Monday, May 04, 2009
Tweet[IWS] CRS: HEALTH CARE REFORM: AN INTRODUCTION [14 April 2009]
IWS Documented News Service
_______________________________
Institute for Workplace Studies----------------- Professor Samuel B. Bacharach
School of Industrial & Labor Relations-------- Director, Institute for Workplace Studies
Cornell University
16 East 34th Street, 4th floor---------------------- Stuart Basefsky
New York, NY 10016 -------------------------------Director, IWS News Bureau
________________________________________________________________________
Congressional Research Service (CRS)
R40517
Health Care Reform: An Introduction
Bob Lyke
April 14, 2009
http://opencrs.com/getfile.php?rid=81262
[full-text, 20 pages]
SUMMARY
Health care reform has emerged as an issue in the 111th Congress, driven by growing concern
about widely discussed problems. Three predominant concerns involve coverage, cost and
spending, and quality. Commonly cited figures indicate that more than 45 million people have no
insurance, which can limit their access to care and their ability to pay for the care they receive.
Costs are rising for nearly everyone, and the country now spends over $2.2 trillion, more than
16% of gross domestic product (GDP), on health care services and products, far more than other
industrialized countries. For all this spending, the country scores but average or somewhat worse
on many indicators of health care quality.
These concerns raise significant challenges. Each of the concerns is more complex than might
first appear, which increases the difficulty of finding solutions. For example, by one statistical
measure, far more than 45 million people face the risk of being uninsured for short time periods,
yet by another, substantially fewer have no insurance for long periods. Insurance coverage and
access to health care are not the same, and it is possible to have one without the other. Having
coverage does not ensure that one can pay for care, nor does it always shield one from significant
financial loss in the case of serious illness. Similarly, high levels of spending may be partly
attributable to the country's wealth, while rising costs, though difficult for many, may primarily
mean that less money is available for other things.
Solutions to these concerns may conflict with one another. For example, expanding coverage to
most of the uninsured would likely drive up costs (as more people seek care) and expand public
budgets (since additional public subsidies would be required). Cutting costs may threaten
initiatives to improve quality. Other challenges include addressing the interests of stakeholders
that have substantial investments in present arrangements and the unease some people have about
moving from an imperfect but known system to something that is potentially better but untried.
Health care reform proposals will likely rekindle debate over perennial issues in American health
care policy. These include whether insurance should be public or private; whether employmentbased
insurance should be strengthened, weakened, or left alone; what role states might play; and
whether Medicaid should be folded into new insurance arrangements. Whether changes to
Medicare should occur at the same time may also be considered. Concerns about coverage, cost
and spending, and quality are likely to be addressed within the context of these issues.
The 111th Congress has already begun work on health care reform. Hearings have been held, and
staffs of the committees of principal jurisdiction are working to draft coordinated bills. Some
comprehensive reform bills have already been introduced, such as H.R. 15 (Representative
Dingell), H.R. 193 (Representative Stark), H.R. 676 (Representative Conyers), H.R. 956
(Representative Kaptur), H.R. 1200 (Representative McDermott), H.R. 1321 (Representative
Eshoo), S. 391 (Senator Wyden), and S. 703 (Senator Sanders).
This report does not discuss or even try to identify all of the concerns about health care in the
United States that are prompting calls for reform. Other concerns may also be important, at least
to some, and will likely contribute to the complexity of the reform debate. The report may be
updated to include other health care reform issues as the debate in Congress unfolds.
Introduction ...............................................................................................................................1
Three Predominant Concerns ......................................................................................................2
Coverage ..............................................................................................................................2
Cost and Spending ................................................................................................................4
Quality.................................................................................................................................5
Some Likely Legislative Issues ...................................................................................................7
The Scope of Reform............................................................................................................8
Public or Private Insurance....................................................................................................9
Employment-Based Insurance...............................................................................................9
The Role of States...............................................................................................................10
Some Congressional Proposals.................................................................................................. 11
Tables
Table A-1. Health Insurance Coverage, by Type of Insurance and Age, 2007 ............................13
Table C-1. Distribution of National Health Care Expenditures by Service, Product, and Activity, 2007 ........15
Table C-2. Distribution of National Health Care Expenditures by Source of Funds, 2007...........16
Appendixes
Appendix A. Overview of Health Insurance Coverage...............................................................13
Appendix B. Characteristics of the Uninsured ...........................................................................14
Appendix C. Distribution of National Health Care Expenditures................................................15
______________________________
This information is provided to subscribers, friends, faculty, students and alumni of the School of Industrial & Labor Relations (ILR). It is a service of the Institute for Workplace Studies (IWS) in New York City. Stuart Basefsky is responsible for the selection of the contents which is intended to keep researchers, companies, workers, and governments aware of the latest information related to ILR disciplines as it becomes available for the purposes of research, understanding and debate. The content does not reflect the opinions or positions of Cornell University, the School of Industrial & Labor Relations, or that of Mr. Basefsky and should not be construed as such. The service is unique in that it provides the original source documentation, via links, behind the news and research of the day. Use of the information provided is unrestricted. However, it is requested that users acknowledge that the information was found via the IWS Documented News Service.
