higher. Adding to the debate is the fact Obama has mentioned to partially offset the cost of a publicly funded option by raising taxes on the wealthy.
Wilson also notes there is concern that a government option may cause employers to drop the expense of providing health care for their employees and let them sign up for public care. This could be very problematic for private insurers and could eventually push them out of business.
Obama argues that a government option would merely provide competition for the private sector, bringing costs down to competitive levels.
Wilson said that more conservative members of Congress favor a different breed of reform. They have put on the table the notion that simply opening up health insurance nationally rather than keeping it in the state will provide enough competition to drive prices down, or provide tax credits to those without coverage to offset the cost.
“Both sides are in agreement that reform needs to happen,” Wilson said. “That is not the question. The question is, how much reform will take place and at what cost?”
Why now?According to Wilson, it would be much harder to attempt some type of reform during a Congressional mid-term election year as in 2010. This is the reason for the large push to get it done now.
Wilson said at a minimum of reform we will see those with pre-existing medical conditions no longer be automatically locked out, and possibly subsidies for the uninsured to purchase their own insurance.
At a maximum, Wilson said, we will see a fully publicly funded government provide a health care system to directly provide insurance for the uninsured.
He said there has to be some type of bill passed because of the time and political capital invested by Obama and not passing anything would be a huge blow politically for the president.
“At the end of the year there will be something called ‘health care reform’ passed,” Wilson said. “We will just see what exactly that looks like.”
