In an earlier blog post, I announced my support for HR 15. I still think it's a good bill. The problem is, it probably doesn't have a chance of passage.
Since the date of that earlier post, a group of congressmen have re-introduced HR 676, the "United States National Health Care Act or the Expanded and Improved Medicare for All Act." This is the same HR 676 that was before the last Congress, and it has now been re-introduced in this Congress under the same bill number. Although in some ways it is quite different from HR 15, it also establishes a single-payer system, and it also permits and encourages methods of payment to providers other than the traditional "payment for service" method. Thus, like HR 15, it is compatible with the expansion of the prevention emphasis that will be so vitally important to improving public health and reducing the cost of health care in the long-term.
As I have said before, paying for health care under the traditional insurance model--which only pays for insured "loss" events AFTER the "loss" has occurred--is fundamently incompatible with a focus on prevention. A system focused on prevention will provide services BEFORE any loss occurs. HR 676 is compatible with this focus, and would allow medical providers to choose to be paid on models that favor prevention, though it also would leaves providers the option to be paid on the traditional pyment for service after loss model if they so chose.
Thus, on these grounds alone, HR 676 would be far preferable to the approach the President seems to prefer--mandated private health insurance coverage, with the federal employeees' Blue Cross plan being opened to everyone who doesn't have other insurance. Any approach which continues our dependence on the payment for "loss," only AFTER the loss, approach to health care financing stands in the way of prevention and will lead to escalating future costs.
HR 676 also has the virtue that it will get us completely away from all of the other trappings of "insurance"--premiums, deductibles and coinsurance--that disproportionately burden low- and middle-income insureds.
However, the real advantage of HR 676 over HR 15 is that HR 676 has a decent chance of passage. This is a big advantage!
I now support HR 676.
See the HR 676.org website