Stuart Basefsky
Director, IWS News Bureau
Institute for Workplace Studies
Cornell/ILR School
16 E. 34th Street, 4th Floor
New York, NY 10016
Telephone: (607) 255-2703
Fax: (607) 255-9641
E-mail: smb6@cornell.edu
****************************************
_______________________________
Institute for Workplace Studies----------------- Professor Samuel B. Bacharach
School of Industrial & Labor Relations-------- Director, Institute for Workplace Studies
Cornell University
16 East 34th Street, 4th floor---------------------- Stuart Basefsky
New York, NY 10016 -------------------------------Director, IWS News Bureau
________________________________________________________________________
Congressional Research Service (CRS)
R40517
Health Care Reform: An Introduction
Bob Lyke
April 14, 2009
http://opencrs.com/getfile.php?rid=81262
[full-text, 20 pages]
SUMMARY
Health care reform has emerged as an issue in the 111th Congress, driven by growing concern
about widely discussed problems. Three predominant concerns involve coverage, cost and
spending, and quality. Commonly cited figures indicate that more than 45 million people have no
insurance, which can limit their access to care and their ability to pay for the care they receive.
Costs are rising for nearly everyone, and the country now spends over $2.2 trillion, more than
16% of gross domestic product (GDP), on health care services and products, far more than other
industrialized countries. For all this spending, the country scores but average or somewhat worse
on many indicators of health care quality.
These concerns raise significant challenges. Each of the concerns is more complex than might
first appear, which increases the difficulty of finding solutions. For example, by one statistical
measure, far more than 45 million people face the risk of being uninsured for short time periods,
yet by another, substantially fewer have no insurance for long periods. Insurance coverage and
access to health care are not the same, and it is possible to have one without the other. Having
coverage does not ensure that one can pay for care, nor does it always shield one from significant
financial loss in the case of serious illness. Similarly, high levels of spending may be partly
attributable to the country's wealth, while rising costs, though difficult for many, may primarily
mean that less money is available for other things.
Solutions to these concerns may conflict with one another. For example, expanding coverage to
most of the uninsured would likely drive up costs (as more people seek care) and expand public
budgets (since additional public subsidies would be required). Cutting costs may threaten
initiatives to improve quality. Other challenges include addressing the interests of stakeholders
that have substantial investments in present arrangements and the unease some people have about
moving from an imperfect but known system to something that is potentially better but untried.
Health care reform proposals will likely rekindle debate over perennial issues in American health
care policy. These include whether insurance should be public or private; whether employmentbased
insurance should be strengthened, weakened, or left alone; what role states might play; and
whether Medicaid should be folded into new insurance arrangements. Whether changes to
Medicare should occur at the same time may also be considered. Concerns about coverage, cost
and spending, and quality are likely to be addressed within the context of these issues.
The 111th Congress has already begun work on health care reform. Hearings have been held, and
staffs of the committees of principal jurisdiction are working to draft coordinated bills. Some
comprehensive reform bills have already been introduced, such as H.R. 15 (Representative
Dingell), H.R. 193 (Representative Stark), H.R. 676 (Representative Conyers), H.R. 956
(Representative Kaptur), H.R. 1200 (Representative McDermott), H.R. 1321 (Representative
Eshoo), S. 391 (Senator Wyden), and S. 703 (Senator Sanders).
This report does not discuss or even try to identify all of the concerns about health care in the
United States that are prompting calls for reform. Other concerns may also be important, at least
to some, and will likely contribute to the complexity of the reform debate. The report may be
updated to include other health care reform issues as the debate in Congress unfolds.
Introduction ...............................................................................................................................1
Three Predominant Concerns ......................................................................................................2
Coverage ..............................................................................................................................2
Cost and Spending ................................................................................................................4
Quality.................................................................................................................................5
Some Likely Legislative Issues ...................................................................................................7
The Scope of Reform............................................................................................................8
Public or Private Insurance....................................................................................................9
Employment-Based Insurance...............................................................................................9
The Role of States...............................................................................................................10
Some Congressional Proposals.................................................................................................. 11
Tables
Table A-1. Health Insurance Coverage, by Type of Insurance and Age, 2007 ............................13
Table C-1. Distribution of National Health Care Expenditures by Service, Product, and Activity, 2007 ........15
Table C-2. Distribution of National Health Care Expenditures by Source of Funds, 2007...........16
Appendixes
Appendix A. Overview of Health Insurance Coverage...............................................................13
Appendix B. Characteristics of the Uninsured ...........................................................................14
Appendix C. Distribution of National Health Care Expenditures................................................15
______________________________
This information is provided to subscribers, friends, faculty, students and alumni of the School of Industrial & Labor Relations (ILR). It is a service of the Institute for Workplace Studies (IWS) in New York City. Stuart Basefsky is responsible for the selection of the contents which is intended to keep researchers, companies, workers, and governments aware of the latest information related to ILR disciplines as it becomes available for the purposes of research, understanding and debate. The content does not reflect the opinions or positions of Cornell University, the School of Industrial & Labor Relations, or that of Mr. Basefsky and should not be construed as such. The service is unique in that it provides the original source documentation, via links, behind the news and research of the day. Use of the information provided is unrestricted. However, it is requested that users acknowledge that the information was found via the IWS Documented News Service.
Stuart Basefsky
Director, IWS News Bureau
Institute for Workplace Studies
Cornell/ILR School
16 E. 34th Street, 4th Floor
New York, NY 10016
Telephone: (607) 255-2703
Fax: (607) 255-9641
E-mail: smb6@cornell.edu
****************************************
# posted by SBasefsky : 10:09 AM
