Health care reform 2009: back to basics

In a victory for the power of reasoned, rationale debate [yes, I am being ironic], Sen. Grassley (R-IA), ranking member on the Senate Finance Committee, announced late last week that a controversial provision in the House reform bill allowing for Medicare funding of a voluntary discussion of living wills and other end-of-life issues would be stripped from any Senate bill. (Indeed, early this morning Grassley clarified to Politico.com and other reporters that at least for purposes of the bipartisan negotiations ongoing within the SFC, the end-of-life language has been gone for weeks.)

Perhaps it makes sense, at a time when the debate has become heated, to take a step back from all the drama and reacquaint ourselves with the basic issues on the table in the 2009 debate over health care. From the sedate (some might say boring) perspective of the policy wonk, and not that of the political firebrand.

A recent introduction to health care reform published by the Congressional Research Service offers a cogent (and brief) summary of the key issues. According to CRS, the 2009 reform effort attempts to address three key concerns:

• health care costs are rising at an unsustainable rate, both for individual families and the society as a whole;
• for all the U.S. spends on health care, by some measures the quality of care provided is inferior to the care provided in other developed countries;
• The number of Americans who lack insurance coverage is a problem in and of itself that also exacerbates the cost and quality issues.

In addition to summarizing key elements of proposed solutions to these problems (e.g., public v. private insurance, the role of employment-based coverage), the report highlights opportunities for further learning. So, if you're an ERISA beginner, go here. Or, if the tax exclusion for employer-provided insurance is your thing, go here.