Sen. Edward Kennedy (D-MA) has been moving to put together a comprehensive health care reform package as his final legacy. At a bare minimum it will involve several radical steps toward a single national health care plan:
* a mandate on all Americans to buy health insurance;
* a mandate on nearly all businesses to help pay for it;
* creation of a national health insurance exchange as the sole or at least primary source of coverage;
* strict regulation of the private insurers allowed to offer coverage through the exchange, including minimum loss ratios, minimum benefit requirements, prior approval of premiums, guaranteed issue (requiring insurers to sell policies regardless of an individual’s medical condition or history), and modified community rating;
* mandatory use of health information technology, pay-for-performance reimbursement, case management, and quality assurances; and
* a federal “reinsurance” program that will absorb expenses in excess of a certain level in exchange for a premium paid for by health plans and self-insured employers.
This proposal will pass easily through the House and, even if the Democrats do not have a filibuster-proof majority in the Senate, they will be able to attract enough Republican support to break a filibuster.
Kennedy may or may not survive long enough to see the bill enacted, but in either case there will be a strong emotional component to the effort as a way to fulfill the lifelong dream of “the Lion of the Senate.”
Greg Scandlen ([email protected]) is director of Consumers for Health Care Choices at The Heartland Institute.