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Health care plan stresses quality, affordability

There are certainly many things to talk about these days in regards to health care. Many people need to decide if they think the health reform bill is worth it. I wanted to make sure I knew what Congress was trying to get through so I sat down last weekend and read the reform bill. I feel that I can now make an educated decision about the bill.

President Obama breaks his health care reform plan down into three parts, saying that it builds upon the strengths of the U.S. health care system.

The first part is quality, affordable and portable health coverage for all. President Obama would like to build on existing private and public programs such as employer health insurance, private individual health insurance, Medicare and Medicaid. To do this, there are two key provisions.

First, establish a new public program that would look a lot like Medicare for those younger than age 65 that would be available to those who do not have access to an employer plan or qualify for existing government programs. Second, create a national health insurance exchange that would be the government organization that would sell insurance plans directly to people who do not have coverage through their employer or individual coverage. Basically, a public-option government health insurance plan, which is authorized in the legislation to follow the practices of Medicare and Medicaid.

Over the weekend, Obama and his top aides signaled retreat on the public option provision, one of the most contentious elements.

The second part of the health reform plan is to modernize the U.S. health care system to lower costs and improve quality. To do that there will have be a state-of-the-art health information technology system. Most medical records are still stored on paper, which makes them difficult to use to coordinate care, measure quality or reduce medical errors. Processing paper claims also costs twice as much as processing electronic claims. The Rand Corp. is a nonprofit company that focuses on conducting research and provides analysis to address challenges that face the United States and the world. The company found that if most hospitals and doctors’ offices adopted electronic health records, it could save up to $77 billion. The electronic records should reduce hospital stays, avoid unnecessary testing and provide for more appropriate drug use.

Finally at the core of the health reform bill is education and promoting of prevention. President Obama would support disease management programs. More than 75 percent of total health care dollars are spent on patients with one or more chronic conditions, such as diabetes, heart disease and high blood pressure. He would also coordinate and integrate care. Rates of chronic diseases have skyrocketed in the last two decades. More than 133 million Americans have at least one chronic disease. With proper care, the onset and progression of these diseases can be contained for many years.

The high and growing cost of health care is a significant issue for people, businesses and government. Spending on health care is a projected to be 17.6 percent of the U.S. gross domestic product in 2009. President Obama hopes that these three basic principles will be able to accomplish many things. First, improve our quality of life through education and prevention. Second, lower our costs and improve the way information is transmitted between doctors and hospitals. Finally, last but not least, have health insurance available and affordable for the more than 66 million people that do not have health insurance presently.

Michael Miele, the health insurance and benefits specialist with MGA Insurance Group, can be reached at (941) 907-3828, ext. 244 or at