As this issue went to press, the Senate had not yet passed a health care reform bill or begun the sure to be arduous process of blending House and Senate legislation to put up for a final vote in both chambers. While we may see April showers and May flowers before health care reform is a done deal, I can't say I'm particularly happy with much of what's been reported in either bill.
I admit, I'm just not going to read the more than 2,000 pages that are the House and Senate health care reform bills. Maybe it's the environmentalist in me (think of all the trees!), or maybe it's the knowledge that much of what I read would make me mad.
However, thanks to my many sources who - bless them - have read the bills in their entirety, I've gained valuable info that pacifies my inner greenie, but unfortunately still gets under my skin.
The latest nuggets come courtesy of Spencer's Benefits Reports, which combed through H.R. 3962 (the bill passed last November in the House) and H.R. 3590 (the Senate's current stab at reform), and found some particularly jagged little pills for employers. Among them, SBR sussed out that H.R. 3950 would require employers to cover (at 100%, mind you):
- Certain evidence-based items (with A or B ratings) in line with United States Preventive Services Task Force recommendations. Yes, that's the same panel that lit a firestorm of controversy last month with its guidelines on mammography. Because of the controversy, though, the USPSTF recs for mammograms are exempt.
- Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.
- Evidence-based preventive care and screenings for children within guidelines supported by the Health Resources and Services Administration.
- Additional women's preventive care and screenings in comprehensive guidelines supported by the Health Resources and Services Administration.
I don't think anyone can argue that greater emphasis on preventive and evidence-based care is absolutely good and necessary. All the same, that's a lot of mandates, no? According to SBR, here's some of what's included on that list of A or B-rated preventive screenings:
- Depression screening.
- Dietary counseling for adults at risk for cardiovascular and diet-related chronic disease.
- Fluoride supplements for preschool children.
- High-blood pressure screening.
- Substance abuse counseling/interventions.
Not only would employers need to cover all of these screenings, they'd need to cover them for a lot more people, since both the House and Senate proposals would cover dependents up to age 27 and 26, respectively. Wow. A dependent at 27?! I may need one of those depression screenings ...
After a recent post on EBN's Daily Diversion blog, two readers seemed to share my discontent.
"While I admit I haven't read the entire bill either, my understanding is that it won't hurt jobs in one sector: for-profit insurance companies," one commented. "I view this rather like mandates for seatbelts. Onerous for some, but just plain common sense for most."
Another commenter was even more blunt: "Maybe this should be renamed the 'job elimination act.' I've told clients they may have to choose between having a job with no health benefits, or health benefits with no job. If Congress mandates all these health costs, my guess is more and more Americans will have no job."
Certainly, not the best way to start a new year.
Send letters, queries and story ideas to Editor-in-Chief Kelley Butler at Kelley Butler.
