Experts duel on plight of health reform and merits of specific provisions

NPR interviewed two leading health care experts - Uwe Reinhardt, a Princeton professor, and Gail Wilensky, an economist who ran Medicare under the first President Bush - to shed light on the current plight of pending health care overhaul.

Defending the legislation, and expressing hope for its survival, Reinhardt says, "The idea of taking the Senate bill, have the House endorse it and then pass it into law is not as far-fetched as even the president [seems to have made] it appear, because the Senate bill does many of the things Americans want. Americans need help buying health insurance. Well, it does that. Americans don't want the premiums based on their own health status, the bill outlaws that. Americans don't want rescission, that is, having their insurance canceled after an illness strikes, this bill outlaws that."

Wilensky, on the other hand, acknowledges the problems of health care, but says the overhaul plans fell short. She says, "There are three significant problems in health care. The Senate bill primarily focused on one and did it reasonably well, that is, expanding coverage to a substantial number of the uninsured. Did very little for the other two, which is slowing health care spending and improving the value and the quality for what we spend" (Siegel, 1/26).

The Washington Times reports that James Carlson, chairman and CEO of the insurer Amerigroup Corp. said "the decision by President Obama and congressional Democrats to cut health insurance companies out of the debate and vilify them was a misguided strategy because insurers were the primary interest group intent on reining in costs. … 'We're frankly conflicted,' he said. 'You can't spend the years we've spent looking at the problems of health care and costs and ever think that this is a situation that can solve itself. Even though there's plenty not to like for us in the reform bills, all things considered we still would like to see something pass and think the Senate version is more workable for us'" (Sands, 1/27).

Meanwhile, The New York Times reports examines one particular point of contention among the competing health reform bills: lifetime caps on insurance coverage. "Many health plans limit the total amount that the insurer will pay for medical care annually or over the policy holder's lifetime. It's an insurance industry practice that angers many consumers, and it's one of many things a health care overhaul must address. But the House and Senate bills take wildly divergent approaches." The House bill would eliminate caps, but the Senate bill would only do so six months after the law's enactment and current plans would be exempt. "But patient advocates say the caps can't disappear fast enough. Increasing lifetime limits would involve a fairly modest increase premium increase, according to the PricewaterhouseCoopers study" (Andrews, 1/26).