HR 3962, the Affordable Health Care for Americans Act, hit the House floor with a thud Thursday morning at 1990 pages, almost double the size of the bill we last saw before the Energy and Commerce hearings at the end of July.  The bill incorporates, of course, amendments from the House jurisdictional committees, but also [...]

On October 12 America’s Health Insurance Plans (AHIP) released a commissioned report by Price Waterhouse Cooper (PWC), “Potential Impact of Health Reform on the Cost of Private Health Insurance Coverage.”   The study reported that health care reform as envisioned by the Senate Finance Committee would raise the cost of private health insurance by 23 percent [...]

Senate Majority Leader Harry Reid (D-NV) answered some important questions at his Capitol Hill news conference today: The health reform bill he will send to the Senate floor will include a public health insurance plan with a state opt-out provision, and as a result the much-courted Sen. Olympia Snowe (R-ME) — the lone Republican to vote in committee for [...]

Editor’s note: Health Affairs Founding Editor John Iglehart recently interviewed American Hospital Association CEO Rich Umbdenstock. The wide-ranging conversation, transcribed below, touched on the ongoing health reform debate, the evolving role of hospitals in community health, the effect of the economy on hospital finances, the evolution of integrated medicine, patient safety, workforce concerns, and other [...]

As Senate and House Committee versions of health reform move toward unified legislation and floor votes, the most complex political challenge is how to resolve the “public option” controversy.  While one would have thought weightier issues such as the shape of Medicare reform, the taxation required to support coverage subsidies, or the presence or absence [...]

The public option is “alive,” Senate Finance Chairman Max Baucus (D-MT) said in a media conference call sponsored by Families USA.
The Senate Finance health reform bill is the only one that does not include a publicly run health insurance plan among the options that would be offered to consumers purchasing coverage in a new health insurance exchange. Baucus and [...]

Insurance exchanges, or “Gateways” as they are called in the Senate HELP bill, are a key element in all of the congressional health reform proposals, as well as the proposal outlined by President Obama in his speech to Congress. The exchange is not some new heavy-handed government regulatory body. Rather, the purpose of the exchange [...]

Editor’s Note: In addition to S. Ward Casscells, M.D. and Hiliary Critchley (photos and bios above), coauthors of this post include Thomas Amoroso, M.D., of the Quincy Medical Center; James Tyll of James Tyll Consulting, LLC; and John Zogby of Zogby International, Inc. The authors are also grateful for analytical advice contributed by Grace Ren [...]

On September 30, 2009, the Harvard School of Public Health, NPR, and the Kaiser Family Foundation released the findings of some new polling on how the public perceives the current debate about health care or health insurance reform.  NPR discussed how most of the public feels that they are not represented in the debate, although [...]

The Senate Finance Committee is now considering a proposal that would impose an aggregate tax of $6.7 billion dollars per year on “any U.S. health insurance provider,” in proportion to market share, whether for profit or not for profit, but not on employers who “self fund” their employees’ coverage.
About 160 million Americans have private health [...]

In recent days, Republican leaders on Capitol Hill have taken up the argument that the Democratic health reform bills represent a “government takeover” of the health care system.  These claims misrepresent the substantive content of the bills, since the approach of the main committee bills is to extend employer-sponsored, private insurance.  But this rhetorical exaggeration [...]

Editor’s Note: In terms of “bending the cost curve,” health-care providers in La Crosse, WI., have clearly demonstrated the ability to deliver high-qualty care for comparatively low costs. La Crosse was one of ten communities featured at a July 21 conference in Washington, D.C. titled “How Do They Do That?  Low-Cost, High-Quality Health Care in [...]

After decades of teaching, I view everything around me as a final exam and assign it letter grades.
Naturally, I graded President Barack Obama’s speech as well. The overall grade is A–, a highly respectable grade at Princeton, although there is variation around this overall average for the different themes in the speech.
The elegance and force [...]

On September 22, 1993, President Bill Clinton spoke to a joint session of Congress about the imperative of enacting health reform. It was a powerful speech. Clinton emphasized the need to fix a “badly broken” system that cost too much and left too many Americans without insurance. He eloquently cited stories of how ordinary Americans [...]

The president’s speech to Congress struck important political notes.  It also included three tantalizing opportunities for adding some aspects of health care reform to what was becoming simply health insurance reform. 
Delaying Implementation of the Exchange
The most obvious new, and possibly controversial, point in the speech was the four-year delay in implementing the Insurance Exchange.  This [...]

After the August congressional recess, health care reform was on life support.  In a speech of remarkable force and eloquence on Wednesday night to a congressional joint session, President Obama made clear that he would use every resource available to him to assure that health reform survives to become law.
The August recess had left hopes [...]

Early in President Barack Obama’s speech to Congress about health care reform, he mentioned health care costs as one of the causes of the problem of lack of insurance coverage. But most of the speech focused on what to do about health insurance costs, not health care costs. Changing the rules about how insurance companies operate [...]

The need to “bend the curve” of rising health care costs is certain. Less certain is the nation’s political will to take on that difficult task.
That conundrum emerged today at a Washington, D.C. briefing sponsored by Health Affairs. The briefing, held to launch the journal’s Sept-Oct issue, a thematic volume titled “Bending The Cost Curve,” [...]

Patients with serious or advanced illnesses would be given more control over their care by language in health reform legislation passed by three House committees that would pay physicians, nurse practitioners, and other providers for counseling Medicare beneficiaries about advance planning for future care decisions.
That was the unanimous opinion expressed by three respected geriatricians at [...]

One by one, various cars are falling off the chugging legislative locomotive of Obama-style health “reform” as it tries to climb hills that are too steep.  The public plan option has checked in for rehab as a co-op and even some end-of-life counseling.  Bending-the-cost-curve measures were turned upside down by the Congressional Budget Office in July.   [...]