Home
News
In Focus
Business
Metro
Nation
World
Sports
Feature
Opinion
View more »Opinion Columns
Wan LixinOpinion deputy editor of Shanghai Daily
Forum emphasizes BRI cooperation between China and Arab countries
Rights to lower sleeper berths should be softened by empathy for fellow passengers
Sunday
- Subscribe
Home » Opinion » China Knowledge
Health care prognosis: Many problems ahead
April 16, 2010, Friday
|
Print Edition
Print Edition
US health care reform may be out of the emergency room, but its prognosis remains sketchy. Passage of the historic 2,400-page legislation that President Barack Obama signed into law on March 23 by no means ended the health care debate.
It just splintered one massive question mark into many others. "The fat lady hasn't even come on stage yet," says Wharton professor of legal studies and health care management Arnold. J. Rosoff.
Questions from employers across the country have already arisen about how to implement the new rules and what they mean for business. Many of the legislation's much-touted cost-cutting measures could backfire, some say.
And the ugly political wrangling, backstabbing and partisan bickering that marred the bill's passage has raised questions about Washington's ability to manage future crises. After all this, the ultimate fate of health care remains up in the air as opponents seek ways to challenge or undo the reform.
As it stands now, the reform is expected to insure 32 million more Americans by mandating that all US citizens carry health insurance and providing government subsidies to help those who can't afford it.
It requires states to set up market-based exchanges so individuals without insurance can find coverage, and bans insurance companies from denying coverage for pre-existing conditions, imposing lifetime caps, or rescinding existing coverage after a person falls ill.
By 2014, it also requires employers with more than 50 employees to offer affordable health insurance or pay annual fines of up to US$750 per full-time worker.
Some business groups, such as the National Federation of Independent Businesses, have said the legislation places an unfair burden on small companies. "Forcing employers to offer health insurance, plain and simple, will cost America jobs and revenue, and inhibit small businesses from growing," the Washington, DC-based group said on its Website.
The reform has a variety of implications for human resource departments, says Wharton management professor Peter Cappelli, who studies workforce issues. He notes that employers are trying to figure out which employees will be covered and what the ramifications of the new law will be. For example, the law says full-time employees must be covered, but what constitutes full-time?
In a recent column for Human Resource Executive Online, Cappelli writes that many provisions in the health care overhaul "spill over" into other human resource issues. "For example, an employer cannot pay for the costs of the mandated health care through reductions in wages, but how will that be assessed in practice?" Cappelli asks. "Will any reductions in pay become suspect as a result?"
Human resource departments are not the only ones with questions about the bill.
"There's uncertainty even about what's in the bill," says Mark Pauly, a Wharton professor of health care systems, business and public policy. This is because the reform calls for a number of changes but doesn't explain exactly how those changes will be made.
The legislation reportedly falls back on the phrase, "The secretary shall," more than a thousand times, Pauly points out, "which means they turned it over to the US Department of Health and Human Services to figure out how to do this."
Loose ends include details of the high-risk pool option, which the government is supposed to create within 90 days of the bill's passage.
"Nobody knows how that's going to work," Pauly says. "The only thing we know is that they're going to put US$5 billion into it. What the coverage will be and what the subsidy will be is up in the air."
The bill's emphasis on "community rating" is another component that could backfire. Community rating is when insurance companies offer the same premium to everyone in the community, regardless of age or health.
Politicians often claim that community rating will lower the costs to high-risk individuals, Pauly says, but they often leave out the flip side of the equation - that insurance companies will probably respond by raising premiums for everyone else.
"Community rating will not lower total cost since it just averages the costs of different risks," says Pauly. "Compared to basing premiums on risk, community rating lowers them for high risks and raises them for the more numerous lower risks."
Rosoff says health care reform "devolved from a policy debate into a political game. Shame on these people for allowing it to become so political."
Rosoff, who has spent five years studying how Argentina, France, Italy, Japan and Singapore made the transition to universal health care, believes the United States "has made a major step" by passing health care reform, but it remains in jeopardy.
(Reproduced with permission from Knowledge@Wharton, http://www.knowledgeatwharton.com.cn. All rights reserved. Shanghai Daily condensed the article.)
