1: Past tort reform that caps malpractice law suits.
2: Allow for health insurance to be sold across state lines.
These measures would cost the taxpayers nothing and would make a big difference in cost. If lawmakers were truly serious about addressing cost and accessability then their proposals would include some form of the above mentioned ideas. The bills being debated don't include either one of these measures, so we can be sure that their playing games, not trying to fix problems.
The problem with just passing only these bills are that, like another poster said, these would do little for taxpayers and doctors alone. If anything, it would do what Medicare Part D did for drug companies (a huge cash giveaway on our tab). Tort reform is definitely needed, but capping malpractice law suits won't do the trick because a) insurance companies won't necessarily lower premiums and b) the number of lawsuits may just increase as a result. Something else, like an expert panel to determine the legitimacy of the lawsuit, needs to be used instead to educate the juries and judges about the issues and screen out frivolous lawsuits. What's needed is not a cap on lawsuits, but prevention of many of these cases from proceeding in the first place. A cap for payouts would just increase the insurance company's profit margin, and there may not be any incentive to reduce premiums. A mechanism needs to be in place to protect doctors from excess costs, but should still give patients some way to fight back if they have unfortunately been wronged by a doctor out of negligence (yes, as untrue as it sounds to some people here, it does happen, and I see it at my hospital as well). This has been tried in several states, and caps did not reduce costs in several states. For some states, it did make the environment more hospitable for doctors, but it did not impact costs.
Another thing I continually hear is deregulating health insurance even more, including insurance to be sold across state lines. This sounds good on paper, but it would possibly exacerbate our current problems more. For one, health insurance companies are exempt from anti-trust laws (McCarran-Ferguson Act); if the health insurance companies start to become an oligopoly (which has happened already in most states), we have no way to break it up. Again, how does that reduce cost? It's more like, how much more will the insurance companies rake in because of that?
In addition, selling insurance across state lines implies that either states will have to reduce regulation on insurance, or the restrictions will be so high that a company would not see any point in trying to expand into another state, especially when another company already has a strong foothold in it. If the former were to happen, insurance companies would only maintain to the bare minimums for their plans, and it would lead to worse quality insurance. I guarantee you denials, premium fixes, and lower coverage would occur; basically, we'd see in the health care industry what happened in the banking industry when the Glass-Steagall Act was repealed in 1999. If insurance were to be sold across state lines, you'd have to repeal the anti-trust laws and regulate the hell out of the insurance companies in order to see any benefit.
The reason the bill is being passed in its form is because the result is greater than the sum of the individual parts. A lot of the "common-sense" reform means nothing if passed slowly and incrementally because without the other laws and regulations to safeguard each other, there are loop-holes and methods around it (outlaw "prexisting conditions" only? Expect to see more technicality-based denials or higher premiums to maintain profit margin).
If lowering cost is the goal then how is spending approximatly 1 trillion in additional money over 10 years going to lower cost?
Current estimates are now at $871 billion, and this is an aggregate sum, not just on the public option. The projections are that the savings will come through saved costs in administration, replacing the current tax exclusion for health insurance with an income tax deduction, new tax payments to employers to the fed government, premiums by individuals who have purchased the plan, and lower health insurance plans due to private companies having to compete with the public option. The misconception people have is that the public option is free. It is NOT FREE, you have to purchase it like any other health plan; you have to pay a monthly/yearly fee, and there is a premium to it. The issue isn't about giving away free care to the uninsured via the government, it's providing an affordable option to the uninsured via the government.
Paying doctors less? That logic implys that the reason health care is so expensive and not accessable is because doctors make too much money.
Current proposals for the public option have ranged for medicare reimbursements + 5-10% or price negotiable. You're right that it does take some investment to bring costs down long-term, but right now it doesn't seem that doctors are going to be paid less; the reason so is that both sides aren't willing to impede on the "patient-physician" relationship. If you want to be pissed at people in the government right now for pay-related issues, be pissed at the senators that recently blocked the recent Medicare bill proposed by Sen. Stabenow to replace the outdated SGR with a better reimbursement formula. Fixing the Medicare system is one of the core things needed to "bend the cost curve", and we can start by closing the loopholes, abuses, fraud, double-billing, and other acts that's contributing to this problem.
