Time ripe for health reform

Saturday's editorial considers some of the health-care reforms gaining the most traction in Congress.

In contrast to the adversarial atmosphere that dominated the health care debate of the 1990s, a new consensus is emerging that systematic reform is necessary, because rising costs now appear to threaten the country's long-term financial stability. Doing nothing, it seems, is no longer affordable.

Out of that consensus, federal lawmakers of all stripes are now racing to draft their own versions. Any bill that passes will likely affect all Americans, so if you have not been paying attention to the details, now is time to start.

Dominating the discussion has been President Obama's calls for near-universal coverage that will lower costs for patients, guarantee choice and not raise the federal debt. His stated preference has been for a government-backed public plan to compete with private insurers (and theoretically lower costs across the board) - which polls show wide support for among Americans - but Republicans are strongly opposed to it, and Obama has said he may be willing to compromise it - especially after seeing its higher-than-expected price tag.

Another common theme is the so-called "pay or play" idea, which aims to encourage employers to provide health benefits and fines them - House Democrats propose 8 percent of their payroll - if they don't. Obama has encouraged an exemption for small businesses if the "pay or play" route is taken.

An opposite approach - which has recently garnered positive reviews in both the liberal American Prospect in the conservative opinion pages of the Wall Street Journal - is the bipartisan Bennett-Wyden bill that would end tax credits on employer-offered health plans and reroute that money to individual families in middle-class tax breaks and subsidies for the poor to buy their private insurance.

The plan has 14 co-sponsors from both parties - liberals who want universal care, and conservatives who want buying power redirected to individuals - but is out of favor with Democratic Sen. Max Baucus, the Finance Committee chairman taking a lead role in the debate. One of its sponsors told the Wall Street Journal this week that he has been meeting with Obama, however, so the idea may have legs yet.

Another significant option is the creation of large "exchanges," pools of individuals who compete for coverage and spread the cost burden. Obama has also offered limited support for a medical liability reform as part of a comprehensive plan.

While all these proposals are works in progress, the intensity of debate in Congress suggests one will soon rise to the fore. With such drastic consequences of defeat, let us offer hopes that a plan does finally come to pass.

Ailing coverage

• Roughly 2.5 million S.C. residents receive health insurance from their employer, and family premiums average $12,676 a year.
• Since 2000, average family premiums have increased by 92 percent in South Carolina.
• S.C. businesses and families pay roughly $600 per year on premiums to subsidize the costs of the uninsured.
• The percent of South Carolinians with employer coverage declined from 65 percent to 57 percent between 2000 and 2007.
• 16 percent of people in South Carolina are uninsured, and 73 percent of them are in families with at least one full-time worker.
• Only 33 percent of small businesses offered health coverage benefits in 2006 - down 7 percent since 2000.
• In 2007, Blue Cross Blue Shield SC constituted 66 percent of the health insurance market share in South Carolina, and Cigna had another 9 percent. The Myrtle Beach market was even less competitive: BCBS has 73 percent of the market, followed by Premier Health at 9 percent.

Sources: American Medical Association; www.healthreform.gov

Out of that consensus, federal lawmakers of all stripes are now racing to draft their own versions. Any bill that passes will likely affect all Americans, so if you have not been paying attention to the details, now is time to start.

Dominating the discussion has been President Obama's calls for near-universal coverage that will lower costs for patients, guarantee choice and not raise the federal debt. His stated preference has been for a government-backed public plan to compete with private insurers (and theoretically lower costs across the board) - which polls show wide support for among Americans - but Republicans are strongly opposed to it, and Obama has said he may be willing to compromise it - especially after seeing its higher-than-expected price tag.

Another common theme is the so-called "pay or play" idea, which aims to encourage employers to provide health benefits and fines them - House Democrats propose 8 percent of their payroll - if they don't. Obama has encouraged an exemption for small businesses if the "pay or play" route is taken.

An opposite approach - which has recently garnered positive reviews in both the liberal American Prospect in the conservative opinion pages of the Wall Street Journal - is the bipartisan Bennett-Wyden bill that would end tax credits on employer-offered health plans and reroute that money to individual families in middle-class tax breaks and subsidies for the poor to buy their private insurance.

The plan has 14 co-sponsors from both parties - liberals who want universal care, and conservatives who want buying power redirected to individuals - but is out of favor with Democratic Sen. Max Baucus, the Finance Committee chairman taking a lead role in the debate. One of its sponsors told the Wall Street Journal this week that he has been meeting with Obama, however, so the idea may have legs yet.

Another significant option is the creation of large "exchanges," pools of individuals who compete for coverage and spread the cost burden. Obama has also offered limited support for a medical liability reform as part of a comprehensive plan.

While all these proposals are works in progress, the intensity of debate in Congress suggests one will soon rise to the fore. With such drastic consequences of defeat, let us offer hopes that a plan does finally come to pass.

Ailing coverage

• Roughly 2.5 million S.C. residents receive health insurance from their employer, and family premiums average $12,676 a year.
• Since 2000, average family premiums have increased by 92 percent in South Carolina.
• S.C. businesses and families pay roughly $600 per year on premiums to subsidize the costs of the uninsured.
• The percent of South Carolinians with employer coverage declined from 65 percent to 57 percent between 2000 and 2007.
• 16 percent of people in South Carolina are uninsured, and 73 percent of them are in families with at least one full-time worker.
• Only 33 percent of small businesses offered health coverage benefits in 2006 - down 7 percent since 2000.
• In 2007, Blue Cross Blue Shield SC constituted 66 percent of the health insurance market share in South Carolina, and Cigna had another 9 percent. The Myrtle Beach market was even less competitive: BCBS has 73 percent of the market, followed by Premier Health at 9 percent.

Sources: American Medical Association; www.healthreform.gov