It just splintered one massive question mark into many others. "The fat lady hasn't even come on stage yet," says Wharton professor of legal studies and health care management Arnold. J. Rosoff.
Questions from employers across the country have already arisen about how to implement the new rules and what they mean for business. Many of the legislation's much-touted cost-cutting measures could backfire, some say.
And the ugly political wrangling, backstabbing and partisan bickering that marred the bill's passage has raised questions about Washington's ability to manage future crises. After all this, the ultimate fate of health care remains up in the air as opponents seek ways to challenge or undo the reform.
As it stands now, the reform is expected to insure 32 million more Americans by mandating that all US citizens carry health insurance and providing government subsidies to help those who can't afford it.
It requires states to set up market-based exchanges so individuals without insurance can find coverage, and bans insurance companies from denying coverage for pre-existing conditions, imposing lifetime caps, or rescinding existing coverage after a person falls ill.
By 2014, it also requires employers with more than 50 employees to offer affordable health insurance or pay annual fines of up to US$750 per full-time worker.
Some business groups, such as the National Federation of Independent Businesses, have said the legislation places an unfair burden on small companies. "Forcing employers to offer health insurance, plain and simple, will cost America jobs and revenue, and inhibit small businesses from growing," the Washington, DC-based group said on its Website.
The reform has a variety of implications for human resource departments, says Wharton management professor Peter Cappelli, who studies workforce issues. He notes that employers are trying to figure out which employees will be covered and what the ramifications of the new law will be. For example, the law says full-time employees must be covered, but what constitutes full-time?
In a recent column for Human Resource Executive Online, Cappelli writes that many provisions in the health care overhaul "spill over" into other human resource issues. "For example, an employer cannot pay for the costs of the mandated health care through reductions in wages, but how will that be assessed in practice?" Cappelli asks. "Will any reductions in pay become suspect as a result?"
Human resource departments are not the only ones with questions about the bill.
"There's uncertainty even about what's in the bill," says Mark Pauly, a Wharton professor of health care systems, business and public policy. This is because the reform calls for a number of changes but doesn't explain exactly how those changes will be made.
The legislation reportedly falls back on the phrase, "The secretary shall," more than a thousand times, Pauly points out, "which means they turned it over to the US Department of Health and Human Services to figure out how to do this."
Loose ends include details of the high-risk pool option, which the government is supposed to create within 90 days of the bill's passage.
"Nobody knows how that's going to work," Pauly says. "The only thing we know is that they're going to put US$5 billion into it. What the coverage will be and what the subsidy will be is up in the air."
The bill's emphasis on "community rating" is another component that could backfire. Community rating is when insurance companies offer the same premium to everyone in the community, regardless of age or health.
Politicians often claim that community rating will lower the costs to high-risk individuals, Pauly says, but they often leave out the flip side of the equation - that insurance companies will probably respond by raising premiums for everyone else.
"Community rating will not lower total cost since it just averages the costs of different risks," says Pauly. "Compared to basing premiums on risk, community rating lowers them for high risks and raises them for the more numerous lower risks."
Rosoff says health care reform "devolved from a policy debate into a political game. Shame on these people for allowing it to become so political."
Rosoff, who has spent five years studying how Argentina, France, Italy, Japan and Singapore made the transition to universal health care, believes the United States "has made a major step" by passing health care reform, but it remains in jeopardy.
(Reproduced with permission from Knowledge@Wharton, http://www.knowledgeatwharton.com.cn. All rights reserved. Shanghai Daily condensed the article.)
- About Us
- |
- Terms of Use
- |
-
RSS - |
- Privacy Policy
- |
- Contact Us
- |
- Shanghai Call Center: 962288
- |
- Tip-off hotline: 52920043
- 沪ICP证：沪ICP备05050403号-1
- |
- 互联网新闻信息服务许可证：31120180004
- |
- 网络视听许可证：0909346
- |
- 广播电视节目制作许可证：沪字第354号
- |
- 增值电信业务经营许可证：沪B2-20120012
Copyright © 1999- Shanghai Daily. All rights reserved.Preferably viewed with Internet Explorer 8 or newer browsers.
