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Debate: US health care reform

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Is the 2010 US health care reform legislation a good idea?

Background and context

For decades, the United States has been trying to reform its health care system. In 2009, the Obama administration made health care reform its largest priority, setting a general framework for the United States Congress to pass legislation by the end of the year. With bills finalized and approved in both the Senate and House of Representatives by the end of 2009, the United States Congress is likely to go on to pass a major joint bill in early 2010. The provisions of this legislation have been hotly debated, with Republicans almost unanimously opposing them and Democrats almost uniformly in support. The main provisions have included a public option (part of the House legislation, but not part of the Senate bill), a mandate for all citizens to buy health insurance (with subsidies for those that cannot afford it), provisions to end insurance company discrimination against individuals with pre-existing conditions, and "exchanges" designed to increase consumer choice and competition between insurers among other things.

Contents

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Reform: Is the bill a major reform and step forward?

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Pro

  • 2009 health bill is much better than nothing Joe Biden. "Why the Senate should vote yes on health care." New York Times. December 19, 2009: "The issues in the health reform bill are complicated, but the consequences of failing to pass it are straightforward. Those who would vote no on this bill need to look into the eyes of Americans who don’t have health care now and tell them they’re going to be better off without this bill — better off continuing to live without health coverage. They should explain to all those Americans who are denied coverage because they have pre-existing conditions or whose insurance ran out because of lifetime caps that they don’t need this bill. And they should tell the families who have insurance and the small-business owners who provide it that the relentless rise in their premiums without this bill will somehow make them glad it didn’t pass."


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Con

  • General statements against 2010 US health care reform David Brooks. "The Hardest Call." New York Times. December 17, 2009: "If I were a senator forced to vote today, I’d vote no. If you pass a health care bill without systemic incentives reform, you set up a political vortex in which the few good parts of the bill will get stripped out and the expensive and wasteful parts will be entrenched. [...] Defenders say we can’t do real reform because the politics won’t allow it. The truth is the reverse. Unless you get the fundamental incentives right, the politics will be terrible forever and ever."


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Uninsured: Does bill help insure 30 million uninsured?

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Pro

  • 2009 health bill provides aid to those without employer insurance. For those that do not receive insurance from their employers, the 2009 health bill provides aid, to make it easier for them to buy insurance for themselves.
  • 2009 health bill provides tax breaks for small employer insurance. For small businesses that will have difficulty offering health insurance to its employees, under the new mandate, the health care bill will provide a tax break to make it easier for them to provide that insurance.


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Con

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Mandates: Are the mandates in the health bill justified?

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Cost-cutting: Does the bill reduce the costs of health care?

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Pro

  • Health care reform limits costs of health care Jonathan Cohn. "Andy Stern: Don't Kill the Bill. Fix It." The Plank, The Republic. December 18, 2009: "The second reason to support the bill is that its authors took the deficit issue seriously. Compared with, say, the prescription drug benefit from a few years ago, this bill is a model of fiscal rectitude. It spends a lot of money to cover the uninsured, but to help pay for it, it also includes serious Medicare cuts and whopping tax increases — the tax on high-cost insurance plans alone will raise $1.3 trillion in the second decade. [...] The bill is not really deficit-neutral. It’s politically inconceivable that Congress will really make all the spending cuts that are there on paper. But the bill won’t explode the deficit, and that’s an accomplishment."
  • Health care law holds insurance companies in check Tom Bevan. "President Obama's Remarks on Senate HC Vote." Time. December 24, 2009: "The reform bill that passed the Senate this morning, like the House bill, includes the toughest measures ever taken to hold the insurance industry accountable. Insurance companies will no longer be able to deny you coverage on the basis of a preexisting condition. They will no longer be able to drop your coverage when you get sick. No longer will you have to pay unlimited amounts out of your own pocket for the treatments you need. And you'll be able to appeal unfair decisions by insurance companies to an independent party."
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Con

  • Health care reform would worsen the deficit Robert Samuelson. "A parody of leadership." Real Clear Politics. December 21, 2009: "the health care proposals would impose massive costs. Remember: The country already faces huge increases in federal spending and taxes or deficits because an aging population will receive more Social Security and Medicare. Projections made by the Congressional Budget Office in 2007 suggested federal spending might rise almost 50 percent by 2030 as a share of the economy (gross domestic product). Since that estimate, the recession and massive deficits have further bloated the national debt. [...] Obama's plan might add almost another $1 trillion in spending over a decade -- and more later."


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Politics: Is health care reform too political?

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Pro

  • Passing historic health care bill victory for Dems. Passing health care reform, the greatest social reform since the 1930s, is a great victory for the Democrats, and for any individual that supported the legislation. For those that opposed the legislation, they will have to explain why they were not willing to sign on to the first major health care reform in 70 years.


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Without public option: Is reform acceptable w/o public option?

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Pro

  • Health care reform still valuable without public option Paul Krugman. "Pass the Bill". New York Times Op-Ed. December 17, 2009: "The public option was always a means to an end: real competition for insurers, an alternative for consumers to existing private plans that does not deny needed care or shift risks onto the vulnerable, the ability to provide affordable coverage over time. I thought it was the best means within our political grasp. It lay just beyond that grasp. Yet its demise--in this round--does not diminish the immediate necessity of those larger aims. And even without the public option, the bill that Congress passes and the President signs could move us substantially toward those goals."
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Con

  • US health reform does not respond to illegal immigration Robert Samuelson. "A parody of leadership." Real Clear Politics. December 21, 2009: "The remaining uninsured may also exceed estimates. Under the Senate bill, they would total 24 million in 2019, reckons Richard Foster, chief actuary of the Centers for Medicare & Medicaid Services. But a wild card is immigration. From 1999 to 2008, about 60 percent of the increase in the uninsured occurred among Hispanics. That was related to immigrants and their children (many American born). Most illegal immigrants aren't covered by Obama's proposal. If we don't curb immigration of the poor and unskilled -- people who can't afford insurance -- Obama's program will be less effective and more expensive than estimated. Hardly anyone mentions immigrants' impact, because it seems insensitive."
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Pre-existing conditions: Is progress in this regard beneficial?

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Abortion: What are the pros/cons of abortion provisions in the bill?

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Pro/con sources

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See also

External links and resources

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