Six Things a Pared-Down Health Reform Bill Should Contain

I advocate incremental but not sweeping reform. Health reform is too big, too personal, too emotional, and too threatening to do otherwise. In my book, Obama, Doctors, and Health Reform, I predict President Obama will get about 1/3 of what he wants in the health reform bill he will end up signing.

But which 1/3? Here would be my six choices.

One, encourage competition across state lines to drive down costs. In this Internet age, I see no reason why data on various plans could not be readily available for all, and why all citizens should not have access to less expensive plans.

Two, end the ability to health plans to deny membership for pre-existing illness. This may raise premiums, but could be offset by wide access to cheaper plans in other states.

Three, have a guarantee that the plan would not increase national debt. This should be concrete guarantee rather than vague proposals about savings through prevention, EMRs, and coordinated care.

Four, a concrete proposal on tort reform. Without such reform, the physician shortage will escalate, and the costs of defensive medicine will continue to soar.

Five, tax breaks, or tax credits, for all citizens, including individuals rather than just for employees.

Six, the ability to choose a plan that fits every individual’s or family’s needs and health status rather than comprehensive plans with every conceivable standard benefit regardless of risk.