Q+A: Obama faces challenge on healthcare overhaul

by Lesley Politi on March 25, 2009

By Donna Smith

 

WASHINGTON (Reuters) – President Barack Obama has launched a drive to overhaul the U.S. healthcare system, a far reaching undertaking that most Americans believe is needed, but are unsure about how to tackle.

 

WHAT’S THE PROBLEM?

 

Americans spend more on healthcare than any other country, yet some 46 million lack health insurance. The cost of care and insurance has been rising rapidly, hurting businesses that provide health coverage to their workers. Most workers get their healthcare coverage through their employers. When workers lose their jobs, many also lose their health insurance. Government programs for the elderly and poor fill in some of the gaps, but not all.

 

WHO IS FOR THE OVERHAUL?

 

Business, consumer and health industry groups and lawmakers agree the current system is not working for many Americans and needs to be fixed. They agree costs are too high and too many people are left with inadequate or no coverage. But beyond that basic agreement lie some deep differences that Obama will have to balance if he is to succeed where others have failed.

 

WHAT DO BUSINESSES WANT?

 

Most large employers and many small businesses offer healthcare coverage to their workers. For workers this is the most cost effective way to receive coverage even if they have to pay some or all of the cost, because insurance is cheaper when the risk is shared among a pool of people. Self-employed people and others seeking insurance in the individual market pay the highest costs because they are not part of a risk-sharing pool. Reducing cost is a primary goal.

 

WHAT DO CONSUMERS WANT?

 

Affordable, effective healthcare that does not disappear when one gets seriously ill or loses a job. Medical bills can pile up fast and lead to bankruptcy.

 

WHAT’S IN IT FOR INSURERS?

 

It depends on how the overhaul is structured to ensure all Americans get coverage. Requiring everyone to obtain health insurance is being considered. Such a mandate, which also would likely include a government subsidy for low income people, would bring more revenues into the insurance industry. But in exchange for the mandate, insurers would no longer be free to exclude people for pre-existing conditions. Insurers also oppose creating a government plan, similar to Medicare for the elderly, that would compete with private insurance.

 

WHAT ABOUT HOSPITALS AND DOCTORS

 

Hospitals want an overhaul that would mean fewer uninsured people and that also would also promote health and wellness instead of just treating sickness. A shortage of doctors is a major concern and they are seeking more money for training. Primary care doctors could benefit from proposals that would improve their compensation for overseeing the care of patients. The goal is to reward doctors for good outcomes, rather than pay for individual procedures and treatments that can lead to higher costs.

 

WHAT’S IN IT FOR PHARMACEUTICAL AND MEDICAL DEVISE

 

INDUSTRIES

 

Covering every American means more people can afford prescription drugs and treatments and thus increase demand. But the overhaul will aim to lower the cost of those drugs and treatments. Provisions promoting the use of generic drugs and requiring more information about the effectiveness of various treatments could impact these industries.

 

WHERE ARE THE BIGGEST BATTLE GROUNDS?

 

Obama has called for a bipartisan effort on the healthcare overhaul. Big partisan battles can be expected over how much government programs will be involved.

 

Democrats and their liberal allies want a government plan to be part of the mix of insurance options available to consumers in order to lower the cost of coverage.

 

Insurers, Republicans and conservatives oppose the idea, arguing it would be the first step toward a complete government takeover of the health industry.

 

A number of Republicans also oppose gathering and providing more information on the effectiveness of treatments. They argue it would eventually lead to rationing of care.

 

(Writing by Donna Smith; Editing by David Storey

Source: www.reuters.com

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