CALPIRG Blog

After much delay and with little fanfare, Congressional Republicans who oppose the health care reform bills working their way through Congress have put forward their own vision for what health care reform should look like.

It's not a pretty sight.

There are a few things to praise.  The bill would prevent insurers from setting lifetime caps on coverage; similarly, it would rein in their ability to retroactively rescind coverage.  There's a little bit of administrative streamlining to get rid of some of that health care paperwork.  And kids stay on their parents' health insurance plans for longer. 

None of that's going to set the world on fire, but those are concrete, measurable improvements over the status quo.  Of course, they're also included, but stronger, in the existing legislation.

Then there are the pieces that are different.   First, what's missing: any effort to reform the incentives in the health care delivery system to lower costs, and any effort to end insurance industry discrimination against the sick.
 
What's being offered up instead?  An attempt to shuffle the sick out of the ordinary insurance market and into so-called "high risk pools" that only cover those who can't get health care anywhere else.  These programs, including California's, have been underfunded and boast huge waiting lists, and the Republican proposal on offer here does little to change this, allocating less than $2 billion a year to help more than 2 million Americans get coverage (that's less than $1,000 per person per year, which won't go very far).

Next, allowing insurers to relocate their corporate headquarters to whichever state has the smallest number of consumer protections.  This is the same deregulatory strategy that brought us the modern credit card industry, with all its loopholes, fine print, and fees, and stripping away state-based regulations of health insurers will, if anything, make the average HMO even more Byzantine and unaccountable.

The legislation's theories for how to lower costs are either discredited, counterproductive, or laughable.  Tort reform is of course on offer -- never mind that a recent CBO study found that even the harshest imaginable set of limitations would save only a net of about $2 billion a year (or about .1% of health care costs), at a cost of annually shifting $4 billion in damages from injured patients to the hospitals that hurt them.

The proposal would also pay states a modest financial bonus if they managed to lower health care costs.  But anyone who's looked at a state budget deficit lately knows that the problem is hardly that states lack a financial incentive to make care more affordable!

Finally, to cap it all off, the bill would repeal the funding for comparative effectiveness research included in the stimulus, apparently out of a preference for the status quo in which doctors get their information on which medications work best from pharmaceutical companies trying to peddle their wares.

By no means is health care reform a partisan issue.  Bipartisan think-tanks have put out serious proposals for solving the health care crisis. Present and former Republican lawmakers and leaders, including Gov. Schwarzenegger, have voiced their support for reform. 

But this proposed legislation simply doesn't represent a credible attempt to grapple with the very real problems in our health care system. If a minority of lawmakers want to move the ball backwards, that's their prerogative -- but they shouldn't stand in the way of the majority that wants real change.