As you’ve probably heard already, Sens. Ron Wyden (D-Ore.) and Bob Bennett (R-Utah) have introduced S. 334, the Healthy Americans Act, a bipartisan bill that would guarantee Americans access to comprehensive health care. The bill would take the burden of insurance off employers by requiring individual Americans to buy a health policy (Sen. Wyden likens it to purchasing car insurance). Reps. Brian Baird (D-Wash.) and Jo Ann Emerson (R-Mo.) are promoting a companion measure in the House. Both measures are based on a conviction that streamlined private health insurance offerings for individuals and families must be developed through purchasing collaboratives that would increase choice and reduce costs, such as the federal government already accomplishes for its employees through FEHBP (Federal Employees Health Benefit Plan). 

The lawmakers’ premise is that this plan would reduce administrative costs by eliminating a lot of the current health insurance and underwriting bureaucracy, while preserving private insurance, and by creating incentives for preventive care, early diagnosis, and improved chronic disease management by guaranteeing that everyone has access to care. The GAO (Government Accountability Office) and the CBO (Congressional Budget Office) have conceded that the concept could reduce costs increases.

But this isn’t the only proposal that will be before Congress next year. More and more unions and consumer groups are again endorsing a “single payer” concept similar to what Sen. Ted Kennedy (D-Mass.) and Rep. Pete Stark (D-Calif.) have long proposed: namely the SGRrrrr — I mean Medicare — for all. The biggest flaw there is having Congress micro- or nano-manage health care with the same awkwardness we observe with SGR, HIT and other highly politicized issues which require more scientific, economic and ethical finesse. 

Frankly, there’s no consensus on these ideas among members of Congress or the American public. But, the fiscal pressures of endlessly rising costs, while the economy is tanking and there are military conflicts out there, means that we are entering an unstable time in which some big-change idea might become politically viable …Which is why ACC is continuing to discuss our system reform ideas and principles with all who are willing to listen. Our 2009 Health System Reform Summit will be more important than ever come February and a new administration.

Wyden and Bennett are aware that mandatory auto insurance laws in many states have not resulted in universal driver coverage — many people get coverage only around the time they need to renew their license, and then drop it soon thereafter. There are no easy solutions, but the status quo is our worst option.